Quality of Care and Mental Health among Nurses during the COVID-19 Pandemic: Results of a Canonical Correlation Analysis

Keywords

Care quality
Mental health
Nurses
COVID-19

How to Cite

Boshaq, E., Davoodi, F., Bahari, R. ., & Taheri Aligoodarzi, K. . (2022). Quality of Care and Mental Health among Nurses during the COVID-19 Pandemic: Results of a Canonical Correlation Analysis. Iranian Red Crescent Medical Journal, 24(1). Retrieved from https://ircmj.com/index.php/IRCMJ/article/view/1162

Abstract

Background and objectives: Nurses have experienced severe psychological stress which seriously affected their mental health during the Coronavirus disease 2019 (COVID-19) pandemic due to exposure to numerous critically ill patients, increased working time, and their colleagues’ disease or demise. Therefore, the present study aimed to examine clinical nurses' mental health status and elucidate its relationship with the quality of care provided by them.

Method: This cross-sectional descriptive study was conducted in 2020 on the nurses working at two hospitals affiliated with Lorestan University of Medical Sciences. A total of 104 nurses were selected from all wards via convenience sampling. The data were collected using the Quality Patient Care Scale and Goldberg and Williams's General Health Questionnaire to check nurses’ general health status. Statistical tests, including canonical correlation analysis, were used to analyze the data in SPSS software (version 20).

Results: There was a negative correlation between mental health and the quality of care provided by male ( =-0.556; P<0.001) and female ( =-0.351; P=0.017) nurses. Social dysfunction, anxiety, and insomnia in male nurses, as well as somatic symptoms and social dysfunction in female nurses, had the largest share of their general health, while physical care had the largest share of nursing care quality.

Conclusion: As evidenced by the obtained results, female nurses had better mental health status and provided higher-quality nursing care during the COVID-19 pandemic, as compared to male nurses. This higher quality may be attributed to women's better mental health status. The important findings of the current study highlight the necessity of regular programs for the improvement of nurses' mental health, thereby enhancing the quality of nursing care.

References

  1. Driggin E, Madhavan M, Bikdeli B, Chuich T, Laracy J, Bondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers and health systems during the coronavirus disease 2019 (COVID-19) pandemic. J Amer Coll Cardi. 2020;75(18):2352-71. PMCID: PMC7198856 DOI: 10.1016/j.jacc.2020.03.031
  2. Cao M, Zhang D, Wang Y, Lu Y, Zhu X, Li Y, et al. Clinical Features of Patients Infected with the 2019 Novel Coronavirus (COVID-19) in Shanghai, China. medRxiv. 2020. PMID: 32511465 doi: 10.1101/2020.03.04.20030395
  3. Wang L, Wang Y, Ye D, Liu Q. Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. Int J Antimic Agen. 2020;55(6):105948. PMCID: PMC7156162 DOI: 10.1016/j.ijantimicag.2020.105948
  4. Lai CC, Liu YH, Wang CY, Wang YH, Hsueh SC, Yen MY, et al. Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Facts and myths. Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi. 2020;53(3):404-12. MCID: PMC7128959 DOI: 10.1016/j.jmii.2020.02.012
  5. Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Beha Immun. 2020;87:40-8. https://doi.org/10.1016/j.bbi.2020.04.028
  6. Pierce M, Hope H, Ford T, Hatch S, Hotopf M, John A, et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lanc Psych. 2020;7(10):883-92. PMCID: PMC7373389 DOI: 10.1016/S2215-0366(20)30308-4
  7. Liu S, Yang L, Zhang C, Xiang YT, Liu Z, Hu S, et al. Online mental health services in China during the COVID-19 outbreak. lanc Psych. 2020;7(4):e17-e8. PMCID: PMC7129099 DOI: 10.1016/S2215-0366(20)30077-8
  8. Huang L, Lin G, Tang L, Yu L, Zhou Z. Special attention to nurses’ protection during the COVID-19 epidemic. Crit Care. 2020;24(120). https://doi.org/10.1186/s13054-020-2841-7
  9. Giorgi G, Lecca LI, Alessio F, Finstad GL, Bondanini G, Lulli LG, et al. COVID-19-Related Mental Health Effects in the Workplace: A Narrative Review. Int J Environ Res Pubc Heal. 2020;17(21):7857. PMCID: PMC7663773 DOI: 10.3390/ijerph17217857
  10. Wang YX, Guo HT, Du XW, Song W, Lu C, Hao WN. Factors associated with post-traumatic stress disorder of nurses exposed to corona virus disease 2019 in China. Med. 2020;99(26):e20965. PMCID: PMC7328992 DOI: 10.1097/MD.0000000000020965
  11. Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brai Behav Immun. 2020;88:901-7. PMCID: PMC7206431 DOI: 10.1016/j.bbi.2020.05.026
  12. Sarboozi Hosein abadi T, Miri K, Askari M, Namazi Nia M. Depression, stress and anxiety of nurses in COVID-19 pandemic in Nohe-Dey Hospital in Torbat-e-Heydariyeh city, Iran. J Milit Med. 2020;22(6):526-33. URL: http://militarymedj.ir/article-1-2543-en.html
  13. Özdemir Ş, Kerse G. The Effects of COVID 19 on Health Care Workers: Analysing of the Interaction between Optimism, Job Stress and Emotional Exhaustion. International and Multidisciplinary. J Soci Sci. 2020;9(2):178-201. https://doi.org/10.17583/rimcis.2020.5849
  14. Nie A, Su X, Zhang S, Guan W, Li J. Psychological impact of COVID‐19 outbreak on frontline nurses: A cross‐sectional survey study. J Clin Nurs. 2020;29(21-22):4217-26. PMCID: PMC7436701 DOI: 10.1111/jocn.15454
  15. Chen MJ, Weng SS. Psychological symptoms among hospital nurses in Taiwan: a cross sectional study. BMC Wom Heal. 2017;17(1):101-5. PMCID: PMC5678555 DOI: 10.1186/s12905-017-0460-5
  16. Zhang C, Zhang H, Zhao M, Li Z, Cook CE, Buysse DJ, et al. Reliability, Validity, and Factor Structure of Pittsburgh Sleep Quality Index in Community-Based Centenarians. Fronti Psych. 2020;11:573530.  PMCID: PMC7488982 DOI: 10.3389/fpsyt.2020.573530
  17. Otte JL, Bakoyannis G, Rand KL, Ensrud KE, Guthrie KA, Joffe H, et al. Confirmatory factor analysis of the Insomnia Severity Index (ISI) and invariance across race: a pooled analysis of MsFLASH data. Menopause (New York, NY). 2019;26(8):850-5. PMCID: PMC6663566 DOI: 10.1097/GME.0000000000001343
  18. Haghighi Khoshkho N. The quality of pre-sented nursing care from nurses and patients viewpoints hospitalized in educational hospitals Tabriz university of Medical Sciences; 2004.http://dspace.tbzmed.ac.ir/xmlui/handle/123456789/63456
  19. Johnston KM, Lakzadeh P, Donato BMK, Szabo SM. Methods of sample size calculation in descriptive retrospective burden of illness studies. BMC Med Res Method. 2019;19(1):9-18. https://doi.org/10.1186/s12874-018-0657-9.
  20. Cohen J. Statistical power analysis for the behavioral sciences, 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. https://doi.org/10.4324/9780203771587
  21. Alipoor F, Inanloo M. The General Health of the Intensive Care Unit Nurses of the Selected Teaching Hospitals Affiliated to Iran University of Medical Sciences (2019). Ir J Nurs. 2020;33(125):1-12. DOI: 10.29252/ijn.33.125.1
  22. Maciaszek J, Ciulkowicz M, Misiak B, Szczesniak D, Luc D, Wieczorek T, et al. Mental Health of Medical and Non-Medical Professionals during the Peak of the COVID-19 Pandemic: A Cross-Sectional Nationwide Study. J Clin Med. 2020;9(8):2527. PMCID: PMC7463597 DOI: 10.3390/jcm9082527
  23. Jamsahar M, Khaki S, Esmeilpour Zanjani S, Mashouf S. Comparison of Quality of Nursing Cares from the Perspective of Nurses and Patients. Sci J Nurs Midw Param Facu. 2020;5(4):72-83. http://sjnmp.muk.ac.ir/article-1-285-en.html
  24. Dehghankar L, Askarian Omran S, Hassandoost, Fateme , Abbas Pour S, Jourabchi Z, Rafiei H. General health of Iranian registered nurses: A cross sectional study. Int J Nov Res Healt Nurs. 2016;3(2):105-8. http://eprints.qums.ac.ir/id/eprint/7529
  25. Taghinejad H, Suhrabi Z, Kikhavani S, Jaafarpour M, Azadi A. Occupational Mental Health: A Study of Work-Related Mental Health among Clinical Nurses. J Clin Diagn Res. 2014;8(9):Wc01-3. PMCID: PMC4225958 DOI: 10.7860/JCDR/2014/8247.4835
  26. Stojanov J, Malobabic M, Stanojevic G, Stevic M, Milosevic V, Stojanov A. Quality of sleep and health-related quality of life among health care professionals treating patients with coronavirus disease-19. Int J Soc Psych. 2021;67(2):175-81. PMCID: PMC7369398 DOI: 10.1177/0020764020942800
  27. Li L, Wan C, Ding R, Liu Y, Chen J, Wu Z, et al. Mental distress among Liberian medical staff working at the China Ebola Treatment Unit: a cross sectional study. Heal Qual Outco. 2015;13:156. PMCID: PMC4583730 DOI: 10.1186/s12955-015-0341-2
  28. Koh D, Lim MK, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of Severe Acute Respiratory Syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn? Med Care. 2005;43(7):676-82. DOI: 10.1097/01.mlr.0000167181.36730.cc
  29. Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Amer J Infect Cont. 2020;48(6):592-8. PMCID: PMC7141468 DOI: 10.1016/j.ajic.2020.03.018
  30. Farokhzadian J, Miri S, Doostkami M, Rezahosseini Z, Shahrbabaki PM. Promoting the psychosocial and communication aspects of nursing care quality using time management skills training. J Educ Heal Promo. 2020;9:361-371. doi: 10.4103/jehp.jehp_549_20
  31. Hartley S, Raphael J, Lovell K, Berry K. Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. Int J Nurs Stud. 2020;102:103490. PMCID: PMC7026691 DOI: 10.1016/j.ijnurstu.2019.103490
  32. Kang L, Li Y, Hu S, Chen M, Yang C, Yang B. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lanc Psych. 2020;7(3):e14. PMCID: PMC7129673 DOI: 10.1016/S2215-0366(20)30047-X