Mental Problems in Dutch Nurses Associated With COVID-19

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Table of Contents

Introduction
Statement of the Problem
Literature Review
Method
Result
Findings
Discussion
Conclusion
References

Introduction

The chosen topic is the study of how the existing difficulties in medical work associated with the pandemic affect the mental health of medical staff. Relevance to nursing is to consider the acute problem and offer various solutions that can contribute to improving the quality of nurses’ work. Regarding the Evidence Pyramid, my research is at the level of Randomized Controlled Studies. This suggests that the article under study can be used as a reference in my research since they are at the same level.

PICO(T) question: In nurses working with COVID-19 patients (P), does irregular sleep patterns (I) relative to regular sleep patterns (C) increase the risk of insomnia (O) during three months?

Statement of the Problem

The problem of the analyzed study is highlighted quite clearly and consists of studying the mental problems of intensive care unit nurses associated with the first COVID-19 surge. The significance of this study lies in the study of the problems experienced by nurses under stress and stressful working conditions during the pandemic. The researchers determine the importance of the study in that “efforts should be made to optimize working conditions and reduce workload to guarantee care in the continuation of the COVID-19 pandemic” (Heesakkers, 2021, p. 1). The study’s primary purpose is to identify patterns of mental problems associated with a stressful situation during COVID-19 in Dutch nurses. Researchers do not single out research questions; however, they define two main goals of their work:

“To measure the prevalence of symptoms of anxiety, depression and PTSD, and work fatigue after the first COVID-19 surge ” (Heesakkers, 2021, p. 2);
“to determine associated risk factors with these mental outcomes” (Heesakkers, 2021, p. 2).

Literature Review

The review uses the appropriate language and includes terms relevant to the topic and the means of logical composition. The review can be called objective since different perspectives are provided in it. However, the study has many outdated studies from 2005, 2006, and 2008. There are no studies from other disciplines in the literature review (Heesakkers, 2021, p. 2). In addition, essential trends and gaps are not noted; the researchers only enter specific data that will be necessary for further study of the problem. The authors insist that the problems of nursery practice, as stated in the work, require the investigation of different practical tools that are able to fix them (Heesakkers, 2021, p. 2). Moreover, the review is not objective enough since the facts are presented that confirm only the researchers’ point of view.

Method

Protection of Human Rights

An ethics review board did not externally review the study. In addition, the study was not thought out enough to minimize risks and maximize benefits to participants. In this case, this is manifested in the fact that the study participants took part in an anonymous online survey. Such an approach is not safe enough for the participants themselves, as there are risks of data leakage. The researchers attempted to organize informed consent to ensure the safety of the participants. However, there were no other procedures that would improve this aspect.

Research Design

This study used an anonymous survey as a qualitative research method. In this case, the research design is appropriate, as the main patterns of mental problems nurses face during the pandemic are determined. The design minimizes the threat to internal validity by using additional variables. Randomization is used as a tool for collecting data for samples. Control is used to avoid interference in the process of working with variables. Manipulation is processed to classify and summarize the data obtained. The latter includes using the Pearson correlation coefficient and the Variance Influence Factor (VIF). Multicollinearity was considered by removing variables with an R > 0.7 or a VIF > 3 from multivariate analyses, respectively (Heesakkers, 2021). All statistical tests are two-sided, and a P value of 0.05 is considered statistically significant (Heesakkers, 2021). IBM SPSS version 25 was used to analyze the data.

Population and Sample

In this study, a population was determined, which consists of 726 Dutch ICU nurses who faced the consequences of the pandemic on their mental state. The study participants were divided into categories according to their work experience, gender, age, and the number of shifts worked. All these criteria can be called eligible and relevant for the data-collecting process. To recruit participants, additional institutes and institutions were involved, which were provided with the necessary information (Heesakkers, 2021). The authors do not provide information on whether strategies were used to strengthen the recruitment. The main screening criteria used is the recognizability of the testing participants. The indicators chosen for this part of the study compose the sampling design that fits best to enhance the representatives (Heesakkers, 2021). The sample size was based on the power analysis method since it helped the research define the significance of the survey. Since the data was collected statistically, the research is free from bias. Consequently, due to this, various groups of nurses were represented.

The main characteristics of the sample are:

Size: 726 people;
Composition: mean age of 45 years, 73.8% was female and had an average work experience of 16.2 years, 586 people Worked more hours in total.

Thus, in this study, probability sampling was used, allowing random data demonstrating diversified indicators to be obtained. Randomization helps the researcher minimize the level of bias. However, it is worth noting that the researchers did not attempt to minimize sampling biases since they did not have a direct impact on the survey participants (Fleetwood, 2022). On the other hand, the sample size is adequate since the participants were selected from various medical institutions.

Data Collection Procedures and Measurement

In this study, the numerical variables indicating the responses in the survey were used. They include the number of non-ICU nurses and the number of ICU nurses. However, patient-centered outcomes were not measured; the researchers only focused on the ways of developing the quality of nursery practice. Key variables were analyzed using a suitable anonymous method. This is manifested in the fact that the indicators correspond to closed questions, which allows researchers to interpret the data correctly (Polit & Beck, 2021). IBM SPSS version 25 was used to interpret the data in this case. It is one of the most effective programs to work with data of this type (Polit & Beck, 2021). The researchers demonstrated how the data were measured and presented critical criteria for their screening “excluding variables with a R > 0.7 or VIF > 3″ (Heesakkers, 2021, p. 2).

However, the information about the tools was not appropriately pretested. There was not a justifiable rationale for the usage of specific tools. In addition, there is no information about the training of data collectors. Accordingly, there is no information about people who took an outside part in deciphering the information received, except researchers. The collectors were blinded to the study hypothesis, anyway the author does not describe who the former is and how they were chosen. The authors claim that there was no intervention within the testing. The data collection took place in an institution room, and further information about the setting was not presented.

Result

Data Analysis

For analysis, only fully completed questionnaires were utilized as a part of the pathos of collecting empirical data. Descriptive data are displayed as mean median or number and percentage for categorical variables for continuous variables. The nonparametric Wilcoxon test was used to determine whether differences in NRS stress scores, which are not normally distributed, existed. The dependent dichotomized symptoms of anxiety, depression, PTSD, and a positive NFR were examined using logistic regression analysis to identify relationships between independent risk variables and the dependent symptoms. However, the level of measurement of the variables and assumptions of the test were not mentioned. There were 2 groups being compared within the practical part of the research. The analysis was aimed at providing an answer to the two research questions posed. The main patterns of mental problems in nurses were identified through data analysis. A robust statistical analysis method was used, as it controlled confounding variables.

Findings

The findings correspond to the goals set, as they confirm the level of the problem existing in the nursery field. All the information received about the study results was adequately presented in a table that reflects the indicators for different categories of survey participants. Anxiety, sadness, and PTSD symptoms were seen at prevalence rates of 27.0%, 18.6%, and 22.2%, respectively (Heesakkers, 2021). The findings correspond to the goals set, as they confirm the level of the problem existing in the nursery field. All the information received about the study results was adequately presented in a table. Findings were reported in a manner that facilitates sufficient information needed for EBP. This is manifested in the fact that all the data is presented in an accessible form that can be verified for reliability. The authors claim that the statistical data is significant as it includes all the required criteria to analyze the problem holistically. However, there is a lack of information about the effect size and precision of estimates.

Discussion

Interpretation of the Findings

The results of the study reflected the fact that on their basis, recommendations are given that are aimed at transforming the activities of nurses in accordance with their needs to reduce stress. Accordingly, these key results and findings of the study are related to the original purpose and the findings of the background researchers. This is manifested in the fact that they pay attention to the problem that employees’ conditions should be monitored to optimize the workflow and conditions (Bloomfield & Fisher, 2019).

The prerequisites for this idea were presented in some of the background studies. However, they insisted that such indicators can be applicable to different countries and medical institutions, as it depends on the different impacts of the pandemic. The generalization is possible since the variables studies are universal for the conditions of different countries. Thus, the conclusion about the generalizability is justified by the universality of the variables. The scientists noted that the main weakness is the inability to transfer the results relative to the global situation, this can cause bias and decrease the level of credibility. The universality of the acquired data is one of the main strengths of the study.

Implication and Recommendations

The researchers demonstrate that the implications presented by them correspond to the fact that it is necessary to introduce several changes regarding the specifics of the work of ICU nurses. The problems discussed in the study contribute to the increase of the general concern about the psychological health of personnel. The scientists suggest that the results of the study indicate a significant increase in mental problems among employees, as they face stressful situations and significant overwork. In practice, the programs of mental support for staff and clients should be introduced. Moreover, the authors claim administrations can introduce different state testing in the working process. Thus, the main task of further research for them is to study possible ways to support nurses in the organization of mental distress.

The stated implications are appropriate relative to the study’s limitations and the magnitude of the effects. This is due to the fact that the results of the study show a significant increase in indicators, which may indicate that the problem is acute. Even though this study applies only to one country, it allows the authors to draw the attention of other researchers to this problem. In addition, there are no important implications in this study that the report neglected to include.

Conclusion

It should be noted that in the article “The impact of the first COVID-19 surge on the mental well-being of ICU nurses” the researchers omitted several aspects that significantly affect the importance and necessity of the obtained research results. The report inspires confidence through the use of information applicable to a specific area of medical knowledge. The results of this study can be applied to my EBP project and to my patient population. This is because of the basic information needed to create a pre-project study. The information that was studied during the evaluation of this study can become a relevant theoretical background for my further research experience since the authors provide a lot of reliable statistics. The latter can be taken to describe the scale of the existing nursery problems. Moreover, the evaluation of the article helps me to avoid the mistakes and shortcomings found in the research in my scientific work. Errors associated with the study’s limitations regarding only one category of medical staff will be taken into account.

References

Bloomfield, J., & Fisher, M. J. (2019). Quantitative research design. Journal of the Australasian Rehabilitation Nurses Association, 22(2), 27–30. Web.

Fleetwood, D. (2022). Types of sampling: sampling methods with examples. QuestionPro. Web.

Heesakkers, H., Zegers, M., van Mol, M., & van den Boogaard, M. (2021). The impact of the first COVID-19 surge on the mental well-being of ICU nurses: A nationwide survey study. Intensive & Critical Care Nursing, 65, 103034. Web.

Polit, D. F., & Beck, C. T. (2022). Nursing research generating and assessing evidence for nursing practice (11th ed.). Lippincott Williams and Williams.

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