Stress and wellbeing in nursing: A multi-dimensional approach

Background and Objectives: In recent years, the interest in health care workers’ wellbeing has increased, and, in particular, several studies have recognised the nursing as one of the professions at higher health risk. Research in the field of Occupational stress has changed, leading to the development of multi-dimensional perspectives, to a greater understanding of work-related stress. Particularly, above all, the Demands Resources and Individual Effects Model (DRIVE Model; Mark and Smith, 2008) is recognised to be one of the most comprehensive and useful approaches due to the emphasis that has been given to the role of individual characteristics in stress process, and it has been also applied in a sample of UK nurses (Mark and Smith, 2012). Nevertheless, a review of the nursing literature revealed some gaps. In particular, Work-Life Balance (WLB), which may assume a key role in nurses’ wellbeing due to the overlapping of two care roles and the shift system, is relatively under-researched in this field. Furthermore, the analysis of gender differences has rarely been considered, and samples used are often asymmetrical or limited exclusively to the women nurses. Therefore, the present study aims at proposing and testing a multi-dimensional model to examine the effects of Job characteristics (Effort; Job Resources), Individual characteristics (Socio-demographic and Employment characteristics; Personality; Coping strategies) and Appraisals (Job Satisfaction; Perceived Positive Life) in the prediction of nurses’ wellbeing (Psychological Diseases; Physical Disorders; Health-adverse behaviours), also including the analysis of the role played by WLB and gender differences in a transactional perspective. Design and Methods: This cross-sectional study was conducted in a sample of 450 Italian nurses (Men=206; Women=244), which completed a questionnaire composed of: Socio-demographic and employment characteristics, Job Content Questionnaire (JCQ); ERI Test; Ways of Coping Checklist-Revised (WCCL-R); Bortner’s Type A Behavioural Style Inventory; Type D Scale-14 (DS14); Job Satisfaction subscale from the Copenhagen Psychosocial Questionnaire (COPSOQ); a single item for Perceived Positive Life; Work-Family Conflict (WFC) and Family-Work Conflict (FWC) Scales; Hospital Anxiety and Depression Scale (HADS); Symptom Checklist-90-Revised (SCL-90-R); a single item assessing Physical Health; and 3 items assessing Health-adverse behaviours. Firstly, a comparison was drawn between findings emerged in the study applying the original DRIVE Model in a sample of UK nurses (Mark and Smith, 2012) and those emerged in our preliminary study. Secondly, original hypotheses have been tested to analyse the role played by gender, WLB and their interplay. Finally, the proposed multi-dimensional model has been tested in the whole sample and separately in male and female nurses. Statistical analyses were carried out using Descriptive statistics, Cross-tabulations and Chi-square, Factor Analyses, Pearson's Correlations, MANOVA, Logistic Regression Analyses (SPSS Version 20, and PROCESS software to test mediation effects). Results: Findings highlighted several significant associations of individual characteristics, job characteristics and appraisals in predicting nurses’ Psychological Diseases, Physical Disorders and Health-adverse behaviours, also revealing significant differences and similarities in the profiles of associations between male and female nurses. Several features peculiar to the Italian context with respect to the UK context were also found. Clinical and research implications were underlined and discussed. Conclusions: Results supported the importance of adopting a transactional and multi-dimensional approach to a greater and more complex understanding of work-related stress in nursing, also emphasising the necessity of including the analysis of WLB and gender differences to define focused interventions to promote nurses’ wellbeing

Paths towards parenthood after repeated treatment failures: a comparative study on predictors of psychological health outcomes in infertile couples persisting in treatments or opting for adoption

Introduction: Infertility literature suggests widespread recourse to long-term medical treatments despite evidence of high stress, costs, and adverse effects of repeated treatment failures. However, there is a lack of research comparing predictors of stress and psychological health outcomes between members of infertile couples who – after repeated failures – persist in pursuing medical treatments (PT) with those who opted for quitting treatments and adopting (QTA). Basing on a transactional and multidimensional approach to infertility-related stress and health, the present study aims at exploring individual (socio-demographics; coping strategies) and situational (infertility-related parameters; infertility-related stressors; couple’s dyadic adjustment dimensions) predictors of state-anxiety and depression in male and female partners of PT-infertile couples and of QTA-infertile couples. Methods: Participants were both members of 176 couples with duration of infertility and a history of medical treatments for at least 3 years (76 PT-infertile couples, 100 QTA-infertile couples). The study variables were compared by study group across genders. Structural equation models (SEM) were used to test main and moderating effects of study variables on state-anxiety and depression by study group and across genders. Results: Members of infertile couples quitting treatments and adopting (QTA) reported significantly lower levels of state-anxiety and depression, higher stress related to need for parenthood and rejection of childfree-lifestyle and lower stress related to social and couple’s relationship concerns than those who persist in pursuing medical treatments (PT). Members of infertile couples quitting treatments and adopting (QTA) recurred to a greater extent to active coping strategies (problem-solving/social-support) and to a lower extent to passive coping strategies (avoiding/turning-to-religion), and they reported higher levels of dyadic adjustment. Specificities in main and moderating factors related to state-anxiety and depression by study group and across genders were found. Conclusion: Findings should be addressed to provide a comprehensive assessment of both members of infertile couples facing repeated treatment failures to identify risks and resources and develop tailored evidence-based interventions

Predictors of psychological health in couples diagnosed with Male infertility: A dyadic approach.

Background: Research underlined that infertile men may experience sense of guilt and failure, loss of self-esteem, high psychosocial and marital stress, and psychological suffering, but little attention was given to individual and dyadic dynamics featuring both partners diagnosed with male infertility. Objective: The study aimed to apply the Actor-Partner-Interdependence Model (APIM) to investigate actor and partner effects of infertility-related stressors (Social Concern, Need for Parenthood, Rejection of Childfree Lifestyle, Couple’s Relationship Concern), coping strategies (Social Support, Avoiding, Positive Attitude, Problem-Solving, Turning to Religion) and dyadic adjustment dimensions (Consensus, Satisfaction, Cohesion, Affectional Expression) on perceived levels of state-anxiety and depression among both members of couples diagnosed with male infertility. Method: Both members of 80 couples with male infertility diagnosis completed self-administered questionnaires. Results: Perception of Social and Couple’s Relationship Concerns and adoption of Avoiding and Turning to Religion coping emerged as risk factors for both partners. Adoption of Social Support and Problem-Solving coping and partners’ perception of Rejection of Childfree Lifestyle emerged as risk factors, while the perception of dyadic adjustment and partners’ adoption of Social Support coping, emerged as protective factors for men's psychological health. Perception of Need for Parenthood and partners’ perception of Rejection of Childfree Lifestyle emerged as risk factors, while the perception of Cohesion, and partners’ perception of Social and Couple’s Relationship Concerns and adoption of Positive Attitude coping, emerged as protective factors for women's psychological health. Conclusions: The study suggested specific individual and dyadic dynamics to be addressed for developing tailored interventions to promote psychological health in couples diagnosed with male infertility

Paths towards parenthood after repeated treatment failures: a comparative study on predictors of psychological health outcomes in infertile couples persisting in treatments or opting for adoption

IntroductionInfertility literature suggests widespread recourse to long-term medical treatments despite evidence of high stress, costs, and adverse effects of repeated treatment failures. However, there is a lack of research comparing predictors of stress and psychological health outcomes between members of infertile couples who – after repeated failures – persist in pursuing medical treatments (PT) with those who opted for quitting treatments and adopting (QTA). Basing on a transactional and multidimensional approach to infertility-related stress and health, the present study aims at exploring individual (socio-demographics; coping strategies) and situational (infertility-related parameters; infertility-related stressors; couple’s dyadic adjustment dimensions) predictors of state-anxiety and depression in male and female partners of PT-infertile couples and of QTA-infertile couples.MethodsParticipants were both members of 176 couples with duration of infertility and a history of medical treatments for at least 3 years (76 PT-infertile couples, 100 QTA-infertile couples). The study variables were compared by study group across genders. Structural equation models (SEM) were used to test main and moderating effects of study variables on state-anxiety and depression by study group and across genders.ResultsMembers of infertile couples quitting treatments and adopting (QTA) reported significantly lower levels of state-anxiety and depression, higher stress related to need for parenthood and rejection of childfree-lifestyle and lower stress related to social and couple’s relationship concerns than those who persist in pursuing medical treatments (PT). Members of infertile couples quitting treatments and adopting (QTA) recurred to a greater extent to active coping strategies (problem-solving/social-support) and to a lower extent to passive coping strategies (avoiding/turning-to-religion), and they reported higher levels of dyadic adjustment. Specificities in main and moderating factors related to state-anxiety and depression by study group and across genders were found.ConclusionFindings should be addressed to provide a comprehensive assessment of both members of infertile couples facing repeated treatment failures to identify risks and resources and develop tailored evidence-based interventions

Work-family conflict and psychophysical health conditions of nurses: Gender differences and moderating variables

Aim This study aims to investigate the associations of perceived work–family conflict with nurses' psychophysical health conditions, exploring gender differences and analyzing the potential moderating effects of perceived job control (skill discretion and decision authority), social support, and job satisfaction. Methods The study was carried out in five hospitals of the Italian Public Health Service. Participants were 450 nurses (206 men, 244 women). Self‐administered questionnaires were used to collect data. Descriptive statistics and hierarchical regression analyses were conducted. Results Female nurses perceived significantly higher levels of work–family conflict, anxiety, depression and somatization. Significant gender differences emerged in the associations between work–family conflict and nurses' psychological health conditions and in moderating variables. Work–family conflict was significantly associated with anxiety and depression in male nurses and with somatization in both genders. The associations of work–family conflict with nurses' psychophysical health conditions were moderated by decision authority and job satisfaction, in male nurses, and by social support, in female nurses. Conclusions Findings suggest including gender‐specific moderating variables for defining tailored policies and interventions within healthcare organizations to reduce perceived work–family conflict and to promote nurses' wellbeing

Work-family conflict and psychophysical health conditions of nurses: Gender differences and moderating variables

Aim This study aims to investigate the associations of perceived work–family conflict with nurses' psychophysical health conditions, exploring gender differences and analyzing the potential moderating effects of perceived job control (skill discretion and decision authority), social support, and job satisfaction. Methods The study was carried out in five hospitals of the Italian Public Health Service. Participants were 450 nurses (206 men, 244 women). Self‐administered questionnaires were used to collect data. Descriptive statistics and hierarchical regression analyses were conducted. Results Female nurses perceived significantly higher levels of work–family conflict, anxiety, depression and somatization. Significant gender differences emerged in the associations between work–family conflict and nurses' psychological health conditions and in moderating variables. Work–family conflict was significantly associated with anxiety and depression in male nurses and with somatization in both genders. The associations of work–family conflict with nurses' psychophysical health conditions were moderated by decision authority and job satisfaction, in male nurses, and by social support, in female nurses. Conclusions Findings suggest including gender‐specific moderating variables for defining tailored policies and interventions within healthcare organizations to reduce perceived work–family conflict and to promote nurses' wellbeing

Teachers' patterns of management of conflicts with students: A study in five European countries

The present study proposed an application of the Rahim' Model of Conflict Management, and aimed to explore the styles of handling interpersonal conflicts with students adopted by teachers from five European countries (Italy, Spain, Germany, Belgium, Austria), identifying specific patterns and evaluating potential differences according to teachers' Gender, Age, Working Seniority and Country of belonging. Overall, 589 secondary school teachers completed a questionnaire consisting of Socio-demographic characteristics and the Rahim Organizational Conflict Inventory-II (ROCI-II, Form B). Non-hierarchical k-means cluster analysis was employed to derive patterns of conflict management, identifying four patterns labelled as Multi-strategic and Engaged, Multi-strategic and Solution-Oriented, Control-Oriented and Avoidant, and Mediating. Significant differences between countries were found in the numbers of teachers grouped across the four patterns. Findings identified stable and meaningful patterns for evaluating teachers' styles of management of interpersonal conflicts with students and for promoting teachers' effectiveness in conflict management in the European school context

Clinical and psychosocial constructs for breast, cervical, and colorectal cancer screening participation: A systematic review.

Research has identified a wide range of psychosocial factors associated to choosing to engage in ongoing cancer screenings. Nevertheless, a systematic review of the theoretical frameworks and constructs underpinning studies on breast, cervical, and colorectal cancer screening participation has yet to be conducted. As part of the action-research project “Miriade,” the present study aims to identifying the main theoretical frameworks and constructs adopted in the literature over the past five years to explain cancer screening participation. According to the PRISMA guidelines, a search of the MEDLINE/PubMed and PsycINFO databases was made. Empirical studies conducted from 2017 to 2021 were included. The following keywords were used: breast OR cervical OR colorectal screening AND adhesion OR participation OR engagement AND theoretical framework OR conceptual framework OR theory. Overall, 24 articles met the inclusion criteria. Each theoretical framework highlighted clinical and psychosocial constructs of cancer screening participation, focusing on the individuals (psycho-emotional functioning and skills plan) and/or the health services perspectives. Findings from the present study acknowledge the plurality of the theoretical frameworks and constructs adopted to predict or promote breast, cervical, and colorectal cancer screening adhesion and the need for new research efforts to improve the effectiveness of cancer screening promotion interventions

The COVID-19 Student Stress Questionnaire: Validation in Spanish university students from health sciences

This study aimed to validate the Spanish version of the COVID-19 Student Stress Questionnaire (CSSQ), a 7-item tool assessing COVID-19-related stressors among university students, namely, Relationships and Academic Life, Isolation, and Fear of Contagion. Participants were 331 Spanish university students. Factor analyses sustained the three factor solution of the original tool. Data also revealed satisfactory convergent and discriminant validity, suitable internal consistency, and significant associations with psychological symptoms, as measured by the Symptom Checklist-90-Revised. The Spanish version of the CSSQ represents a valid tool to be used in clinical settings to timely identify students at high psychological risk and to develop evidence-based interventions during/after the pandemic