Self-Rated Health and Sick Leave among Nurses and Physicians: The Role of Regret and Coping Strategies in Difficult Care-Related Situations.

Stéphane Cullati,Delphine S Courvoisier,Boris Cheval,Pierre Chopard,Thomas Agoritsas,Ralph E Schmidt

doi:10.3389/fpsyg.2017.00623

Stéphane Cullati, Delphine S Courvoisier + Show 4 more

Open Access

https://doi.org/10.3389/fpsyg.2017.00623

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Abstract

Moral distress – such as feeling strong regret over difficult patient situations – is common among nurses and physicians. Regret intensity, as well as the coping strategies used to manage regrets, may also influence the health and sickness absence of healthcare professionals. The objective of this study was to determine if the experience of regret related to difficult care-related situations is associated with poor health and sick leave and if coping strategies mediate these associations. Two cross-sectional surveys were conducted in Switzerland (Geneva, 2011 and Zurich, 2014). Outcomes were self-rated health (SRH) and sick leave in the last 6 months. We examined the associations of regret intensity with the most important care-related regret, number of recent care-related regrets, and coping strategies, using regressions models. Among 775 respondents, most reported very good SRH and 9.7% indicated absence from work during four working days or more. Intensity of the most important regret was associated with poor SRH among nurses and physicians, and with higher sick leave among nurses. Maladaptive emotion-focused strategies were associated with poor SRH among nurses, whereas adaptive emotion-focused strategies were positively associated with higher SRH and lower sick leave among physicians. Because care-related regret is an integral part of clinical practice in acute care hospitals, helping physicians and, especially, nurses to learn how to deal with negative events may yield beneficial consequences at the individual, patient care, and institutional level.

Highlights

Providing safe and good quality healthcare to patients in acute care settings requires healthy healthcare professionals (Rowe and Kidd, 2009; West et al, 2009)
Prolonged sick leaves (≥10 days) were reported by 1.7% of physicians compared to 6.3% of nurses (p < 0.001)
In accordance with our proposed theoretical model (Courvoisier et al, 2013b), these findings suggest that lingering feelings of moral distress regarding perceived shortcomings or failures in patient care may impact healthcare professionals’ own health in important ways

Summary

Introduction

Providing safe and good quality healthcare to patients in acute care settings requires healthy healthcare professionals (such as physicians and nurses) (Rowe and Kidd, 2009; West et al, 2009). Moral distress is common among healthcare professionals working in acute care settings (Pauly et al, 2009; Sirriyeh et al, 2010; Huffman and Rittenmeyer, 2012; Burston and Tuckett, 2013; Oh and Gastmans, 2015). Moral distress can be related to the healthcare professionals’ negative judgment about the quality of care he/she provided to the patients, such as inappropriate care (Piers et al, 2011), loss of control (Shapiro et al, 2011) or stress of conscience (Glasberg et al, 2008), or to healthcare professionals’ involvement in medical errors (Sirriyeh et al, 2010). The experience of care-related regret is frequent (Courvoisier et al, 2013a), in part because working in acute care hospitals constrains the way healthcare professionals make clinical decisions and attend to patients’ care. Experiencing regrets, may be associated with poor health conditions among healthcare professionals (Schmidt et al, 2015)

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