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      Gender differences in the experience of burnout and its correlates among Chinese psychiatric nurses during the COVID‐19 pandemic: A large‐sample nationwide survey

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          Abstract

          Psychiatric nurses often experience burnout and other mental health symptoms. However, few studies have examined these phenomena and gender‐specific associated factors during the COVID‐19 pandemic. We surveyed a national sample of psychiatric nurses ( N = 8971) from 41 tertiary psychiatric hospitals in China as part of a large national survey conducted during the pandemic. The Maslach Burnout Inventory‐Human Service Survey was used to assess burnout and the Depression, Anxiety, and Stress Scale‐21 was used to assess mental health symptoms. Binary logistic regression analyses were used to explore factors associated with burnout in the entire sample and separately by gender. The overall prevalence of burnout was 27.27%, with the rate in male psychiatric nurses (32.24%) being significantly higher than that in female psychiatric nurses (25.97%). Many key demographic factors (such as the male gender and marital status), work‐related variables (such as a mid‐level professional title, having an administrative position, longer working hours, more monthly night shifts, and the perceived negative impact of the COVID‐19 pandemic on medical work) were significantly associated with burnout in the whole sample. Moreover, burnout was associated with depression, anxiety, and stress symptoms in the whole sample. Gender‐specific factors associated with burnout were also identified: burnout was associated with night shifts in male psychiatric nurses, whereas it was associated with single or married marital status, a mid‐level professional title, and having an administrative position among female psychiatric nurses. The high rates of burnout and mental health symptoms in psychiatric nurses need attention from hospital administrators. While mental health symptoms, longer working hours, and the perceived impact of COVID‐19 are associated with burnout in both genders, gender‐specific factors also warrant special attention when developing gender‐specific interventions.

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          Most cited references51

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          The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

          The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.
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            Prevalence of mental disorders in China: a cross-sectional epidemiological study

            The China Mental Health Survey was set up in 2012 to do a nationally representative survey with consistent methodology to investigate the prevalence of mental disorders and service use, and to analyse their social and psychological risk factors or correlates in China. This paper reports the prevalence findings.
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              Implications for COVID-19: a systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic

              Background Pandemics and epidemics are a public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individuals, society and the nursing profession. Objectives To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. Design This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. Data sources A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. Review methods All studies describing nurses’ experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. Results Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. Conclusions Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses’ require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce.
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                Author and article information

                Contributors
                fengjiang@sjtu.edu.cn
                huanzhongliu@ahmu.edu.cn
                Journal
                Int J Ment Health Nurs
                Int J Ment Health Nurs
                10.1111/(ISSN)1447-0349
                INM
                International Journal of Mental Health Nursing
                John Wiley and Sons Inc. (Hoboken )
                1445-8330
                1447-0349
                11 August 2022
                11 August 2022
                : 10.1111/inm.13052
                Affiliations
                [ 1 ] Department of Psychiatry Chaohu Hospital of Anhui Medical University Hefei China
                [ 2 ] Department of Psychiatry, School of Mental Health and Psychological Sciences Anhui Medical University Hefei China
                [ 3 ] State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
                [ 4 ] School of Health Policy and Management Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
                [ 5 ] Department of Psychiatry and Behavioral Sciences Emory University Atlanta Georgia USA
                [ 6 ] Department of Psychological and Brain Sciences Washington University in St. Louis Missouri USA
                [ 7 ] Atlanta VA Medical Center Decatur Georgia USA
                [ 8 ] Institute of Healthy Yangtze River Delta Shanghai Jiao Tong University Shanghai China
                [ 9 ] School of International and Public Affairs Shanghai Jiao Tong University Shanghai China
                Author notes
                [*] [* ] Correspondence: Huanzhong Liu, Department of Psychiatry, Chaohu Hospital of Anhui Medical University, No. 64 Chaohu North Road, Chaohu District, Hefei 238000, China. Email: huanzhongliu@ 123456ahmu.edu.cn

                Feng Jiang, Institute of Health Yangtze River Delta, Shanghai Jiaotong University, No. 1954 Huashan Road, Xuhui District, Shanghai 200030, China. Email: fengjiang@ 123456sjtu.edu.cn

                Article
                INM13052 IJMHN-2022-310.R1
                10.1111/inm.13052
                9538055
                35957615
                41be69ef-b938-4399-8b74-f8f3585c4c63
                © 2022 John Wiley & Sons Australia, Ltd.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 26 July 2022
                Page count
                Figures: 0, Tables: 2, Pages: 12, Words: 9328
                Funding
                Funded by: National Clinical Key Specialty Project Foundation (CN) , doi 10.13039/501100013277;
                Funded by: Beijing Medical and Health Foundation , doi 10.13039/501100011930;
                Award ID: mh180924
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.0 mode:remove_FC converted:07.10.2022

                Nursing
                burnout,covid‐19 pandemic,gender differences,mental health symptoms,psychiatric nurses
                Nursing
                burnout, covid‐19 pandemic, gender differences, mental health symptoms, psychiatric nurses

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