Commentary: Mental health
Tackling nurses’ mental health issues: key risk factors, consequences and organisational solutions for improving well-being 10.1136/ebnurs-2024-104113 Ebtsam Aly Abou Hashish 1,2 1 Faculty of Nursing, Alexandria University, Alexandria, Egypt, 2 College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
assessment methods and revealed an increase in global publications between 2009 and 2021. Risk factors were analysed through the social ecological model, covering intrapersonal, interpersonal, organisational, political and environmental domains. Key modifiable factors included unhealthy lifestyles, a lack of social support, work- place violence, job demands and sleep disturbances. The consequences of poor mental health included negative physical, behavioural, occupational and intrap- ersonal impacts. 2 Commentary This comprehensive scoping review significantly advances our understanding of nurses’ mental health by synthesising longitudinal evidence and offering a holistic view of the multilevel influences on nurses’ well-being. Identifying modifiable risk factors highlights several intervention opportunities. The review confirms that behaviours and lifestyles can predict nurses’ mental health, aligning with previous meta-analyses. 2 5 The review’s strength lies in its focus on cohort studies, which provide stronger evidence for causal relationships than cross-sectional research. This approach allows for a nuanced understanding of the predictors and consequences of mental health issues among nurses. It reveals bidirectional relationships between some risk factors and mental health, emphasising the complex, cyclical nature of these associations. Findings suggest that targeted strategies—such as improving social support, addressing workplace violence and managing job demands—could signifi- cantly enhance nurses’ mental well-being. 2 6 However, the review has limitations such as bias from self-reported data, lack of quantification of risk factors and outcomes and predominance of studies from high-income countries, limiting global applicability. Additionally, the absence of male participants highlights a gap in understanding gender differences in mental health experiences. 2 Overall, the review highlights the need for multilevel interventions to support nurses’ mental health. While individual approaches are vital, addressing organ- isational risk factors is crucial for supportive environments. Future research should evaluate intervention strategies and the long-term impacts of mental health problems on nurses and patient outcomes. This review also underscores the urgent need for evidence-based policies to protect nurses’ mental well-being. X Ebtsam Aly Abou Hashish @Ebtsam Abou hashish. @ebtsam_aly Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Competing interests None declared. Ethics approval Not applicable. Provenance and peer review Commissioned; internally peer reviewed. © Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ. ORCID iD Ebtsam Aly Abou Hashish http://orcid.org/0000-0003-0492-7615 References 1 Yunitri N , Chu H, Kang XL, et al . Global prevalence and associated risk factors of posttraumatic stress disorder during COVID-19 pandemic: A meta-analysis. Int J Nurs Stud 2022;126:104136. 2 Yang J , Chen Y, Tian Y, et al . Risk factors and consequences of mental health problems in nurses: A scoping review of cohort studies. Int J Ment Health Nurs 2024. 3 Arksey H , O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005;8:19–32. 4 Tricco AC , Lillie E, Zarin W, et al . PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med 2018;169:467–73. 5 De Nys L , Anderson K, Ofosu EF, et al . The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. Psychoneuroendocrinology 2022;143:105843. 6 Carter H , Dennis A, Williams N, et al . Identity-based social support predicts mental and physical health outcomes during COVID-19. Br J Soc Psychol 2023;62:845–65.
Correspondence to: Professor Ebtsam Aly Abou Hashish; ebtsam_ss@ hotmail.com
Commentary on : Yang J, Chen Y, Tian Y, Li X, Yu Q, Huang C, Chen Z, Ning M, Li S, He J, Du J, Huang B, and Li Y (2024). Risk factors and consequences of mental health problems in nurses: A scoping review of cohort studies. International Journal of Mental Health Nursing . Advance online publication. https://doi.org/10.1111/inm.13337
Implications for practice and research
► Implement interventions to reduce workplace bullying, violence and job demands while promoting healthy lifestyles and social support for nurses. ► Future research should investigate nurses’ mental health in low-income and middle-income countries, explore gender differences and evaluate the effectiveness of mental health interventions. Context Mental health issues among nurses are widespread and jeopardise healthcare systems and patient care. 1 Yang et al 2 conducted a pioneering scoping review using cohort study evidence to explore the risk factors and consequences of these issues, marking the first comprehensive longitudinal analysis in this area. Given the heightened mental health challenges during the COVID-19 pandemic, the review is particularly timely. It offers crucial insights for developing targeted policies and interventions to support nurses’ mental well-being. The findings are vital for advancing nursing practice, education, research and policy. 2 Methods The researchers conducted a systematic search across six major databases (PubMed, EMBASE, Epistemonikos, Web of Science, CINAHL, PsycINFO) for cohort studies published before March 2023. Following Arksey and O’Malley’s framework 3 and Preferred Reporting Items for Systematic review and Meta-Analysis extension for Scoping Reviews guidelines. 4 Study selection was managed by screening titles, abstracts and full texts, with inclusion criteria specifying cohort studies involving nurses with at least one year of follow-up, mental health as an exposure or outcome and English language. Data extraction was conducted independently by five researchers, focusing on study characteristics, mental health variables, risk factors and consequences. Descriptive statistics and visual representations, including global mapping, were used to summarise findings with Stata V.16.0. 2 Findings The review examined 171 cohort studies on nurses’ mental health from 16 coun- tries, predominantly high-income nations. The studies used diverse mental health
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Evid Based Nurs Month 2024 | volume 0 | number 0 |
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