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      Changes in distress and turnover intentions among hospital‐based nurses working during the first 8 months of the COVID‐19 pandemic in Denmark: A prospective questionnaire study

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          Abstract

          Aim

          To describe changes in distress among Danish hospital‐based nurses during the early month of the COVID‐19 pandemic and to examine predictors of distress and turnover intentions.

          Background

          Outbreak of infectious diseases such as the COVID‐19 pandemic can increase the likelihood that health professionals suffer from poor mental health even after the outbreak.

          Methods

          A prospective study among 426 Danish hospital‐based nurses during the early month of the pandemic. Participants completed self‐administered questionnaires regarding mental health and COVID‐19 worries, as well as turnover intentions.

          Results

          Nurses with brief work experience reported higher increase in distress. Feeling unsafe at work, having low trust in management and being anxious for relatives were associated with increased distress. Finally, feeling unsafe at work, being anxious for relatives and having low trust in management were predictors of intention to change job.

          Conclusion

          This study suggests that the subjective experiences of uncertainty in work during the COVID‐19 pandemic have more impact on nurses' distress than COVID‐19 related conditions at hospitals. Finally, the study provides empirical support for the association between COVID‐19‐related worries and turnover intentions.

          Implication for nursing management

          Knowledge of risk factors for psychological distress as well as predictors of turnover intention is necessary and may provide nurses and health‐care systems with the ability to respond better against future pandemics and to retain nurses in the organization and in the profession.

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          Most cited references41

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 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-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              A Global Measure of Perceived Stress

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                Author and article information

                Contributors
                Role: Senior researcherberini@rm.dk
                Role: Researcher
                Role: Senior researcher
                Role: Associate professor
                Journal
                J Nurs Manag
                J Nurs Manag
                10.1111/(ISSN)1365-2834
                JONM
                Journal of Nursing Management
                John Wiley and Sons Inc. (Hoboken )
                0966-0429
                1365-2834
                27 September 2022
                27 September 2022
                : 10.1111/jonm.13781
                Affiliations
                [ 1 ] Department of Public Health and Health Services Research DEFACTUM Aarhus Denmark
                [ 2 ] Department of Forensic Psychiatry Aarhus University Hospital Psychiatry Aarhus Denmark
                [ 3 ] Department of Psychology and Behavioural Sciences Aarhus University Aarhus Denmark
                Author notes
                [*] [* ] Correspondence

                Berit Kjærside Nielsen, Department of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Olof Palmes Alle 15, DK‐8200m Aarhus N, Denmark.

                Email: berini@ 123456rm.dk

                Author information
                https://orcid.org/0000-0003-2279-2291
                Article
                JONM13781
                10.1111/jonm.13781
                9539220
                36042540
                7f997168-3e4f-4992-bd7f-59a5cce3e47c
                © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 August 2022
                : 11 April 2022
                : 29 August 2022
                Page count
                Figures: 0, Tables: 6, Pages: 11, Words: 8314
                Funding
                Funded by: DEFACTUM
                Funded by: Central Denmark Region , doi 10.13039/501100010078;
                Funded by: Health Research Foundation of Central Denmark Region
                Funded by: Research Foundation of Danish Nurses Organization
                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

                covid‐19 pandemic,follow‐up survey,nurses,psychological distress,turnover intentions

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