How the Lagged and Accumulated Effects of Stress, Coping and Task Affect Mood and Fatigue during Nurse’s Shifts

Nurses experience significant stress and emotional exhaustion, leading to burnout and fatigue. This study assessed how the nurses’ mood and fatigue evolves during their shifts, and the lagged and accumulated factors that influence these phenomena. A two-level design with repeated measures was applied to a sample of 113 nurses, performing an ecological momentary assessment of different parameters and multilevel longitudinal two-level modelling of the data. Accordingly, mood appeared to be explained by effort, by the negative lagged effect of reward and by accumulated effort, each following a quadratic trend, and it was influenced by previously executing a direct care task. By contrast, fatigue was explained by the current and lagged effect of effort, by the lagged effect of reward and by accumulated effort, again following quadratic trends. Fatigue was also associated with direct care, and the prior effect of documentation and communication tasks. Mood was also explained by problem-focused and emotion-focused coping strategies, indicative of negative mood, and by support-seeking and refusal coping strategies. Hence, mood and fatigue do not depend on a single factor like workload but rather, on the evolution and distribution of tasks, as well as on the stress during a shift and how it is handled.

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How the Lagged and Accumulated Effects of Stress, Coping, and Tasks Affect Mood and Fatigue during Nurses’ Shifts

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17197277 ◽

2020 ◽

Vol 17 (19) ◽

pp. 7277

Author(s):

Fermín Martínez-Zaragoza ◽

Jordi Fernández-Castro ◽

Gemma Benavides-Gil ◽

Rosa García-Sierra

Keyword(s):

Coping Strategies ◽

Repeated Measures ◽

Negative Mood ◽

Direct Care ◽

Negative Effects ◽

Control Effort ◽

Support Seeking ◽

Ecological Momentary ◽

Demand Control ◽

Lagged Effect

Nurses experience significant stress and emotional exhaustion, leading to burnout and fatigue. This study assessed how the nurses’ mood and fatigue evolves during their shifts, and the temporal factors that influence these phenomena. Performing a two-level design with repeated measures with moments nested into a person level, a random sample of 96 nurses was recruited. The ecological momentary assessment of demand, control, effort, reward, coping, and nursing tasks were measured in order to predict mood and fatigue, studying their current, lagged, and accumulated effects. The results show that: (1) Mood appeared to be explained by effort, by the negative lagged effect of reward, and by the accumulated effort, each following a quadratic trend, and it was influenced by previously executing a direct care task. By contrast, fatigue was explained by the current and lagged effect of effort, by the lagged effect of reward, and by the accumulated effort, again following quadratic trends. (2) Mood was also explained by problem-focused and emotion-focused coping strategies, indicative of negative mood, and by support-seeking and refusal coping strategies. (3) Fatigue was also associated with direct care and the prior effect of documentation and communication tasks. We can conclude that mood and fatigue do not depend on a single factor, such as workload, but rather on the evolution and distribution of the nursing tasks, as well as on the stress during a shift and how it is handled. The evening and night shifts seem to provoke more fatigue than the other work shifts when approaching the last third of the shift. These data show the need to plan the tasks within a shift to avoid unfinished or delayed care during the shift, and to minimize accumulated negative effects.

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The Impact of Coping Strategies on Situational Coping in Daily Life: An Ecological Momentary Assessment Study with the mHealth application TrackYourStress (Preprint)

10.2196/preprints.19382 ◽

2020 ◽

Author(s):

Teresa O'Rourke ◽

Carsten Vogel ◽

Dennis John ◽

Rüdiger Pryss ◽

Johannes Schobel ◽

...

Keyword(s):

Social Support ◽

Coping Strategies ◽

Daily Life ◽

Stress Coping ◽

Positive Thinking ◽

Active Stress ◽

Situational Coping ◽

Ecological Momentary ◽

The Impact ◽

Positive Effect

BACKGROUND It is necessary to cope with situations in daily life to prevent stress-related health consequences. However, coping strategies might differ in their impact on dealing with stressful situations in daily life. Moreover, the effect of coping strategies on situational coping might differ between women and men. OBJECTIVE The aim of this study was to investigate the impact of coping strategies on situational coping in everyday life situations and to investigate gender differences. METHODS An ecological momentary assessment study with the mobile health app TrackYourStress (TYS) was conducted with 113 participants. Coping strategies were measured at baseline with the coping scales Positive Thinking, Active Stress Coping, Social Support, Support in Faith, and Alcohol and Cigarette Consumption of the Stress and Coping Inventory (SCI). Situational coping was assessed by the question “How well can you cope with your momentary stress-level” (slider 0-100) in daily life over four weeks. Multilevel models were conducted to test the effects of the coping strategies on situational coping. Additionally, gender differences were evaluated. RESULTS Positive Thinking (P=.03) and Active Stress Coping (P=.04) had significant positive impacts on situational coping in the total sample. For women, only Social Support had a significant positive effect on situational coping (P=.046). For men, only Active Stress Coping had a significant positive effect on situational coping (P=.001). Women had higher scores on the SCI scale Social Support than men (P=.007). CONCLUSIONS These results suggest that different coping strategies could be more effective in daily life for women than for men, which should be considered in the development of interventions aimed at reducing stress consequences through coping. Interventions taking gender into consideration might lead to better coping-outcomes than generalized interventions.

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COPING WITH TEST SITUATIONS AND EXAM PERFORMANCE AMONG STUDENTS

TEME ◽

10.22190/teme190626075r ◽

2021 ◽

pp. 1245

Author(s):

Milica Ristić ◽

Blagica Zlatković

Keyword(s):

Coping Strategies ◽

Coping Strategy ◽

Test Performance ◽

Repeated Measures ◽

Negative Impact ◽

Main Idea ◽

Exam Performance ◽

Stress Coping ◽

Significant Difference ◽

Stress Coping Strategies

This study examined whether there were statistically significant differences in the level of expression of certain stress coping strategies during exam-taking among students. What was also tested was the correlation of coping strategies with the satisfaction with one’s performance on the written exam, and also whether certain exam coping strategies and satisfaction with one’s performance could be statistically significant predictors of the grade students obtained on the exam. The sample included 111 students (28 male and 83 female) attending the second year of the Pedagogical Faculty in Vranje. Before the written exam, the students completed the α scale from the KON6 test battery, which served as a measure of anxiety. The main idea in applying this scale was to assess whether students appraised the upcoming exam as a source of stress. Immediately after they finished the exam, they were given the Coping with test situation scale. In the end, the students were asked to rate how satisfied they were with their performance on the previously completed written exam. The results of ANOVA with repeated measures have shown that there was a statistically significant difference regarding the level of expression of certain stress coping strategies during the exam, where the most prominent was the problem-focused one. Satisfaction with one’s performance on exam was in the statistically significant negative correlation with emotion-focused and imagination/distraction coping strategies. Statistically significant predictors of students’ grades proved to be the satisfaction with their own test performance and imagination/distraction coping strategy. Although the results indicated that the problem-focused coping strategy is the most prominent one, the imagination/distraction coping strategy is the one that had the most influential negative impact on the exam performance.

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The Role of Sexual Abuse and Dysfunctional Attitudes in Perceived Stress and Negative Mood in Pregnant Adolescents: An Ecological Momentary Assessment Study

Journal of Pediatric and Adolescent Gynecology ◽

10.1016/j.jpag.2014.09.012 ◽

2015 ◽

Vol 28 (5) ◽

pp. 327-332 ◽

Cited By ~ 6

Author(s):

Kate Walsh ◽

Archana Basu ◽

Catherine Monk

Keyword(s):

Sexual Abuse ◽

Perceived Stress ◽

Ecological Momentary Assessment ◽

Negative Mood ◽

Dysfunctional Attitudes ◽

Pregnant Adolescents ◽

Assessment Study ◽

Ecological Momentary ◽

Momentary Assessment

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Affect in response to stressors and coping strategies: an ecological momentary assessment study of borderline personality disorder

Borderline Personality Disorder and Emotion Dysregulation ◽

10.1186/s40479-017-0059-3 ◽

2017 ◽

Vol 4 (1) ◽

Cited By ~ 6

Author(s):

Sadia R. Chaudhury ◽

Hanga Galfalvy ◽

Emily Biggs ◽

Tse-Hwei Choo ◽

J. John Mann ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Coping Strategies ◽

Ecological Momentary Assessment ◽

Borderline Personality ◽

Assessment Study ◽

And Coping ◽

Ecological Momentary ◽

Momentary Assessment

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Emotional intelligence intervention in older adults to improve adaptation and reduce negative mood

International Psychogeriatrics ◽

10.1017/s1041610220003579 ◽

2020 ◽

pp. 1-11

Author(s):

Iraida Delhom ◽

Encarnación Satorres ◽

Juan C. Meléndez

Keyword(s):

Older Adults ◽

Emotional Intelligence ◽

Treatment Group ◽

Coping Strategies ◽

Repeated Measures ◽

Strong Predictor ◽

Negative Mood ◽

Control Group ◽

Emotional States ◽

Before And After

Abstract Objectives: Emotional intelligence (EI) is a strong predictor of negative mood. Applying emotional skills correctly can help to increase positive emotional states and reduce negative ones. This study aims to implement EI intervention designed to improve clarity, repair EI dimensions and coping strategies, and reduce negative mood in older adults. Design: Participants were randomly assigned to the treatment or control group. Setting: Participants were evaluated individually before and after the intervention. Participants: Participants included 111 healthy older adults; 51 in the treatment group and 60 in the control group. Intervention: An EI program was implemented. The program was administered over 10 sessions lasting 90 min each. Measurements: EI dimension (attention, clarity, and repair), coping strategies, hopelessness, and mood were assessed. Results: Analysis of variance for repeated measures was applied. In the treatment group, scores on clarity and emotional repair increased and attention to emotions decreased; problem-focused coping (problem-solving, positive reappraisal, and seeking social support) showed significant increases, whereas emotion-focused coping (negative self-focused and overt emotional expression) obtained significant decreases; scores on negative mood measures declined significantly. Conclusions: An intervention based on EI is effective in older adults. After the EI intervention, the participants showed significant increases in their levels of clarity and emotional repair and intermediate levels of attention. In addition, the intervention was found to influence adaptation results, increasing the use of adaptive coping strategies and decreasing the use of maladaptive strategies, as well as reducing hopelessness and depressive symptoms.

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Application of an Ecological Momentary Assessment Protocol in a Workplace Intervention: Assessing Compliance, Criterion Validity, and Reactivity

Journal of Physical Activity and Health ◽

10.1123/jpah.2019-0152 ◽

2019 ◽

Vol 16 (11) ◽

pp. 985-992

Author(s):

Katie Weatherson ◽

Lira Yun ◽

Kelly Wunderlich ◽

Eli Puterman ◽

Guy Faulkner

Keyword(s):

Ecological Momentary Assessment ◽

Repeated Measures ◽

Criterion Validity ◽

Workplace Intervention ◽

Assessment Protocol ◽

Before And After ◽

Measured Position ◽

Objectively Measured ◽

Ecological Momentary ◽

Momentary Assessment

Background: Ecological momentary assessment (EMA) is a method of collecting behavioral data in real time. The purpose of this study was to examine EMA compliance, identify factors predicting compliance, assess criterion validity of, and reactivity to, using EMA in a workplace intervention study. Methods: Forty-five adults (91.1% female, 39.7 [9.6] y) were recruited for a workplace standing desk intervention. Participants received 5 surveys each day for 5 workdays via smartphone application. EMA items assessed current position (sitting/standing/stepping). EMA responses were time matched to objectively measured time in each position before and after each prompt. Multilevel logistic regression models estimated factors influencing EMA response. Cohen kappa measured interrater agreement between EMA-reported and device-measured position. Reactivity was assessed by comparing objectively measured sitting/standing/stepping in the 15 minutes before and after each EMA prompt using multilevel repeated-measures models. Results: Participants answered 81.4% of EMA prompts. Differences in compliance differed by position. There was substantial agreement between EMA-reported and device-measured position (κ = .713; P < .001). Following the EMA prompt, participants sat 0.87 minutes more than before the prompt (P < .01). Conclusion: The use of EMA is a valid assessment of position when used in an intervention to reduce occupational sitting and did not appear to disrupt sitting in favor of the targeted outcome.

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Assessing young adults’ ENDS use via Ecological Momentary Assessment and a Smart Bluetooth enabled ENDS device

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa205 ◽

2020 ◽

Author(s):

Zehan Li ◽

Carson Benowitz-Fredericks ◽

Pamela M Ling ◽

Joanna E Cohen ◽

Johannes Thrul

Keyword(s):

San Francisco ◽

Ecological Momentary Assessment ◽

Repeated Measures ◽

Sensitivity Analyses ◽

Smart Device ◽

Liquid Volume ◽

Daily Diaries ◽

Self Reports ◽

Ecological Momentary ◽

Momentary Assessment

Abstract Introduction The assessment of electronic nicotine delivery systems (ENDS) use poses unique challenges that go beyond established assessment methods for tobacco cigarettes. Recent studies have proposed using Ecological Momentary Assessment (EMA), a method to collect self-reported data on mobile devices, or data passively collected by “smart” Bluetooth enabled ENDS to assess use. The current study sought to compare ENDS use data using EMA and puff counts collected from a smart device. Methods We recruited 18 young adult ENDS users (age M=23.33; 44.4% female) from the San Francisco Bay Area. For a total of 30 days, participants completed daily diaries by EMA and used a second-generation smart Bluetooth enabled ENDS that collected puff data. Repeated measures correlations, multilevel regressions, and paired T-tests assessed concordance of EMA reports and ENDS data. A subset of 4 highly compliant participants were selected for sensitivity analyses. Results Among all 18 participants, completion of EMA daily diaries was high (77.4%). The ENDS device collected approximately twice as many puffs per day as participants reported. Compared to self-reported number of sessions and amount of e-liquid used, self-reported puff counts had the highest correlation with device collected puff counts (rrm = 0.49; p < .001). Correlations between self-reported and device collected puff counts improved among the subset of 4 highly compliant participants (rrm = 0.59; p < .001). Conclusion Self-reports potentially underestimate use of ENDS. Puff counts appear to be the best self-reported measure to assess ENDS use compared to number of sessions or liquid volume. Implications The comparison of EMA self-reports and passively collected ENDS device data can inform future efforts to assess ENDS use. Self-reported puff counts are preferable over number of sessions or amount of liquid used, but compared to objective usage data, self-reported puff counts may still underestimate actual use. ENDS use behavior is likely higher than users estimate and report. Future research on improved measures of ENDS use is needed.

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When and how do hospital nurses cope with daily stressors? A multilevel study

PLoS ONE ◽

10.1371/journal.pone.0240725 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0240725

Author(s):

Fermín Martínez-Zaragoza ◽

Gemma Benavides-Gil ◽

Tatiana Rovira ◽

Beatriz Martín-del-Río ◽

Silvia Edo ◽

...

Keyword(s):

Social Support ◽

Coping Strategies ◽

Repeated Measures ◽

Coping Style ◽

Coping Styles ◽

Direct Care ◽

University Hospitals ◽

Coping With Stress ◽

Control Effort ◽

Working Day

Background During their workday, nurses face a variety of stressors that are dealt with using different coping strategies. One criticism of the contextual models of work stress is that they fail to focus on individual responses like coping with stress. Neverthless, little is know about the momentary determinants of coping in nurses. Objectives To identify the momentary predictors of problem-focused approaching coping and emotion-focused approaching coping, as well as those for seeking social support and refusal coping strategies, during the working day in nurses. Design This study uses descriptive, correlational, two-level design with repeated measures. Settings Wards of two University hospitals. Participants A random cohort of 113 nurses was studied. Methods An ecological momentary assessment was made of demand, control, effort, reward, nursing task, coping, mood and fatigue, and of coping style by questionnaire. Multilevel two-level statistical analyses were performed in order to identify both within person and between person relationships. Results Different momentary types of coping were associated with different tasks. The problem-focused coping could be explained by the direct care and medication tasks, demand, planning coping style, mood, and negatively by acceptation coping style. Emotion-focused coping could be explained by documentation and medication tasks (negatively), mood, demand, distraction, and disengagement coping styles. Seeking social support coping could be explained by the task of communication, mood, fatigue (negatively), and seeking emotional support as a coping style. Refusal coping could be explained by mood, and the coping style of focusing and venting emotions. Refusal coping is not specific to any task. Conclusions The choice of the coping strategy depends on the task, of their appraisal and on the different styles of coping.

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