The mental health of nurses is deteriorating. Maintaining nurses' resilience has become a focal point for future nursing development.

We aim to rank the effectiveness and acceptability of resilience-focused interventions for nurses.

A systematic review and network meta-analysis were conducted, with comprehensive searches across PubMed, Embase, Cochrane Library, Web of Science, and other databases. Frequentist random-effects network meta-analyses were employed, and RoB-2 was used to assess the quality of evidence.

Resilience-focused interventions were found to significantly enhance nurses' resilience (95%CI 0.61, 1.41). Offline field interventions (95%CI 0.64, 1.59) outperformed online interventions (95%CI -0.02, 0.45). Both group (95%CI 0.32, 0.87) and individual (95%CI 0.63, 1.59) interventions showed effectiveness. Anger Management Psychoeducation (95%CI 3.65,7.93, SUCRA = 98.2), Emotional Intelligence training (95%CI 3.32,6.51, SUCRA = 95), and Mindfulness-Based Stress Reduction (95%CI 2.60,5.88, SUCRA = 92.4) were the most effective interventions.

Anger Management Psychoeducation, Mindfulness-Based Stress Reduction, and Emotional Intelligence training are the most effective interventions for enhancing nurses' resilience.

CRD42021289477. REGISTRATION OF CLINICAL TRIAL AND REGISTRATION IDENTIFICATION NUMBER: Not applicable.

Work-related stress is a major health issue in most industrialized countries. Heart rate variability biofeedback (HRV-BfB) can promote resilience and stress coping capacity. Mobile HRV-BfB could contribute to stress prevention in the workplace. Little is known about whether the type of training, with digital or live instruction, has an impact on the training outcome. This study analyzes the psychophysiological effects of four-week workplace resilience training with mobile HRV-BfB and the influence of instruction format (digital or live) on training success. This was a prospective, three-arm, non-randomized controlled trial with parallel group design. 73 employees of a bearing and seal manufacturer (58.9% male, 86.3% full-time employment, 67.1% office workers) attended resilience training with HRV-BfB, live (n = 24) or digital (n = 19) format, or served as waitlist controls (n = 30). HRV-BfB training spanned four weeks. Participants applied resilience techniques to increase HRV using visual biofeedback. Data were collected at baseline (T0), post-intervention (T1), and another four weeks later (T2). Primary outcome measure was the Burnout scale of the Copenhagen Psychosocial Questionnaire (COPSOQ) at T1. Secondary outcome measures included further COPSOQ scales, self-reported sleep quality (Pittsburgh Sleep Quality Index, PSQI), and HRV parameters. Burnout parameters decreased significantly in HRV-BfB and waitlist. The decrease (T0-T1 and T0-T2) showed higher effect sizes in HRV-BfB (Cohen's d: 0.63; 0.69) than in waitlist (d: 0.27; 0.36). Sleep quality improved in HRV-BfB with small effect sizes (no change for waitlist). SDNN (standard deviation of beat-to-beat intervals) increased in HRV-BfB between T0 and T1 (d: 0.23;). In subgroup analysis, digital reached higher effect sizes for improvement in burnout (d: 0.87; 0.92) and sleep quality (d: 0.59; 0.64) than live learning (burnout: d: 0.43; 0.51; sleep quality: d: 0.28; 0.22). HRV-analysis revealed no differences between subgroups. Four-week mobile HRV-BfB resilience training reduced stress and burnout symptoms in employees. No significant differences were found between HRV-BfB digital or live. Hence, companies should choose the approach that fits their company profile or, if possible, offer both formats to accommodate the different needs of employees. However, findings were nonhomogeneous and should be verified by further studies.Trial Registration: ClinicalTrials.gov , NCT04897165, 05/18/2021, retrospectively registered.

Workplace violence (WPV) is a harmful phenomenon happening in psychiatric wards. Despite preventive efforts, mental health services cannot eliminate WPV. If mental health services can increase the coping and resilience of frontline mental healthcare professionals (FMHPs) towards WPV, it could contribute to their mental health and well-being. To perform a systematic review of comparative studies on interventions to improve coping and resilience towards WPV aimed at FMHPs working in psychiatric wards. Systematic review on comparative intervention studies, with electronic searches in MEDLINE, Embase, Cochrane CENTRAL, PsycINFO and CINAHL. We registered our protocol in PROSPERO (CRD42022373757). Performing a meta-analysis seemed not to be feasible, so we provided a narrative summary of the included studies, methodological quality and results. We included nine studies, with interventions focused on positive behavioural support, resilience enhancement and aggression management training. Most studies reported positive effects, though with a moderate to high risk of bias. Positive behavioural support, biofeedback and aggression management training are promising interventions in our review. Biofeedback interventions and positive behavioural support could be valuable additions to existing training programmes to improve coping and resilience. Future studies should focus on demonstrating the robustness of effects, the mechanism of increasing coping and resilience regarding WPV and the development and implementation of effective interventions.

Previous studies have advocated the benefits of resilience-based interventions for creating a healthy and sustainable workforce. However, resilience is defined and measured in diverse ways. Therefore, the aim of this systematic review is (1) to identify how resilience is defined within different workplace interventions, translated into intervention content, and measured in these interventions; and (2) to synthesize the effectiveness of these interventions.

A systematic literature search was conducted and included articles from 2013 - 2023. Twenty-four studies met the inclusion criteria, covering a total of 26 unique interventions. Definitions were categorized as: resilience as a trait, process, or outcome. Cohen's D was calculated to depict the effect sizes within the intervention groups from pre-test to post-test and, when possible, from pre-test to 3-month follow-up.

Included studies applied a wide range of definitions; most definitions fitted within the trait-orientation, conceptualizing resilience as an individual characteristic or ability, or the process-orientation, conceptualizing resilience as a dynamic process. No studies solely used the outcome-orientation, but some did combine elements of all three orientations. Various definitions, measures and intervention strategies were applied, however, almost half of the studies (46%) showed inconsistencies within these choices. Furthermore, findings show that most resilience-based interventions in the workplace have a positive impact. While educational workshops with a higher frequency and duration had medium to large effects, solely digital interventions had small effects, changing to small to medium when combined with non-digital elements.

Findings suggest that resilience-based can benefit employees by enhancing their psychological well-being. This, in turn, can lead to improved work-related outcomes such as productivity, thereby offering advantages to employers as well. This underscores the growing recognition that resilience should be viewed as a shared responsibility between the individual and the organization. Further advancement in the field of resilience-based interventions in the workplace calls for future research to focus on maintaining consistency when choosing a definition of resilience, developing intervention content, and choosing an outcome measure.

The search protocol was preregistered in the Open Science Framework, see Hollaar et al. (2023). https://doi.org/10.17605/OSF.IO/UKYF7 .

Health care providers (HCP) experience high stress and burnout rates. Mindfulness Based Interventions (MBI) with biofeedback may help improve resiliency but require further research.

Aims were to evaluate changes in sleep patterns, nocturnal physiology, stress, mood disturbances, and perceived experience with biofeedback during the Mindfulness in Motion (MIM) intervention. Data from 66 HCP were included after removing those below 75 % compliance with wearable sensors and wellness surveys. Participants were enrolled in MIM, including eight weekly one-hour virtually delivered synchronous group meetings and ∼10 min of mindfulness home practice at least 3 times per week using a mobile application. Participants wore wearable sensors to monitor sleep and nocturnal physiology and completed short daily stress and mood disturbances.

According to mixed effect models, no sleep nor physiological metrics changed across MIM (p > 0.05). More time was spent in bed after MIM sessions (8.33±1.03 h) compared to night before (8.05±0.93 h; p = 0.040). Heart rate variability was lower nights after MIM (33.00±15.59 ms) compared to nights before (34.50±17.04 ms; p = 0.004) but was not clinically meaningful (effect= 0.033). Significant reductions were noted in perceived stress at weeks 3 through 8 compared to Baseline and lower Total Mood Disturbance at weeks 3, 5, 6, and 8 compared to Baseline (p < 0.001).

Participating in the MIM with mobile applications and wearable sensors reduced perceived stress and mood disturbances but did not induce physiological changes. Additional research is warranted to further evaluate objective physiological outcomes while controlling for confounding variables (e.g., alcohol, medications).

Various trials are investigating the effect of digital and face-to-face interventions on nurse resilience; however, it remains unclear whether these interventions have immediate, short-term or long-term effects.

The objective of the systematic review is to identify the types of interventions and assess the immediate (<3 months), short-term (3-6 months), and long-term (>6 months) effects of these interventions on nurse resilience.

This systematic review was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD 42023434924), and results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol.

Data were collated from the databases of CINAHL, Cochrane Library, Embase (OVID), Medline, and Scopus between March and May 2023. The research protocol was determined following the framework of population, exposure, outcomes, and type of study. The articles with full text published between 2000 and 2023 were included. Studies were included if they (1) involved the nurses who provided patient care directly, (2) utilised digital or face-to-face interventions, (3) reported resilience outcomes, and (4) were randomised controlled trials or clinical trials. The JBI critical appraisal tool was utilised to assess the risk of bias for the studies collected.

A total of 18 studies met the criteria and were analysed. Pooled results demonstrated that digital interventions had a statistically significant positive effect on nurse resilience at 4-5-month follow-ups (standardised mean difference [SMD] = 0.71; 95 % CI = 0.13, 1.29; P = 0.02) compared to no interventions. Additionally, pooled data showed no effect on nurse resilience at all the follow-ups, compared to no interventions. No significant results were observed in comparisons of digital or face-to-face interventions between the intervention and control groups.

The review assessed digital and face-to-face resilience interventions in nurses across 18 trials. Digital methods showed a short-term impact within 4-5 months, whilst face-to-face interventions had no effect during follow-ups. Realistic expectations, ongoing support, and tailored interventions are crucial for nurse resilience enhancement.

It was identified digital interventions had a short-term impact on nurse resilience, whilst face-to-face interventions had no effect during follow-ups @fionayyu.

Intussusception occurs in children and progresses rapidly. If not treated in time, it may lead to secondary complications such as intestinal perforation, which affect the quality of life and health of children. Surgery is the most common clinical treatment and has a good effect. However, the postoperative prognosis of children with intussusception has a correlation with the postoperative rehabilitation method. Therefore, in this study, we explored the relationship between postoperative rehabilitation, gastrointestinal function, and the expression of inflammatory factors in children with intussusception.

To explore the relationship between postoperative rehabilitation, gastrointestinal function, and inflammatory factor levels in children with intussusception.

The medical records of 18 children who were admitted to our hospital for intussusception surgery between October 2022 and May 2024 were retrospectively reviewed. The patients were divided into the routine nursing group (n = 6) and rehabilitation training group (n = 12) according to the postoperative rehabilitation method. The general data, gastrointestinal function, and inflammatory factor levels of the two groups were statistically analyzed. Pearson correlation analysis of gastrointestinal function, inflammatory factors, and postoperative rehabilitation was performed.

We found no significant intergroup differences in sex, age, or disease course (P > 0.05). The times to first defecation, bowel sound recovery, and anal exhaust were shorter and inflammatory factor levels were lower in the rehabilitation training group than in the routine nursing group (P < 0.05). Pearson correlation analysis showed that gastrin and motilin levels were positively correlated with postoperative rehabilitation (P < 0.05). Interleukin (IL)-2, IL-4, IL-6, IL-10, high-sensitivity C-reactive protein, and tumor necrosis factor-α levels were negatively correlated with postoperative rehabilitation (P < 0.05). Gastrointestinal function was positively correlated (P < 0.05), and levels of inflammatory factors were negatively correlated with postoperative recovery time (P < 0.05).

We found a positive correlation between gastrointestinal function and postoperative rehabilitation training, and a negative correlation between inflammatory factor levels and rehabilitation training in children with intussusception.

The purpose of this study is to compare the efficacy of mind-body practices (MBPs) and multiple psychological methods, and identify the optimal method for relieving work-related stress among healthcare workers (HCWs) by network meta-analysis (NMA).

We applied six electronic databases, namely PubMed, Web of Science, Embase, PsycINFO, Cochrane, and Chinese National Knowledge Infrastructure to identify relevant RCTs from inception to September 16, 2023, and implemented a search strategy based on the PICOS principles. Data selection, extraction, and analysis of bias were carried out independently and in duplicate by separate researchers. State 16.0 was used to conduct NMA for comparing the effectiveness of various therapies.

We identified 23 studies including MBPs and three different psychological therapies, namely mindfulness-related therapy (MRT), psychoeducational therapy (PT), and comprehensive therapy (CT), which were divided into eleven specific techniques, namely yoga, meditation techniques (MT), Qigong, muscle relaxation(MR), biofeedback therapy (BT), mindfulness-based interventions (MBIs), modified mindfulness-based stress reduction (MBSR-M), mindfulness-based interventions combined with others (MBIs-C), mindfulness-based awareness(MBA), PT and CT. Our NMA results of MBPs and three psychological therapies showed MBPs (SMD = -0.90, CrI:-1.26, -0.05, SUCRA = 99%) were effective for occupational stress in HCWs, followed by MRT(SMD = -0.48, CrI:-0.87, -0.08, SUCRA = 66.5%). NMA results of eleven specific techniques showed yoga (SMD = 1.36, CrI:0.91, 1.81, SUCRA = 97.5%) was the most effective technique in relieving the stress of HCWs, followed by MR (SMD = 1.36, CrI:0.91, 1.81, SUCRA = 87.3%).

Our study suggested MBPs may be the most effective intervention to improve the occupational stress of HCWs. Furthermore, yoga is likely to be the most optimal of MBPs. Hospital managers should attach importance to yoga in addressing occupational stress among medical workers.

Workplace violence (WPV) against emergency nurses has been common but unavoidable. Promoting resilience may mitigate the subsequent health harms of workplace violence. Current interventions mainly focused on internal factors related to resilience, though the external factors can influence personal growth.

To test the effect, feasibility, and acceptability of a Comprehensive Active Resilience Education (CARE) program on promoting resilience in emergency nurses exposed to workplace violence.

This is a two-armed quasi-experimental using mixed methods, following the TREND checklist.

This study was conducted from March 2023 to July 2023 in a tertiary hospital in Shanghai, China. Emergency nurses exposed to workplace violence were recruited using cluster sampling and allocated to the intervention and control groups. The intervention group received the CARE program. The control group received no intervention.

71participants were recruited and no participants withdrew during the intervention. The resilience and anxiety scores displayed a significant effect in the group*time interaction effect. After four months, the intervention group demonstrated a significant improvement in resilience and anxiety scores. The intervention group showed greater improvement in coping, perceived organizational support, and depression scores compared to the control group. Two themes of joyful engagement experience and effective intervention were identified from qualitative interviews with the intervention group.

The Comprehensive Active Resilience Education (CARE) program was effective, feasible, and acceptable in increasing resilience in emergency nurses exposed to workplace violence. The CARE program we developed can be replicated and integrated into systematic education programs for all nurses to help them maintain their mental health and good job performance while dealing with workplace violence.

The aim of this study is to assess the levels, relationships, and predictors of resilience and perceived stress among psychiatric nurses working in inpatient units. A descriptive, cross-sectional, predictive design was employed to collect data from 140 psychiatric nurses through a self-reported questionnaire. The questionnaire consisted of sociodemographic and work-related variables, Connor-Davidson Resilience Scale (CD-RISC-25), and perceived stress scale (PSS-10). The total mean score of the perceived stress was 22.73 (SD = 3.54) indicating a moderate level. The total mean score of the resilience was 49.49 (SD = 15.31) indicating a low level. Resilience correlated positively with educational level and job satisfaction; and negatively with intention to leave psychiatric settings. Significant differences were found in resilience with educational level, intention to leave psychiatric settings, and job satisfaction. Three independent variables predicted resilience: educational level, ward/unit, and job satisfaction; and only one variable (intention to leave psychiatric settings) predicted the perceived stress.

Interoceptive dysfunctions are increasingly implicated in a number of physical and mental health conditions. Accordingly, there is a pertinent need for therapeutic interventions which target interoceptive deficits. Heartrate and heartrate variability biofeedback therapy (HR(V)-BF), interventions which train individuals to regulate their cardiovascular signals and constrain these within optimal parameters through breathing, could enhance the functioning of interoceptive pathways via stimulation of the vagus nerve. Consequently, this narrative systematic review sought to synthesise the current state of the literature with regard to the potential of HR(V)-BF as an interoceptive intervention across behavioural, physiological and neural outcome measures related to interoception. In total, 77 papers were included in this review, with the majority using physiological outcome measures. Overall, findings were mixed with respect to improvements in the outcome measures after HR(V)-BF. However, trends suggested that effects on measures related to interoception were stronger when resonance frequency breathing and an intense treatment protocol were employed. Based on these findings, we propose a three-stage model by which HR(V)-BF may improve interoception which draws upon principles of interoceptive inference and predictive coding. Furthermore, we provide specific directions for future research, which will serve to advance the current knowledge state.

Stress management and biofeedback interventions have been shown to be effective in improving mental and physical health outcomes. However, previous research studies and synthesized models for applying these interventions in research utilization are insufficient.

This study aimed to synthesize a model for applying stress management and biofeedback interventions in research utilization.

A systematic review and meta-analysis were conducted according to the PRISMA guidelines.Multiple studies were used to assess the effectiveness of applying stress management and biofeedback interventions published from 2017 to 2023. The process included identifying the research questions, conducting a comprehensive literature search, assessing study quality, extracting data, synthesizing the data, analyzing and interpreting the findings, drawing conclusions, and making recommendations.

The results indicated a significant mean effect size without evidence of publication bias. The effect sizes of the subgroups among the study variables were not significantly different [Q = 4.02, p = .26]. However, there were significant differences regarding the mean effect sizes among the studies [Q = 63.59, p < .001] and also in terms of the test of subgroups among the participants [Q = 8.49, p = .04].

The results emphasize the importance of evidence-based practice and highlight the need for ongoing evaluation and refinement of interventions. The proposed model was supported by related theories and research studies in order to ensure the robustness and reliability to guide practice and future research in the field of biofeedback interventions. By following this model, researchers and practitioners can ensure that stress management and biofeedback interventions are evidence-based and are effective in improving mental and physical health outcomes.

Psychiatric nurses are at a higher risk for exposure to violence and aggression, leading to potential burnout, moral injury, post-traumatic stress, and turnover. There is little evidence of a preferred strategy to support nurses and decrease the impact of traumatic experiences on psychiatric nurses. The aim of this integrative review was to explore potential strategies to decrease the impact of traumatic experiences among nurses in psychiatric settings.

Following a systematic search of PsycINFO/Ovid, CINAHL, and MEDLINE/Pubmed, Joanna Briggs Institute quality appraisal tools were used to analyze quality of the articles. Thirteen articles met the inclusion/exclusion criteria for this study. Data were analyzed and synthesized into three key themes and seven sub-themes.

Three themes were noted to be common to the included texts. 1. Interpersonal Supports (Formal Support, Peer/Supervisor Support, and Informal Family/Social Support). 2. Organizational Supports (Perception of Job Safety/Satisfaction, Promoting Personal Resilience, Supporting Team Resilience, and Organizational Commitment to Resilience). 3. Protection of Personal Resources.

Many common suggestions for decreasing the impact of exposure to violence and trauma were noted across the thirteen articles, however, there is little evidence of a preferred strategy, how strategies are developed and employed or the efficacy of any particular strategy. Further investigation is needed to identify and evaluate supportive interventions, their feasibility and efficacy.

Nurses primarily focus on caring for others, but they also require care and support to enhance their own resilience. Thus, this study aims to determine the effects of psychological interventions on nurses' resilience support and to define the influence of moderating variables that can affect these effects. The literature search was conducted in 10 electronic databases, and 5 randomized controlled trials and 10 non-randomized controlled trials were finally selected for analysis (a total of 852 participants). Statistical analyses of the effect sizes and homogeneity of the intervention programs were conducted using RevMan 5.3 from the Cochrane Library and the R program. Publication bias in the retrieved studies was tested using contour-enhanced funnel plots. The meta-analysis found that psychological interventions were effective in improving nurses' resilience immediately after the intervention (SMD = 0.59, 95% CI 0.31 to 0.86, Z = 4.18, p < 0.001) and in the short term within three months (SMD = 1.52, 95% CI 0.74 to 2.31, Z = 3.80, p < 0.001). Interventions using emotion regulation, relaxation, and self-compassion were particularly effective, and the intervention period was effective in both a short period of 1 day and a long period of more than 12 weeks. In addition, the optimal one-session time was 121-150 min, and offline interventions were more effective than online interventions. Furthermore, the effect size was affected by the intervention time for one session (QB = 12.02, df = 3, p = 0.007) and the on/offline intervention method (QB = 5.85, df = 1, p = 0.015). These findings may inform the development of targeted interventions and resilience support systems for nurses. However, in the future, more rigorous studies, such as randomized controlled trials, should be conducted to ensure strict control over the variables and to establish a stronger evidence base for the effectiveness of these interventions.

to assess the effect of cardiovascular biofeedback on nursing staff stress when compared to an activity without self-monitoring.

a randomized controlled clinical trial, carried out with nursing professionals from a university hospital. The intervention group (n=58) performed cardiovascular biofeedback, and the control (n=57) performed an online puzzle without self-monitoring, totaling nine meetings over three weeks. The outcome was assessed using the Stress Symptoms and Work-Related Stress scales, and the biological marker heart rate variability. The generalized estimating equations method was used.

the intervention had no effect on self-reported instruments (p>0.050). However, there was an effect of time (p<0.050) on all heart rate variability indicators, demonstrating changes over the sessions.

cardiovascular biofeedback showed promising results in the biological marker, suggesting that it can be used in nursing staff as a complementary therapy by promoting better autonomic nervous system regulation.

The purpose of this study was to examine the perceived self-efficacy of the clinical nurse specialist working in the United States during the COVID-19 pandemic and explore whether there was any difference in self-efficacy based on practice focus (spheres of impact) and if differences existed between self-efficacy and demographics.

This study used a nonexperimental, correlational, cross-sectional design utilizing a voluntary, anonymous, 1-time survey administered through Qualtrics (Qualtrics, Provo, UT).

The National Association of Clinical Nurse Specialists and 9 state affiliates distributed the electronic survey starting late October 2021 through January 2022. Survey content consisted of demographics and the General Self-efficacy Scale, which measures the individual's perceived ability to cope and execute tasks when faced with hardship or adversity. Sample size was 105.

Results included a high perception of self-efficacy of the clinical nurse specialist working during the pandemic, no statistical significance in practice focus, and a statistically significant difference in the scores of self-efficacy for participants with previous infectious disease experience compared with those without experience.

Clinical nurse specialists with previous infectious disease experience can guide policy, be utilized in multifaceted roles to support future infectious disease outbreaks, and develop training to prepare and support clinicians during crises such as pandemics.

Workplace violence on health workers in the workplace causes physical and psychological problems. Negative impacts on victims of workplace violence such as physical problems, anxiety, depression, stress, and risk of death or risk of suicide. This problem needs to be addressed immediately so as not to impact post-traumatic stress disorder and reduce the work performance of health workers. The purpose of this study is to explore interventions to reduce the negative impact of workplace violence on health workers. This study used scoping review design with a descriptive approach to data analysis. The CINAHL, PubMed, and Scopus databases were used in this investigation. This study used PCC's framework (Population, Content, Context). The keywords are workplace violence, healthcare personnel, interventions, and programs were used by the authors. Search strategy used PRISMA Extension for Scoping Reviews. The sample are health workers, original research used a randomized control trial or quasi-experiment design, and the publication time had to be within the previous ten years (2014-2023). The JBI assessment was used to assess the quality of the article. We found 11 articles who discuss about interventions to reduce negative effects of workplace violence among health workers. This study shows that there is a decrease in psychological problems in victims of workplace violence such as anxiety, depression, and incidents of workplace violence. The range of sample in this study are 30-440 respondents. The authors discovered three different types of interventions: training programs, cognitive behavior therapy, and workplace violence programs. Interventions must focus on both the physical and psychological needs of the victims of workplace violence, psychiatric nurses and psychologists carried out interventions in a thorough manner. Interventions carried out by psychiatric nurses and psychologists can reduce the negative impact of workplace violence on health workers such as anxiety, depression and other psychological problems.

To examine the relationship between workplace violence (WPV) and professional identity among Chinese psychiatric nurses and the mediating effects of psychological capital (PsyCap) from this association.

Seven public tertiary psychiatric hospitals in Liaoning Province, China.

A total of 952 psychiatric nurses were recruited for this study. Registered nurses who have been engaged in psychiatric nursing for more than 1 year were eligible as participants in this investigation.

Questionnaires consisting of the Workplace Violence Scale, the Occupational Identity Scale, the Psychological Capital Questionnaire and a demographic data sheet were used to collect participant information. We used hierarchical multiple regression and asymptotic and resampling strategies to examine the mediating role of PsyCap in the relationship between WPV and professional identity.

WPV was negatively associated with professional identity after controlling for demographic factors (β=-0.353; p<0.001). PsyCap mediated the relationship between WPV and professional identity, according to the mediation analysis (a×b=-0.150, bias-corrected and accelerated 95% CI (BCa 95% CI) (-0.185 to -0.115); p<0.001). In addition, two dimensions of PsyCap: hope (a×b=-0.075, BCa 95% CI (-0.104 to -0.049); p<0.001) and resilience (a×b=-0.064, BCa 95% CI (-0.090 to -0.039); p<0.001) mediated the association between WPV and professional identity. For professional identity, hope, resilience and PsyCap mediation accounted for 21.6%, 18.1% and 42.4%, respectively.

Based on these findings, PsyCap could partially mediate the relationship between WPV and professional identity. Therefore, hospital administrators should implement measures to prevent and reduce WPV and provide nurses with skills training programmes to improve the PsyCap such as hope and resilience.

Mental health problems, including burnout among nurses, are common and important. With the rapid development of information and communication technologies and the rise in use of smartphones, the use of e-mental health strategies is increasing in public and clinical settings, and initial clinical trials using this intervention have been conducted. This systematic review evaluated whether e-healthcare interventions improve burnout and other mental health aspects in nurses.

Six electronic databases including MEDLINE (via PubMed), EMBASE (via Elsevier), the Cochrane Library Central Register of Controlled Trials, the Cumulative Index of Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and PsycARTICLES were searched to collect relevant randomized controlled trials up to January 28, 2021, using e-healthcare interventions for mental health in nurses. The e-healthcare intervention was classified as web-based, smartphone-based, and real-time online interventions. The primary outcome was burnout in this population. Due to the heterogeneity of the interventions used in the included studies, quantitative synthesis was not performed, but included studies were analyzed qualitatively. Also, the details of e-healthcare for the mental health of nurses were analyzed. The methodological quality of included studies was assessed using Cochrane's Risk of Bias tool.

Seven randomized controlled trials were included in this study. The 20-minute session of an online form of the emotional freedom technique was reported to significantly improve burnout severity compared to no intervention (P < .001). Other outcomes, such as career identity, quality of work life, workplace bullying, job stress, turnover intention, distress, anxiety, and resilience in nurses, were also reported to be improved by e-healthcare interventions. The methodological quality of the included studies was generally poor.

In conclusion, there was some evidence that e-healthcare interventions may improve mental health outcomes, including burnout in nurses, compared with no intervention. However, due to the poor methodological quality and wide heterogeneity of the interventions and outcomes in the included studies, we were not able to reach sufficiently reliable conclusions. E-healthcare intervention for nurses in the new coronavirus disease era was discussed. High-quality clinical trials in this area should be conducted in the future.

Workplace violence (WPV) against health-care professionals has been a concern worldwide as it strains the relationship between the patient and healthcare professionals. Implementing mitigation interventions to help the healthcare professionals to prevent and manage these violent episodes might make the workplaces more secure.

This study aimed to synthesize the recent evidence on intervention strategies for workplace violence.

Four electronic databases (PubMed, Wiley, Cochrane and Google Scholar) were searched for peer-reviewed intervention studies published in the last 11 years to mitigate workplace violence. A qualitative synthesis of the findings from included studies was done.

A total of 17 studies were identified based on prevention and management of workplace violence. The interventions were mainly educational in nature based on a workshop format. These interventions were found to be effective in improving the perceived ability to deal with situations that lead to violence.

Strategies to mitigate violent episodes could be helpful to health-care professionals and administrators in their attempts to make safer workplaces in the health-care settings.

Respiratory sinus arrhythmia (RSA) is a phenomenon in which the heart rate (HR) changes with respiration, increasing during inspiration and decreasing during expiration. RSA biofeedback training has an effect in relieving negative mental conditions, such as anxiety and stress. Respiration is an important indicator affecting the parasympathetic activation within the body during RSA biofeedback training. Although there are existing studies that consider individual differences when selecting optimized respiration using heart rate variability, the studies that use the high frequency components of HRV, which is an indicator of parasympathetic activation, are insufficient. For this reason, this paper proposes a process to identify optimized respiration for efficient RSA feedback, consisting of three steps: (1) application, (2) optimization, and (3) validation. In the application phase, we measured PPG data against various respiratory cycles based on the HF components of HRV and calculated the proposed heart stabilization indicator (HSI) from the data. Then, we determined the optimized respiration cycle based on the HSI in the optimization step. Finally, we analyzed seven stress-related indices against the optimized respiration cycle. The experimental results show that HSI is associated with the parasympathetic nervous system activation, and the proposed method could help to determine the optimal respiratory cycle for each individual. Lastly, we expect that the proposed design could be used as an alternative to improving the efficiency of RSA biofeedback training.

This study aimed to investigate whether the impact of workplace violence (WPV) on nurses' mental health varies with mental resilience and coping strategies.

Workplace violence is a serious threat to nurses' mental health, and its impact on nurses' mental health is influenced by many factors.

A cross-sectional study involving 349 participants was conducted over 12 months. The data were analyzed using SPSS 25.0 and SPSS PROCESS macro.

In total, 82.52% of nurses were exposed to WPV. WPV not only affects mental health directly but also indirectly through mental resilience. Coping strategies had a moderating effect among WPV, mental resilience and mental health. When nurses coped with psychological violence with intolerance, WPV had a stronger negative effect on their mental health. When nurses coped with psychological violence with tolerance but coped with physical violence with intolerance, mental resilience had a stronger positive effect on their mental health.

Good mental resilience and coping with psychological violence with tolerance while coping with physical violence with intolerance can help buffer WPV and promote mental health.

Employers who have a "zero tolerance" policy regarding WPV need to re-examine how they currently operate.

To scope the evidence on interventions used to help mental health nurses cope with stressful working environments.

Nursing managers may implement interventions to support mental health nurses cope in their role. However, the evidence supporting these interventions has not been recently reviewed.

A scoping review was conducted which entailed searching and selecting potential studies, undertaking data extraction and synthesis.

Eighteen studies published since 2000 were identified. They employed different designs, ten used quasi-experimental methods. Interventions involving active learning appeared beneficial, for example stress reduction courses and mindfulness. However, small sample sizes, short follow-up periods and variation in outcome measures make it difficult to identify the optimum interventions. No studies have considered cost-effectiveness.

There is some evidence that mental health nurses benefit from interventions to help them cope with stressful working environments. However, higher quality research is needed to establish the effectiveness and cost-effectiveness of different interventions.

Managers should provide opportunities and encourage mental health nurses to engage in active learning interventions, for example mindfulness to help them cope with stressful working environments. Nurses also want managers to address organisational issues; however, no research on these types of interventions was identified.

Background: Nurses are facing unprecedented amounts of pressure because of the ongoing global health challenges. Improving nurses' resilience to job-related stress and enhancing their strategies to cope effectively with stressors are key issues facing many health care institutions during the COVID-19 pandemic. This literature review aimed to: a) provide a thorough overview of individual-level interventions for stress management among nurses, b) identify measurement tools utilized to evaluate nurses' stress level, and c) provide the best evidence-based recommendations for future research and practice adapted to the current restrictions. Design: Systematic review. Data Sources: Studies published between January 2000 and October 2020 were retrieved from the following sources: EBSCOhost, Dortmund University Library, PubMed, Medline, Google Scholar, Applied Nursing Research, and reference lists from relevant articles. Review methods: Individual-level interventions with a control group or a placebo intervention were included in the final sample. Primary outcome was defined as a change in individual stress level or stress symptoms which were measured by objective or subjective instruments with evidence of validity. Articles published in English or German were included in the present review. Results: In total, 27 relevant studies were included into the current review. There are some indications that technology-delivered interventions with relaxation and stress management interventions comprising cognitive-behavioral components might be effective in decreasing stress among nurses and improving their well-being. Furthermore, although there were some attempts to collect objectively measured parameters for assessing the primary outcome of stress, the majority of the interventions utilized self-reported stress scales. Conclusion: A wide range of interventions are available for nurses. However, it is of utmost importance to develop and implement stress management programs that are conveniently accessible in the workplace and above all, meet the current restrictions for minimizing human contacts. To this end, innovative interventions delivered through digital technology, such as virtual reality, seem to be a promising solution for combating the detrimental impact of stress on nurses. Special attention should be also paid to applying standardized objective measurement tools to allow the assessment of sensitive physiological indices and the generalizability of scientific knowledge.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has created new and unpredictable challenges for healthcare systems. Healthcare professionals are heavily affected by this rapidly changing situation, especially frontline healthcare professionals who are directly engaged in the diagnosis, treatment, and care of patients with COVID-19 and may experience psychological burdens. The objective of this study is to explore the evolution of psychosocial, cardiovascular, and immune markers in healthcare professionals with different levels of exposure to the COVID-19 pandemic. Methods and Analysis: This is a STROBE compliant, blended, exploratory study involving online and onsite approaches that use wearable monitoring. A planned random probability sample of residents, staff physicians, nurses, and auxiliary healthcare professionals will be recruited. The study sample will be stratified by exposure to the COVID-19 pandemic. As a first step, recruitment will be conducted online, with e-consent and using e-surveys with Maslach Burnout Inventory, Fuster-BEWAT score, and sociodemographic characteristics. Onsite visits will be planned for the second step where participants will receive a wearable setup that will measure heart rate, actimetry, and sleep quality monitoring, which will be used together with blood sampling for immune biomarkers. Steps 1 and 2 will then be repeated at 2-3 months, and 6 months. Power BI and Tableau will be used for data visualization, while front-end data capture will be used for data collection using specific survey/questionnaires, which will enable data linkage between e-surveys, internet of things wearable devices, and clinical laboratory data. Clinical Trial Registration: ClinicalTrials.gov; Identifier: NCT04422418.