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British Journal of Healthcare and Medical Research - Vol. 9, No. 1
Publication Date: February, 25, 2022
DOI:10.14738/jbemi.91.11842. Ando, M., Kukihara, H., & Kurihara, H. (2022). Mental Health of Psychiatry Nurses Related with Fatigue, Resilience and Self- Compassion in COVID-19 Pandemic. British Journal of Healthcare and Medical Research, 9(1). 137-142.
Services for Science and Education – United Kingdom
Mental Health of Psychiatry Nurses Related with Fatigue,
Resilience and Self-Compassion in COVID-19 Pandemic
Michiyo Ando
Facalty of Nursing, Daiichi University of Pharmacy
Fukuoka, Japan
Hiroko Kukihara
School of Nursing, Faculty of Medicine, Fukuoka University
Fukuoka, Japan
Haruka Kurihara
Facalty of Nursing, Daiichi University of Pharmacy
Fukuoka, Japan
ABSTRACT
Patients and nurses experienced much stress because of infection prevention rule,
limitation of meeting families, or going out freely. Then the present study examined
1) the relationships among mental health, mental fatigue, physical fatigue, self- compassion, and resilience, 2) the relationships between mental fatigue and factors
of resilience or self-compassion, 3) the most effective factor on mental health of
psychiatry nurses in COVID-19 pandemic. Participants were 132 psychiatry nurses
at 4 hospitals in Western Japan. They completed questionnaires about mental
health by the General Health Questionnaire (GHQ), mental fatigue, physical fatigue,
self-compassion, and resilience. The ethical committee permitted this research.
Results showed the following. The GHQ related with mental fatigue (r=.70), physical
fatigue (r=.54), self-compassion (r= -.50), and Resilience (r= -.40). The GHQ related
with “Positivity in nursing (r=-.42)” in resilience factors: positivity in nursing,
interpersonal skill, having anchor in personal life, responsivity to novelty. Also the
GHQ related with “Over-identification (r=-.35) of self-compassion factors: self- compassion, self-judgment, common humanity, Isolation, mindfulness, and over- identification. From the multiple regression analysis, the mental fatigue was the
most effective factor on GHQ (β=.59). These results suggest that mental health
related with fatigue, resilience, and self-compassion. Nurses with positivity in
nursing and over-identification had high mental health. And mental fatigue was the
most effective factor on mental health of psychiatry nurses in COVID-19 pandemic.
The intervention to alleviate their mental fatigue will be required.
Keywords: mental health, psychiatry nurse, fatigue, resilience, self-compassion
INTRODUCTION
In 2021, we experience a prevalence of COVD-19 and many nurses worked very hard coping
with prevention. Frontline health care workers, including clinical nurse who work directly with
COVID-19 patients, are particularly vulnerable to developing mental and psychological issue
[1]. Labrague [2], or Usher et al. [3] showed higher prevalence rates of anxiety, emotional
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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 1, February - 2022
Services for Science and Education – United Kingdom
exhaustion, depression, mental disorder, and fatigue among nurses during the height of the
pandemic. Since nurses’ mental health affects quality of care for patients, it is very important.
Resilience is one of the factors to cope with stress. Cooper et al. [4] demonstrated that resilience
is defined as “a complex and dynamic process which when present and sustained enables
nurses to positively adapt to workplace stressors, avoid psychological harm and continue to
provide safe, high-quality patient care. Some previous studies showed the relationships
between resilience and mental health. Hen, et al. [5] showed that in China citizens with a higher
resilience level had a lower prevalence of generalized anxiety disorder, and resilience also
showed a mediating effect, with a negative influence on worry factors. Resilience of nurses in
Spain negatively correlated with the reported levels of perceived stress, anxiety and
depression, and resilience medicated the relationships between stress and mental health [6].
Moreover, self-compassion is another influential factor. Neff [7] showed that self-compassion
involves being open to and moved by one’s own suffering, experiencing feelings of caring and
kindness toward oneself, taking an understanding, nonjudgmental attitude toward one’s own
experience is part of the common human experience. Self-compassion entails three basic
components: 1) extending kindness and understanding to oneself rather than harsh self- criticism and judgment; 2) seeing one’s experiences as part of the larger human experience
rather than as separating and isolating; and 3) holding one’s painful thoughts and feelings in
balanced awareness rather than over-identifying with them. This self-compassion negatively
related with depression or anxiety, and positively related with satisfaction with life [8]. Self- compassion of nurses positively related with the professional quality of life [9] and negatively
with burnout [10]. And Kemper et al. [11] showed that self-compassion of medical staffs
positively related with and resilience or sleep disorder, and showed the negative relationships
between self-compassion and burnout. On the other hand, recently fatigue is focused as an
important factor to mental health. Pandemic fatigue (PF) is an emerging health concern among
individuals during the COVID-19. PF, which defined as physical and mental tiredness, may occur
during a pandemic as a consequence of the interpretations in the usual routines and activities
of an individual due to various measures implemented to decrease virus transmission by World
Health Organization [12]. As frontline health care workers, clinical nurses face tremendous
amount of stress due to several factors like long work shifts in PPE, constant changes protocols
and a lack of relevant experience caring for highly infectious patients [13]. These factors
increase nurses’ fatigue and lead to poor nursing care provision and poor patient out coms [14].
We need to examine relationships among mental health, fatigue, resilience, and self- compassion, and the most effective factors on mental health of nurses. Psychiatry nurses may
have much stress than other nurses because some of patients are hard to understand
importance of infection control by characteristic of illness. So the present study aimed to
examine relationships among mental health, fatigue, resilience, and self-compassion of
psychiatry nurses.
METHODS
Participants
Participants were 132 psychiatry nurses in 4 hospitals in Japan.
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Ando, M., Kukihara, H., & Kurihara, H. (2022). Mental Health of Psychiatry Nurses Related with Fatigue, Resilience and Self-Compassion in COVID- 19 Pandemic. British Journal of Healthcare and Medical Research, 9(1). 137-142.
URL: http://dx.doi.org/10.14738/jbemi.91.11842
Procedure
We used 4 kinds of questionnaires:
1) Japanese version General Health Questionnaire 12 (GHQ12) [15] which is translated
from Goldbberg.
2) Self-compassion scale [16], was consisted of 6 factors (self-kindness, self-judgement,
common humanity, isolation, mindfulness, over-identification).
3) The Resilience scale for nurse [17], was consisted of 4 factors (positivity in nursing,
interpersonal skill, having an anchor in personal life, responsivity to novelty).
4) The Self-diagnosis fatigue checklist [18], was consisted of 2 factors (mental fatigue,
physical fatigue).
The head nurse in a hospital introduced the research and pass the envelope including
questionnaires and explanation about the research. A nurse answered the questionnaire and
submitted it into a collection box voluntarily. We get informed consent when the nurse
submitted. After about 2 weeks, the head nurse mailed the envelope back to the researchers.
Data Analysis
We calculated basic statistic and mean score about each questionnaire. The correlation analysis
was conducted on each mean score. Next we conducted correlation between mental health and
each factor of resilience and self-compassion. Then we conducted a multiple regression
analysis, a dependent variable was mental health, and independent variables were fatigue,
resilience, and self-compassion.
RESULTS
The correlation scores were all significant (Table 1). The General Health Questionnaire (GHQ)
related with mental fatigue (r=.70), physical fatigue (r=.54), self-compassion (r=-.50), and
resilience (r=-.40). Also, physical fatigue related with mental fatigue(r=.78), resilience(r=-.35),
and self-compassion(r=-.27). Moreover, mental fatigue related with resilience (r=-.43) and self- compassion.
Table 1 Correlation coefficients among variables
GHQ physical fatigue mental fatigue resilience self -compassion
GHQ -
physical fatigue .54 ** -
mental fatigue .70 ** .78 ** -
resilience -.40 ** -.35** -.43 ** -
self-compassion -.50 ** -.27 ** -.34 ** .30 ** -
* * p<.01
Next, we investigated relationships between mental fatigue and factors of resilience and self- compassion (Table 2). Resilience included the 5 factors: (positivity in nursing, interpersonal
skill, having anchor in personal life, responsivity to novelty). The correlation scores “positivity
in nursing (r=-.42)” and “responsivity to novelty (r=-.34)” were high in Resilience. Self- compassion included the 6 factors (self-compassion, self-judgment, common humanity,
isolation, mindfulness, and over-identification). The correlation scores “over-identification (r=-
.35)” or “isolation (r=-.29) were high in self-compassion.