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      Burdens, resources, health and wellbeing of nurses working in general and specialised palliative care in Germany – results of a nationwide cross-sectional survey study

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          Abstract

          Background

          Palliative care in Germany is divided into general (GPC) and specialised palliative care (SPC). Although palliative care will become more important in the care sector in future, there is a large knowledge gab, especially with regard to GPC. The aim of this study was to identify and compare the burdens, resources, health and wellbeing of nurses working in GPC and SPC. Such information will be helpful for developing prevention programs in order to reduce burdens and to strengthen resources of nurses.

          Methods

          In 2017, a nationwide cross-sectional survey was conducted. In total, 437 nurses in GPC and 1316 nurses in SPC completed a questionnaire containing parts of standardised instruments, which included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ), the Patient Health Questionnaire (PHQ-2), the Resilience Scale (RS-13) Questionnaire, a single question about back pain from the health survey conducted by the Robert Koch Institute as well as self-developed questions. The differences in the variables between GPC and SPC nurses were compared.

          Results

          SPC nurses reported higher emotional demands as well as higher burdens due to nursing care and the care of relatives while GPC nurses stated higher quantitative demands, i.e. higher workload. SPC nurses more often reported organisational and social resources that were helpful in dealing with the demands of their work. Regarding health, GPC nurses stated a poorer health status and reported chronic back pain as well as a major depressive disorder more frequently than SPC nurses. Furthermore, GPC nurses reported a higher intention to leave the profession compared to SPC nurses.

          Conclusions

          The findings of the present study indicate that SPC could be reviewed as the best practice example for nursing care in Germany. The results may be used for developing target group specific prevention programs for improving health and wellbeing of nurses taking the differences between GPC and SPC into account. Finally, interventional and longitudinal studies should be conducted in future to determine causality in the relationship of burdens, resources, health and wellbeing.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12912-021-00687-z.

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          Most cited references74

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          The Patient Health Questionnaire-2: validity of a two-item depression screener.

          A number of self-administered questionnaires are available for assessing depression severity, including the 9-item Patient Health Questionnaire depression module (PHQ-9). Because even briefer measures might be desirable for use in busy clinical settings or as part of comprehensive health questionnaires, we evaluated a 2-item version of the PHQ depression module, the PHQ-2. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day"). The PHQ-2 was completed by 6000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-2 depression severity increased from 0 to 6, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-2 score > or =3 had a sensitivity of 83% and a specificity of 92% for major depression. Likelihood ratio and receiver operator characteristic analysis identified a PHQ-2 score of 3 as the optimal cutpoint for screening purposes. Results were similar in the primary care and obstetrics-gynecology samples. The construct and criterion validity of the PHQ-2 make it an attractive measure for depression screening.
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            The PHQ-9: A New Depression Diagnostic and Severity Measure

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              • Article: not found

              Development and psychometric evaluation of the Resilience Scale.

              This study describes the development and initial psychometric evaluation of the 25-item Resilience Scale (RS) in a sample of 810 community-dwelling older adults. Principal components factor analysis of the RS was conducted followed by oblimin rotation indicating that the factor structure represented two factors (Personal Competence and Acceptance of Self and Life). Positive correlations with adaptational outcomes (physical health, morale, and life satisfaction) and a negative correlation with depression supported concurrent validity of the RS. The results of this study support the internal consistency reliability and concurrent validity of the RS as an instrument to measure resilience.
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                Author and article information

                Contributors
                elidiehl@uni-mainz.de
                sandra_rieger87@web.de
                letzel@uni-mainz.de
                a.schablon@uke.de
                Albert.Nienhaus@bgw-online.de
                Luis-Carlos.Escobar@seat.es
                pdietz@uni-mainz.de
                Journal
                BMC Nurs
                BMC Nurs
                BMC Nursing
                BioMed Central (London )
                1472-6955
                6 September 2021
                6 September 2021
                2021
                : 20
                : 162
                Affiliations
                [1 ]GRID grid.410607.4, Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, ; Obere Zahlbacher Str. 67, 55131 Mainz, Germany
                [2 ]GRID grid.13648.38, ISNI 0000 0001 2180 3484, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf, ; Building W38, Martinistraße 52, 20246 Hamburg, Germany
                [3 ]GRID grid.491653.c, ISNI 0000 0001 0719 9225, Department for Occupational Medicine, Hazardous Substances and Health Science, , Institution for Accident Insurance and Prevention in the Health and Welfare Services (BGW), ; Pappelallee 33/35/37, 22089 Hamburg, Germany
                [4 ]GRID grid.432860.b, ISNI 0000 0001 2220 0888, Federal Institute for Occupational Safety and Health (BAuA), ; Nöldnerstr. 40-42, 10317 Berlin, Germany
                Author information
                http://orcid.org/0000-0002-4832-1992
                Article
                687
                10.1186/s12912-021-00687-z
                8419389
                34488742
                caddbd3c-e649-47a3-ad7a-54676e00f7f6
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 11 September 2020
                : 23 August 2021
                Funding
                Funded by: Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege
                Funded by: Johannes Gutenberg-Universität Mainz (1030)
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Nursing
                stress,strain,burnout,depression,intention to leave the profession,prevention
                Nursing
                stress, strain, burnout, depression, intention to leave the profession, prevention

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