Kim Foster

Nurses’ resilience and the emotional labour of nursing work: An integrative review of empirical literature

BACKGROUNDnThe emotional labour of nursing work involves managing the emotional demands of relating with patients, families and colleagues. Building nurses resilience is an important strategy in mitigating the stress and burnout that may be caused by ongoing exposure to these demands. Understandings of resilience in the context of emotional labour in nursing, however, are limited.nnnOBJECTIVESnTo investigate the state of knowledge on resilience in the context of emotional labour in nursing.nnnDESIGNnIntegrative literature review.nnnDATA SOURCESnCINAHL, Medline, Scopus, and PsycINFO electronic databases were searched for abstracts published between 2005 and 2015 and written in English. Reference lists were hand searched.nnnREVIEW METHODSnWhittemore and Knafls integrative review method was used to guide this review. The constant comparative method was used to analyze and synthesize data from 27 peer-reviewed quantitative and qualitative articles. Methodological quality of included studies was assessed using the Mixed Methods Assessment Tool.nnnRESULTSnEmotional labour is a facet of all aspects of nursing work and nurse-patient/family/collegial interactions. Emotional dissonance arising from surface acting in emotional labour can lead to stress and burnout. Resilience can be a protective process for the negative effects of emotional labour. Several resilience interventions have been designed to strengthen nurses individual resources and reduce the negative effects of workplace stress; however they do not specifically address emotional labour. Inclusion of emotional labour-mitigating strategies is recommended for future resilience interventions.nnnCONCLUSIONnResilience is a significant intervention that can build nurses resources and address the effects of emotional dissonance in nursing work. There is a need for further investigation of the relationship between resilience and emotional labour in nursing, and robust evaluation of the impact of resilience interventions that address emotional labour.

Emotional intelligence increases over time: A longitudinal study of Australian pre-registration nursing students

BACKGROUNDnEmotional intelligence (EI) has been associated with positive outcomes for nursing students. Higher EI is associated with personal wellbeing and stress management, higher academic performance, stronger nursing leadership and practice performance, and greater patient safety. While there is an increasing body of evidence on nursing students EI, there is minimal evidence on EI over time during pre-registration programs.nnnOBJECTIVESnTo measure EI in pre-registration nursing students from program commencement to conclusion to ascertain EI over time and examine the relationship between EI and academic performance.nnnDESIGN AND SETTINGnLongitudinal repeated measures study between March 2010-February 2013 at a metropolitan university in Australia.nnnPARTICIPANTSn111 nursing students (74.8% female) contributed data on at least two occasions. Participants were enrolled in a pre-registration Master of Nursing degree. Half the cohort (55.0%) comprised Graduate Entry students who completed the course in two years full time. The other 45% were enrolled in an undergraduate degree in arts, science or health science, combined with the same pre-registration Master of Nursing Degree. These students completed their Combined Degree program in four years full time. Participants had a mean age of 24.7years (SD=7.36).nnnMETHODSnEI was measured for commencing students (T1) using the Assessing Emotions Scale (AES), then a further three times: end of first year (T2; 9 months follow up); beginning of second year (12 months follow up; T3) and end of the program (T4; 24/36 months follow up).nnnRESULTSnStudents EI was found to increase across the program; one subscale of EI (managing others emotions) was related to higher academic performance; and there was a significant increase in the Utilising Emotions subscale scores over time.nnnCONCLUSIONSnPre-registration nurse education contributes to strengthening students EI over time. Specific EI education scaffolded throughout programs is recommended in pre-registration curricula.

Mental health professionals' family-focused practice with families with dependent children: A survey study

BackgroundMany people with a mental illness are parents caring for dependent children. These children are at greater risk of developing their own mental health concerns compared to other children. Mental health services are opportune places for healthcare professionals to identify clients’ parenting status and address the needs of their children. There is a knowledge gap regarding Thai mental health professionals’ family-focused knowledge and practices when working with parents with mental illness and their children and families.MethodsThis cross –sectional survey study examined the attitudes, knowledge and practices of a sample (nu2009=u2009349) of the Thai mental health professional workforce (nurses, social workers, psychologists, psychiatrists) using a translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ).ResultsThe majority of clinicians reported no training in family (76.8%) or child-focused practice (79.7%). Compared to other professional groups, psychiatric nurses reported lower scores on almost all aspects of family-focused practice except supporting clients in their parenting role within the context of their mental illness. Social workers scored highest overall including having more workplace support for family-focused practice as well as a higher awareness of family-focused policy and procedures than psychiatrists; social workers also scored higher than psychologists on providing support to families and parents. All mental health care professional groups reported a need for training and inter-professional practice when working with families.ConclusionsThe findings indicate an important opportunity for the prevention of intergenerational mental illness in whose parents have mental illness by strengthening the professional development of nurses and other health professionals in child and family-focused knowledge and practice.

Acculturation, resilience, and the mental health of migrant youth: a cross-country comparative study

OBJECTIVESnUsing data from an international collaborative research project on youth resilience in the context of migration, this study aims to investigate how different acculturation patterns (i.e. integration, assimilation, separation and marginalization) influence the mental health of migrant youth, and whether resilience might function as a mediator in the association between acculturation and mental health.nnnSTUDY DESIGNnA cross-sectional pilot study conducted in six countries employing a common survey questionnaire.nnnMETHODSnThe study sample was 194 youths aged 10-17 years (medianxa0=xa013.6) from six countries (Australia, Canada, China, New Zealand, South Africa, and United Kingdom) and included cross-border and internal migrants. Mental health and well-being was measured by the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). Resilience was measured by the Child and Youth Resilience Measure-28 (CYRM-28). Acculturation was assessed using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA). Multivariate regression and path analysis were performed to examine the hypothesized mediation model.nnnRESULTSnResilience scores correlated strongly with mental health and well-being. Acculturation exerted no significant direct effects on the mental health of migrant youths. Nevertheless, compared to youths who were integration-oriented, assimilation-oriented youths tended to exhibit lower levels of resilience, resulting in poorer mental health. Compared to youths from other countries, migrant youths from China also reported lower levels of resilience, which led to poorer mental health outcome.nnnCONCLUSIONnAcculturation plays a significant role in the mental health of migrant youth, with different acculturative orientations exhibiting different influences through the mediation effect of resilience. Fostering resilience and facilitating integration-oriented acculturation are recommended public health strategies for migrant youth.

Emotional intelligence and perceived stress of Australian pre-registration healthcare students: A multi-disciplinary cross-sectional study

BACKGROUNDnHealthcare students can experience high levels of stress. Emotional intelligence can moderate stress and increase wellbeing however there has been no prior research on the relationship between emotional intelligence and stress in Australian healthcare students.nnnOBJECTIVESnTo measure emotional intelligence (EI) and perceived stress (PS) in final year healthcare students (nursing, pharmacy and dentistry), and to explore the relationships between EI, PS and discipline.nnnDESIGN AND SETTINGnA cross sectional survey of pre-registration healthcare students at a metropolitan university in Australia.nnnPARTICIPANTSn203 pre-registration final year healthcare students (nu202f=u202f58 nursing; nu202f=u202f112 pharmacy; nu202f=u202f34 dentistry).nnnMETHODSnEmotional Intelligence was measured using the GENOS Emotional Intelligence Inventory (Concise Version) and stress was measured using the Perceived Stress Scale (PSS).nnnRESULTSnA significant negative correlation was found between EI and PS in nursing and pharmacy students. No difference was found in EI across disciplines. Mean EI scores were lower than normative means. PS was significantly higher than the normative mean for pharmacy and dentistry students and higher than nursing students.nnnCONCLUSIONSnEmotional intelligence can have a protective effect against stress for healthcare students and can be increased via targeted educational interventions. To support student wellbeing there is a clear need for pre-registration healthcare curricula to include educational components on strengthening EI.

Challenges of developing and conducting an international study of resilience in migrant adolescents

The sequelae of migration and the effects of local migration policies on children’s physical and mental health are critical to examine, particularly given the historically high numbers of migrants and displaced people. The vulnerability of the study sample and the need to work across cultures and contexts makes research on this group challenging. We outline lessons learned through conducting a pilot study of resilience resources and mental health among migrant youth in six countries. We describe the benefits and challenges, and then provide recommendations and practical advice for social work researchers attempting cross-cultural team research on migrants.

Family-focused practice with EASE: A practice framework for strengthening recovery when mental health consumers are parents

This paper provides a framework for essential family-focused practices (EASE: Engage, Assess, Support, Educate) for clinicians to support parents with mental illness in the context of their family. The framework is underpinned by relational recovery as the parent/consumers recovery is considered within the context of their relationships, including the relationship between clinician and parent/consumer. The central aim is to strengthen nurses and other clinicians capacity to address key psychosocial needs of parents and to strengthen relational recovery in families where parents have mental illness. The EASE framework is a theory and evidence-informed family practice approach to relational recovery within healthcare provision. The EASE practice components are defined and illustrated with practice exemplars that operationalize the framework within adult service settings. Potential applications and outcomes of using EASE are also described. The framework is intended as a practical guide for working with parents and families in inpatient and community mental health settings and may also be relevant for clinicians in a range of contexts including child welfare and primary health care.

Psychological trauma in the context of familial relationships: A concept analysis

Many forms of psychological trauma are known to develop interpersonally within important relationships, particularly familial. Within the varying theoretical constructs of psychological traumas, and distinct from the processes of diagnosis, there is a need to refine the scope and definitions of psychological traumas that occur within important familial relationships to ensure a cohesive evidence base and fidelity of the concept in application to practice. This review used a philosophical inquiry methodology of concept analysis to identify the definitions, antecedents, characteristics, and consequences of the varying conceptualizations of psychological trauma occurring within important relationships. Interactions between concepts of interpersonal trauma, relational trauma, betrayal trauma, attachment trauma, developmental trauma, complex trauma, cumulative trauma, and intergenerational trauma are presented. Understanding of the discrete forms and pathways of transmission of psychological trauma between individuals, including transgenerationally within families, creates opportunities for prevention and early intervention within trauma-focused practice. This review found that concepts of psychological trauma occurring within familial relationships are not exclusive of each other but overlap in their encompassment of events and circumstances as well as the effect on individuals of events in the short term and long term. These traumas develop and are transmitted in the space between people, both purposefully and incidentally, and have particularly profound effects when they involve a dependent infant or child. Linguistic and conceptual clarity is paramount for trauma research and practice.

Participants' Voices From Within a Healthy Lifestyle Group

Weight gain is a serious health concern. People with mental illnesses are at increased risk of weight gain. The primary treatment is lifestyle changes such as increasing physical activity and dietary changes. This qualitative study explored the experience of people with schizophrenia who participated in a healthy lifestyle program. Four themes were identified. The findings indicate that benefits of the program were more than physical health improvements and included regular access to a health professional, gaining social relationships, and a sense of belonging. Future recommendations include retaining a group structure in lifestyle interventions to facilitate these additional benefits.