Self-efficacy Outcomes Research Articles

Short-term outcomes of the Therapist-assisted Online Parenting Strategies intervention for parents of adolescents treated for anxiety and/or depression: A single-arm double-baseline trial

This study aimed to evaluate whether the Therapist-assisted Online Parenting Strategies programme increased parenting behaviours known to be supportive of adolescents experiencing anxiety and/or depression. Secondary parenting outcomes of parental self-efficacy, parental accommodation, carer burden, parent-adolescent attachment, family functioning and parent distress were also examined, along with adolescent outcomes of anxiety and depression symptoms, suicidal ideation and sleep. Seventy-one parents (94.4% females) and their adolescents (73.2% females) aged 12-18 years (Mean = 15.02, SD = 1.56) being treated for depression and/or anxiety in Australia were recruited into a single-arm double-baseline open-label trial. Parents received Therapist-assisted Online Parenting Strategies, which comprised up to nine web-based modules each supplemented with coaching sessions via videoconferencing. Outcomes were analysed using latent growth curve modelling to determine if changes to outcomes at post-intervention (4 month post-second baseline) exceeded changes between two baselines measured 1 month apart. Sixty-five parents (91.6%) completed at least one module of the online parenting intervention and on average received nine coaching sessions (SD = 2). Parenting behaviours targeted by Therapist-assisted Online Parenting Strategies improved at post-intervention (Cohen's d = 1.16, 95% confidence interval [0.78, 1.51]). Parent-reported parental self-efficacy and parent-adolescent attachment increased (Cohen's d = 1.44 [1.05, 1.82] and 0.39 [0.05, 0.74], respectively), while impairments to family functioning and parent distress decreased (Cohen's d = -0.51 [-0.86, -0.16] and -0.84 [-1.23, -0.44], respectively). Changes to adolescent anxiety, depression and sleep were not significant. The Therapist-assisted Online Parenting Strategies intervention improved self-reported parenting behaviours, parental self-efficacy, parent levels of distress, parent-adolescent attachment, and family functioning in parents with adolescents being treated for anxiety and/or depression. However, significant changes in adolescent mental health and sleep outcomes at post-intervention were not observed. The usefulness of a therapist-supported online parenting programme in addressing a service gap for parents seeking professional help is indicated. Australian New Zealand Clinical Trials Registry Number (ACTRN) 12618000290291, prospectively registered on 26 February 2018; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368031.

A Worksite Self-management Program for Workers with Chronic Health Conditions Improves Worker Engagement and Retention, but not Workplace Function

Purpose An increasing number of workers in the US have chronic health conditions that limit their ability to work, and few worksite interventions have been tested to improve worker coping and problem solving at work. The purpose of this study was to evaluate a worksite-based health self-management program designed to improve workplace function among workers with chronic health conditions. Methods We conducted a randomized, controlled trial of a worksite self-management program (“Manage at Work”) (clinicaltrials.gov #NCT01978392) for workers with chronic health conditions (N = 119; 82% female, ages 20–69). Most workers were recruited from the health care or light manufacturing industry sectors. Workers attended a 5-session, facilitated psychoeducational program using concepts of health self-management, self-efficacy, ergonomics, and communication. Changes on outcomes of work engagement, work limitation, job satisfaction, work fatigue, work self-efficacy, days absent, and turnover intention at 6-month follow-up were compared to wait-list controls. Results The most prevalent chronic health conditions were musculoskeletal pain, headaches, vision problems, gastrointestinal disorders, respiratory disorders, and mental health disorders. The self-management program showed greater improvement in work engagement and turnover intent at 6-month follow-up, but there was no evidence of a parallel reduction in perceived work limitation. Trends for improved outcomes of work self-efficacy, job satisfaction, and work fatigue in the intervention group did not reach statistical significance in a group x time interaction test. Conclusions Offering a worksite self-management program to workers with chronic health conditions may be a feasible and beneficial strategy to engage and retain skilled workers who are risking disability.Clinical trial registration: Clinicaltrials.gov #NCT01978392.

Nutraceuticals and Behavioral Therapy for Headache.

Headache affects and disables at least 1 billion people worldwide. Patients and providers seek new therapies to relieve headache without the side effects and financial burden of current treatments. This narrative review highlights recent treatment advances in integrative headache medicine: nutraceuticals and behavioral therapies. Growing use of complementary and alternative medicine (CAM) therapies for headache (riboflavin, coenzyme Q10, magnesium, vitamin D, melatonin) alongside mainstream treatments is increasing with improving evidence of quality, safety, and tolerability. Increasing interest in medical cannabis is tempered by lack of evidence regarding safety and efficacy. Behavioral therapies including cognitive behavioral therapy (CBT), biofeedback, mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT) improve patient resiliency and self-efficacy outcomes and reduce disability. The body of evidence for nutraceutical and behavioral CAM interventions for headache continues to grow and improve in quality. Providers and patients should educate themselves regarding CAM therapies as part of integrative headache management. Future studies should examine combinatorial trials of CAM therapies against current standards of headache care.

Science and mathematics teacher communities of practice: social influences on discipline-based identity and self-efficacy beliefs

BackgroundTeacher communities of practice, identity, and self-efficacy have been proposed to influence positive teacher outcomes in retention, suggesting all three may be related constructs. Qualitative studies of communities of practice can be difficult to empirically link to identity and self-efficacy in larger samples. In this study, we operationalized teacher communities of practice as specific networks related to teaching content and/or pedagogy. This scalable approach allowed us to quantitatively describe communities of practice and explore statistical relationships with other teacher characteristics. We asked whether these community of practice networks were related to identity and self-efficacy, similar to other conceptualizations of communities of practice.ResultsWe analyzed survey data from 165 in-service K-12 teachers prepared in science or mathematics at 5 university sites across the USA. Descriptive statistics and exploratory factor analyses indicated that math teachers consistently reported smaller communities of practice and lower identity and self-efficacy scores. Correlations revealed that communities of practice are more strongly and positively related to identity than self-efficacy.ConclusionWe demonstrate that teacher communities of practice can be described as networks. These community of practice networks are correlated with teacher identity and self-efficacy, similar to published qualitative descriptions of communities of practice. Community of practice networks are therefore a useful research tool for evaluating teacher characteristics such as discipline, identity, self-efficacy, and other possible outcomes (e.g., retention). These findings suggest that teacher educators aiming to foster strong teacher identities could develop pre-service experiences within an explicit, energizing community of practice.

How Do Clinical Electives during the Clerkship Year Influence Career Exploration? A Qualitative Study

Problem: Although many students begin medical school with some idea of their specialty interest, up to 80% of these students choose a different specialty by their final year. This pivot tends to happen in the clerkship year, when students are immersed in the clinical environment, gaining a practical understanding of the day-to-day work in different fields. Yet, in this year students have limited experiences with specialties. Clinical electives during the clerkship year may aid students in career development. The authors examined student career exploration through the lens of social cognitive career theory (SCCT). SCCT posits three variables that influence career development: personal goals, self-efficacy, and understanding outcome expectations. With this framework, the authors sought to understand how a program of clinical electives during the clerkship year influences students’ perceptions of their career exploration. We aimed to: (1) describe an innovative clerkship elective program designed for career exploration, and (2) explore how this influenced students’ career exploration using qualitative analysis. Intervention: Beginning in 2018, students at our institution were required to participate in three 2-week clinical electives during their clerkship year, called Clinical Immersive Experiences (CIExes). CIExes were categorized into four different types: apprenticeship, clinical skills building, integrative (multi-disciplinary), or subspecialty. Authors invited fourth year students to participate in interviews (January to March 2019) about how they selected electives and how these electives contributed to their career exploration. Interviews continued until reaching information sufficiency. Authors coded and analyzed transcripts using template analysis. Context: This curricular intervention took place in the context of large-scale curricular redesign. Students began clerkships partway into their second year of medical school. The family and community medicine clerkship, which was previously a 6-week core clerkship, was changed to a longitudinal format, thus freeing up 6 weeks for electives. Other core clerkships included anesthesia (2 weeks), medicine (8 weeks), neurology (4 weeks), obstetrics and gynecology (6 weeks), pediatrics (6 weeks), psychiatry (4 weeks), and surgery (8 weeks). Impact: From 15 student interviews, we identified three major themes. First, CIExes facilitated personalized career exploration. All students felt that at least one elective helped them solidify their decision about a specialty choice. Second, CIExes promoted focused learning and skills development that complemented core rotations. They noted the benefit of positive relationships with supervisors, particularly attendings, during these electives. Third, students highlighted how these electives fostered a positive learning environment and enhanced wellbeing. SCCT clarified how the CIEx program helped students advance their personal goals, self-efficacy, and outcome expectations during a pivotal time in medical school. Lessons Learned: We learned that from the student perspective, the inclusion of clinical electives in the clerkship year benefited students’ career exploration by helping them develop and refine their career goals, increase self-efficacy, and test outcome expectations in a meaningful way as anticipated from SCCT. In addition, we found that CIExes created a positive learning environment that allowed deep relationships to develop in fields of interest and that supported a strong sense of wellbeing. Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.1891545

Effects of patient decision aids in patients with type 2 diabetes mellitus: A systematic review and meta-analysis.

This study aimed to systematically evaluate the effectiveness of patient decision aids on knowledge, decisional conflict and decisional self-efficacy outcomes in patients with diabetes. A comprehensive database search was performed using the Web of Science, Cochrane Library, PubMed, Embase, PsycINFO (Ovid), CINAHL (EBASCO), CNKI, VIP, Wan Fang Database and the Ottawa Decision Aid Library Inventory (http://decisionaid.ohri.ca/index.html) from inception to 13 October 2019. Two reviewers independently searched databases, screened articles, extracted data and evaluated the risk bias of included studies. Then Rev Man 5.3 software was adopted for statistical analysis. Ten articles containing 1,452 people with diabetes were selected. The results of meta-analysis showed that patient decision aids had a positive effect on reducing decisional conflict and improving decisional self-efficacy among patients with type 2 diabetes. Meanwhile, this article also revealed that patient decision aids have beneficial short-term effects on improving knowledge, but there was no significant long-term effect. Patient decision aids are capable of becoming support tools to improve shared decision making. Further implementation studies are required to transform patient decision aids tools into clinical practice.

Reducing HIV/STI Risk Among Adolescents Aged 12 to 14 Years: a Randomized Controlled Trial of Project Prepared

Despite calls for evidence-based HIV/STI prevention programs for youth aged 12 to 14 transitioning to adolescence, few effective programs exist. In a two-group intent-to-treat randomized trial in the Bronx, NY, 397 participants were randomly assigned to Project Prepared or an attention control, TEEN. Participants completed surveys at baseline, 6 months, and 12 months. Prepared had two components, an 11-session program and a 3-week internship. Content covered sexual risk behavior, social cognitions, gender norms, relationships, and resilience. TEEN built communication skills and had the same intensity and structure as Prepared but no sexual content. In both, boys and girls were trained together in mixed groups of ~ 11 teens. Primary outcomes were HIV knowledge, self-efficacy, condom outcome expectancy, and behavioral intentions. Secondary outcomes were relationship expectations and endorsement of risky gender norms. Generalized estimating equation analyses showed youth randomized to Prepared had significant improvements compared to TEEN at T2 in HIV knowledge, sexual self-efficacy, and outcome expectancy for condom use. At T3, there were significant differences favoring Prepared in outcome expectancy for condom use, sexual self-efficacy, and intention for partner communication about HIV/AIDS or STIs. Analyses by gender showed program effects in both boys (intention to talk to a partner about condom use, abstinence self-efficacy, sexual self-efficacy, and condom outcome expectancy) and girls (gender norms, and abstinence outcome expectancy). Prepared effectively reduced risk in young adolescents. ClinicalTrials.gov ID: NCT01880450, Protocol ID: 2008-551

Examining the Role of Peer Support on Work Experiences for Young Women With Disabilities

This study examined the protective effect of perceived peer support on involvement in work experiences in a sample of 366 young women receiving special education services in 26 high schools. Career self-efficacy and career outcome expectations are well-established predictors of behaviors aimed at achieving career goals, such as obtaining work experiences. Hence, we also evaluated their role as mediators of the hypothesized effect of perceived peer support on work experiences. Regression analyses (accounting for clustering within schools) revealed that perceived peer support had an indirect effect on work experiences, with the effect being channeled through career self-efficacy, but not through career outcome expectations. Although perceived peer support was significantly associated with career self-efficacy and career outcome expectations, only career self-efficacy predicted work experiences at follow-up. Our findings suggest that perceived peer support, a relatively malleable factor, can promote career self-efficacy and career outcomes for this population.

Promoting teacher self-efficacy for supporting English learners in mathematics: effects of the Visual Access to Mathematics professional development

Teachers’ confidence and facility with strategies that position and support students who are English learners (ELs) as active participants in middle grades mathematics classrooms are key to facilitating ELs’ mathematics learning. The Visual Access to Mathematics (VAM) project developed and studied teacher professional development (PD) focused on linguistically-responsive teaching to facilitate ELs’ mathematical problem solving and discourse. This study examines whether VAM PD has a positive impact on teachers’ self-efficacy in supporting ELs in mathematics and how components of the PD may have influenced teacher outcomes. Results from a field test involving a cluster randomized trial of 101 teacher participants from 47 schools showed that VAM PD had a positive impact on participants’ self-efficacy related to teaching ELs in mathematics, based on pre/post self-efficacy survey responses. An analysis of participants’ written reflections suggests that supported implementation of language strategies with ELs in their mathematics teaching contexts was a key PD component that contributed to teacher self-efficacy outcomes. Findings offer implications for mathematics teacher PD and for facilitating ELs’ learning in mathematics.

The quality of international mobility experiences, general self-efficacy and job search self-efficacy: A time-lagged investigation

Grounded on social cognitive career theory as a framework, the present research investigates whether high quality international mobility experiences of students enhance their general self-efficacy perceptions and improve job-search self-efficacy behavior (JSSE-B) and job-search self-efficacy outcome (JSSE-O) following graduation. Data was collected at two different time points from students who enrolled to an international mobility program. The first survey was conducted shortly after students returned to home country, and the second survey after 23 months on average following the first survey. The results revealed that the quality of international experiences had a positive and indirect effect on JSSE-B and JSSE-O and this relationship was mediated by general self-efficacy of participants. The findings suggested that both general self-efficacy and by extension job search self-efficacy could be enhanced through properly designed international student mobility programs, benefits of which are not constrained to a limited time span, but prevail after graduation, as well.

Evaluating an Advance Care Planning Skills Training for Medical, Nursing, and Social Work Students

Advance care planning (ACP) helps to ensure future healthcare is congruent with individual preferences. Curricula for health-focused professions rarely include ACP content. This is a repeated measures evaluation of an innovative, interprofessional student training to enhance the ability to lead ACP discussions. Outcomes were measured via self-report surveys at two timepoints (baseline = T1 [n = 35]; posttraining follow-up = T2 [n = 20]) and included validated measures of communication self-efficacy, ACP self-efficacy, and interprofessional teamwork. Data collection from a third timepoint (T3), following randomized group assignment is currently underway. The matched T1–T2 sample (N = 17) included students from medicine (64.7%), nursing (17.6%), and social work (17.6%). Participants were largely young (M=26 years), non-Hispanic (94.0%), White (59.0%), and female (71.0%). Paired t tests examined change from T1 to T2 for all outcomes. Despite worse communication self-efficacy (Mdiff=1.6, p<.001) and ACP self-efficacy (Mdiff=.92, p<.001), perceptions of interprofessional teamwork improved (Mdiff=3.0, p=.008). These T1–T2 findings mirror results from similar, prior research, which subsequently discovered that both self-efficacy outcomes and their effect sizes for change worsened at T2, but ultimately and substantially improved at T3. These fluctuations suggest participants initially overestimated their self-efficacy related to ACP at T1 and corrected their appraisals at T2. Other studies should account for this self-correction. Further replication is needed to understand the dip that appears to occur before anticipated improvements occur.

Outcomes of Visual Self-Expression in Virtual Reality on Psychosocial Well-Being With the Inclusion of a Fragrance Stimulus: A Pilot Mixed-Methods Study.

AimsIn this pilot mixed-methods study, we examined the participants experiences of engaging in virtual drawing tasks and the impact of an olfactory stimulus (calming fragrance blend) on outcomes of affect, stress, self-efficacy, anxiety, creative agency, and well-being (satisfaction with life).MethodsThis study used a parallel mixed-methods, simple block randomization design. The study participants included 24 healthy adults aged 18 to 54 years, including 18 women and six men. The participants completed two 1-h immersive virtual art making sessions and were randomly assigned to receive either a fragrance or a non-fragrance condition for the first session. Quantitative (standardized self-report measures) and qualitative (open-ended survey responses and virtual artwork) datasets were collected concurrently and integrated during data analysis.ResultsThe quantitative results indicated that the fragrance condition demonstrated a significant reduction in negative affect (e.g., feeling hostile, jittery, upset, distressed, etc.), namely, reduced feelings of negativity when compared to the non-fragrance condition. A trend toward improvement in self-efficacy was also seen in the fragrance condition. No significant changes were found for fragrance or non-fragrance conditions for positive affect, anxiety, and creative agency. The qualitative findings included five themes related to art making experiences in virtual reality in both conditions: fun and joy; novelty of virtual media, experimentation, and play; relaxation and calm; learning curve; and physical discomfort and disorientation. Four themes were identified for virtual art content and visual qualities: nature imagery, references to memories and personal symbols, fantasy and play within imagery, and depiction of everyday objects.ConclusionsOverall, the participants reported positive responses to the novel virtual art making experiences which were further heightened by the inclusion of the fragrance stimulus for negative affect. These preliminary findings need to be replicated with larger sample sizes to confirm the outcomes and the trends that were seen in this pilot study. Further research is recommended to examine the differences between experiences of virtual and traditional art media and to examine different olfactory stimuli promoting focus and concentration.

The Effect of Mindfulness, Psychological Flexibility, and Emotional Intelligence on Self-Efficacy and Functional Outcomes Among Chronic Pain Clients

Chronic pain-related research has increased substantially during the last decade. However, empirical studies addressing mental health interventions to increase self-efficacy and reduce functional impairments is limited. This study investigated whether better functional outcomes (physical and psychosocial daily functioning) and greater self-efficacy among persons with chronic pain is associated with mindfulness, psychological flexibility, and emotional intelligence (N = 148). Two multiple regression analyses, each controlling for demographic factors, indicated that psychological flexibility predicted both daily functioning and self-efficacy, and emotional intelligence predicted self-efficacy among chronic pain clients. Mental health benefits of psychological flexibility and emotional intelligence can therefore potentially be used by psychotherapists to help boost clients’ positive beliefs in, and ability to function with, chronic pain.

Family-based Interventions Benefit Individuals With Musculoskeletal Pain in the Short-term but not in the Long-Term: A Systematic Review and Meta-Analysis.

The benefits of family-based interventions for patients with musculoskeletal pain have been previously shown in individual randomized controlled trials (RCTs), but no systematic review has summarized their effects. A systematic review was conducted to assess the effectiveness of family-based interventions on clinical and biopsychosocial outcomes in people with musculoskeletal pain (PROSPERO CRD42018118442). Meta-analyses were performed for the outcomes of pain intensity, disability, mood, self-efficacy, and marital adjustment. Of 1223 records identified, 18 reports representing 15 RCTs were included in the qualitative review and 10 in the meta-analyses. Family-based interventions were more effective to reduce pain (mean difference [MD], -3.55/100; 95% confidence intreval [CI], -4.03 to -3.06) and disability (MD, -1.51/100; 95% CI, -1.98 to -1.05) than individual-focused interventions at short-term, but not at mid term or long term. There were no effects on other outcomes. Family-based interventions were more effective to reduce pain (MD, -6.05/100; 95% CI, -6.78 to -5.33) compared with usual care only at short-term. No effects were found on disability and other outcomes. There is moderate-quality evidence that family-based interventions result in small, significantly better pain and disability outcomes in the short-term compared with individual-focused interventions in patients with musculoskeletal pain. Based on low-quality evidence, family-based interventions result in small improvements on pain in the short-term compared with usual care. Future studies should review the content and optimize the mechanisms underpinning family-based interventions in musculoskeletal pain so that the approach could be further tested in adequately powered RCTs.

Blended learning versus face-to-face learning in an undergraduate nursing health assessment course: A quasi-experimental study

BackgroundBlended learning, which integrates face-to-face and online instruction, is increasingly being adopted. A gap remains in the literature related to blended learning, self-efficacy, knowledge and perceptions in undergraduate nursing. ObjectivesTo investigate outcomes of self-efficacy, knowledge and perceptions related to the implementation of a newly blended course. DesignThis was a quasi-experimental pre-post test design. SettingThis study was conducted at an undergraduate university in Alberta, Canada. ParticipantsA total of 217 second-year undergraduate nursing students participated and 187 participants completed all study components. MethodsA convenience sampling method was used. Data were collected at the start and end of the semesters. Data were analyzed using descriptive and inferential statistics using R(3.4.3) and R-Studio(1.1.423). ResultsThere were no significant differences in self-efficacy scores between groups or in the pre-post surveys (p > 0.100) over time. There was no significant difference in knowledge between the blended online and face-to-face groups (p > 0.100). For students in the blended course, perceptions of the online learning environment were positive. ConclusionBlended learning has the potential to foster innovative and flexible learning opportunities. This study supports continued use and evaluation of blended learning as a pedagogical approach.

Community-Based Interventions Targeting Obesity for People With Intellectual Disability: A Systematic Review

Abstract Date Presented 03/27/20 Individuals with intellectual disabilities have a high risk of obesity. The effectiveness of community-based interventions at improving obesity-related outcomes was assessed. Results showed low to moderate evidence for nutritional, physical activity, and health knowledge and self-efficacy outcomes and low evidence for physical fitness. OTs are well-suited to align community-based interventions with meaningful outcomes to improve the health and well-being of people with intellectual disabilities. Primary Author and Speaker: Megan Gray Additional Authors and Speakers: Kathryn Bach, Yasmeena Ougayour, Karla Ausderau

Interlocking Effects of Self-Efficacy and Self-Regulation on Social Ties and Social Entrepreneurial Orientation

In recent years, the projection of Social entrepreneurs’ cognitive drive is a critical factor that needs attention in determining the efficiency of social entrepreneurial orientation in entrepreneurship studies. In order for Social entrepreneurs to be fully oriented in improving social well-being through long term developmental project and not merely considered to perform acts of charity, there has to be a social cognitive mechanism as a key characteristic of social value creation. There are however, significant gaps in understanding social entrepreneur orientation hence, few empirical studies on the subject. This paper using both the Social Network and Social Cognitive theories attempts to identify the relationship between Social ties, self-efficacy, self-regulation and entrepreneurial orientation outcomes. Using the Partial lest square of the structural equation model to analyze a survey data of 397 Philanthropist (i.e. social activist, environmentalist and other social innovators) NGOs in Ghana, the findings proved that, the level of an individual’s self-efficacy and Self-regulation is not only important to consider as a driving social entrepreneurs’ cognitive behaviors but also fruitful in improving social Entrepreneurial orientation. The study reveals some directions for social innovators seeking to promote their social entrepreneurial orientation skills using cognitive measures alongside social connections in solving a social problem. Keywords: key words, business ties; political ties; self-efficacy; self-regulation; social entrepreneurial orientation DOI: 10.7176/JRDM/68-06 Publication date: August 31 st 2020

Students’ connectedness is linked to higher gratitude and self-efficacy outcomes

Students’ connectedness to various social agents has been linked to specific domains of self-efficacy but little is known about the mechanisms linking connectedness to adaptive student outcomes. This research aimed to examine the associations of connectedness with academic self-efficacy (Study 1) and career development self-efficacy (Study 2) via the mediating effects of gratitude using prospective research design among Hong Kong high school students. Sample comprised 141 high school students in Study 1 and 132 high school students in Study 2. There was a 12-month interval between Time 1 and Time 2 survey administration. Study 1 showed that Time 1 connectedness to parents and peers positively predicted Time 2 academic self-efficacy through the mediating role of Time 2 gratitude. Study 2 demonstrated that Time 1 connectedness to parents and school positively predicted Time 2 career development self-efficacy via Time 2 gratitude. Converging evidence was reached on the mediating influence of gratitude on the link between connectedness and different domains of self-efficacy. Teachers, guidance counselors and psychologists are encouraged to provide increased opportunities for students to strengthen their peer relationships and connection with families in order to boost their self-confidence in performing academic and career developmental activities.

Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study

BackgroundDuring the Coronavirus Disease 2019 (COVID-19) pandemic, frontline nurses face enormous mental health challenges. Epidemiological data on the mental health statuses of frontline nurses are still limited. The aim of this study was to examine mental health (burnout, anxiety, depression, and fear) and their associated factors among frontline nurses who were caring for COVID-19 patients in Wuhan, China.MethodsA large-scale cross-sectional, descriptive, correlational study design was used. A total of 2,014 eligible frontline nurses from two hospitals in Wuhan, China, participated in the study. Besides sociodemographic and background data, a set of valid and reliable instruments were used to measure outcomes of burnout, anxiety, depression, fear, skin lesion, self-efficacy, resilience, and social support via the online survey in February 2020.FindingsOn average, the participants had a moderate level of burnout and a high level of fear. About half of the nurses reported moderate and high work burnout, as shown in emotional exhaustion (n = 1,218, 60.5%), depersonalization (n = 853, 42.3%), and personal accomplishment (n = 1,219, 60.6%). The findings showed that 288 (14.3%), 217 (10.7%), and 1,837 (91.2%) nurses reported moderate and high levels of anxiety, depression, and fear, respectively. The majority of the nurses (n = 1,910, 94.8%) had one or more skin lesions, and 1,950 (96.8%) nurses expressed their frontline work willingness. Mental health outcomes were statistically positively correlated with skin lesion and negatively correlated with self-efficacy, resilience, social support, and frontline work willingness.InterpretationThe frontline nurses experienced a variety of mental health challenges, especially burnout and fear, which warrant attention and support from policymakers. Future interventions at the national and organisational levels are needed to improve mental health during this pandemic by preventing and managing skin lesions, building self-efficacy and resilience, providing sufficient social support, and ensuring frontline work willingness.

Effect of linguistic acculturation on self-efficacy and anxiety in caregivers of Latina breast cancer survivors.

12121 Background: Latina breast cancer survivors and their caregivers face unique challenges. Acculturation is the acquisition of the cultural elements of a dominant society. Higher acculturation in Latino survivors is positively correlated with self-efficacy in patient-provider communication and improved patient-reported outcomes. There is a paucity of research on how language acculturation affects caregiver and patient outcomes. We examined associations over time between linguistic acculturation among caregivers of Latina survivors and outcomes of caregiver self-efficacy and anxiety. Methods: We partnered with four community-based organizations that serve Latino families facing cancer. We enrolled 136 Latina breast cancer survivors and their caregivers for a randomized trial comparing a dyadic coping intervention to usual care (e.g., support groups). Participants completed surveys including demographic and clinical information, the short acculturation scale for Hispanics, caregiver inventory to assess self-efficacy and PROMIS domains of anxiety at baseline and 6-months after the intervention. Results: In multivariate linear regressions models, we examined the effect of acculturation on caregiver self-efficacy and anxiety, controlling for demographics (patient and caregiver age, caregiver education, employment), patient treatment history (chemotherapy and surgery) patient and caregiver language preference (Spanish or English) and intervention arm (intervention vs. usual care). Greater caregiver self-efficacy at 6-months was associated with younger patient age (t=-2.93, p=.004), older caregiver age (t=2.63, p = .01), female caregiver gender (t=2.79, p = .006) and higher acculturation (t=2.01, p=.04), controlling for baseline self-efficacy, patient language and randomization group. Caregiver anxiety was not related to caregiver acculturation or patient language preferences. Conclusions: Caregivers’ language acculturation was significantly associated with their self-efficacy over time, suggesting that caregivers with lower acculturation experience lower confidence in their provision of care for Latina survivors. These findings are particularly salient because participants for this study were enrolled from organizations with bilingual services. Caregivers of Latina survivors without access to these community resources may face even more striking challenges. Future work can explore how caregivers’ confidence relates to survivors’ adherence to care and patient outcomes over time.