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To identify latent profiles of insomnia, fatigue, recovery, psychological distress and burnout among hospital nurses; examine variations in personal and work-related characteristics across profiles; investigate associations between profiles and outcomes such as patient care quality, nursing work satisfaction and workplace satisfaction; and assess the moderating role of organisational support on these relationships.
A cross-sectional descriptive study.
This study analysed survey data from 2488 hospital nurses using latent profile analysis, multinomial logistic regression and hierarchical multiple linear regression.
Four well-being profiles emerged: low, average, above-average and high well-being. Profiles differed significantly in personal and work-related characteristics. Nurses in the high well-being profile were associated with better patient safety, care quality and satisfaction. Organisational support moderated the negative associations between low well-being profiles and nursing work and workplace satisfaction.
Tailored interventions addressing factors associated with low well-being and enhancing organisational support may be beneficial for improving nurse well-being, delivering high-quality care and supporting nurse retention in sustainable healthcare environments.
Healthcare organisations should prioritise nurse well-being through targeted interventions, adequate staffing, recovery opportunities and stress management resources to support a resilient and sustainable workforce.
The findings revealed the diversity of well-being patterns among hospital nurses and provided insights for identifying subgroups at higher risk of impaired patient safety, reduced care quality and dissatisfaction with nursing work and the workplace. Greater organisational support was associated with weaker negative relationships between poor well-being and nurse outcomes.
STROBE guidelines.
No direct patient or public contribution.
Commentary on: Veresova M, Michail M, Richards H, et al. Emergency department staff experiences of working with people who self-harm: A qualitative examination of barriers to optimal care. Int J Mental Health Nurs. 2024. doi: 10.1111/inm.13353
Implications for practice and research Support from specialist mental health clinicians is a key mechanism for improving self-harm care among emergency department (ED) staff. Findings underpin the need for compassion and empathy when treating people presenting in distress, especially those who present multiple times. Future research should focus on strategies for improving implementation of self-harm clinical guidelines in EDs.
Emergency departments (EDs) have a crucial role in suicide prevention. Around 18% of people who died by suicide presented to ED in the month prior to death, commonly for self-harm.
Patients who survive admission to intensive care unit (ICU) for critical illness are at high risk of developing muscle atrophy and weakness, commonly diagnosed as ICU-acquired weakness (ICUAW). The development of ICUAW is closely linked to long-term symptoms and impairments known as post-intensive care syndrome (PICS). Despite heightened recognition of impairments, there is limited research supporting effective interventions to improve muscle and physical outcomes after hospital discharge. Prior to developing and testing interventions for ICU survivors, it is imperative to understand the trajectory of muscle and physical function recovery following an ICU stay. The purpose of this study is to longitudinally investigate skeletal muscle health and physical function outcomes after ICU admission.
This protocol describes a single site, prospective, observational study in adult patients who have survived a critical illness (ie, sepsis or acute respiratory failure). Patients will participate in a battery of testing including primary outcomes: muscle power and physical function; and secondary outcomes: muscle strength, muscle size, endurance and physical activity (by accelerometry) at hospital discharge and 3, 6, and 12 months post-discharge. A subset of patients will participate in muscle biopsy and venipuncture. To examine if the trajectory of recovery predicts primary outcomes, we will perform multivariate linear regression models in 150 evaluable patients. To examine differences in molecular and cellular outcomes in plasma and muscle tissue, a control group of community-dwelling adults without history of an ICU stay will be enrolled as a comparator group. Enrolment started on 18 October 2022 with an estimated completion date of 1 August 2027.
This protocol was approved by the University of Kentucky Office of Research Integrity Medical Internal Review Board (# 77407), with patients providing informed written consent. We anticipate our findings to establish recovery trajectories, improving the classification of patients who experience sustained physical disability. Improved identification of recovery trajectories of muscle and physical function enables future studies to employ an individually targeted rehabilitation approach, that is, precision medicine, with the goal of improving patient outcomes. The cellular findings will support the development of novel interventions specifically designed for detecting underlying mechanisms. We intend to disseminate findings to patients, healthcare professionals, the public and other relevant groups via conference presentations and manuscripts without publication restrictions.
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