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  1. Ramoo V, Abdullah KL, Piaw CY
    J Clin Nurs, 2013 Nov;22(21-22):3141-52.
    PMID: 24118518 DOI: 10.1111/jocn.12260
    AIMS AND OBJECTIVES: To assess Malaysian nurses' perceived job satisfaction and to determine whether any association exists between job satisfaction and intention to leave current employment.
    BACKGROUND: There is currently a shortage of qualified nurses, and healthcare organisations often face challenges in retaining trained nurses. Job satisfaction has been identified as a factor that influences nurse turnover. However, this has not been widely explored in Malaysia.
    DESIGN: Cross-sectional survey.
    METHODS: Registered nurses in a teaching hospital in Malaysia completed a self-administered questionnaire. Of the 150 questionnaires distributed, 141 were returned (response rate = 94%).
    RESULTS: Overall, nurses had a moderate level of job satisfaction, with higher satisfaction for motivational factors. Significant effects were observed between job satisfaction and demographic variables. About 40% of the nurses intended to leave their current employment. Furthermore, age, work experience and nursing education had significant associations with intention to leave. Logistic regression analysis revealed that job satisfaction was a significant and independent predictor of nurses' intention to leave after controlling for demographic variables.
    CONCLUSION: The results suggest that there is a significant association between job satisfaction and nurses' intention to leave their current employment. It adds to the existing literature on the relationship between nurses' job satisfaction and intention to leave.
    RELEVANCE TO CLINICAL PRACTICE: Methods for enhancing nurses' job satisfaction are vital to promote the long-term retention of nurses within organisations. Attention must be paid to the needs of younger nurses, as they represent the majority of the nursing workforce and often have lower satisfaction and greater intention to leave than older nurses do. Strategies to nurture younger nurses, such as providing opportunities for further education, greater management decision-making capabilities and flexible working environment, are essential.
    KEYWORDS: Malaysian nurses; intention to leave; job satisfaction; nursing; teaching hospital; turnover
  2. Nahasaram ST, Ramoo V, Lee WL
    J Nurs Manag, 2021 Sep;29(6):1848-1856.
    PMID: 33544403 DOI: 10.1111/jonm.13281
    AIM: To determine the occurrence, factors and outcome of missed nursing care from the perspective of Malaysian nurses.

    BACKGROUND: Missed nursing care is an important issue in the global health care sector. However, little is known on the extent of missed nursing care in the Malaysian context and its contributing factors.

    METHODS: A cross-sectional design was adopted for data collection using the MISSCARE Survey instrument. Participants comprised 364 nurses from medical and surgical wards of a large teaching hospital. Data were analysed using descriptive, binomial logistic and hierarchical regression analyses.

    RESULTS: The overall occurrence of missed nursing care was 1.88 (on a scale of 1.00-5.00), which differed across 24 nursing care elements. Basic nursing care and communication-related care were the most frequently missed elements. Types of ward and labour resources were identified as contributing factors to missed nursing care (p  .05).

    CONCLUSION: The occurrence of missed nursing care was noted to be low.

    IMPLICATIONS FOR NURSING MANAGEMENT: Practical strategies such as an acuity-based staffing system, close monitoring of rendered care and strengthening of teamwork are recommended to minimize missed nursing care.

  3. Lee BO, Yao CT, Ramoo V
    J Appl Gerontol, 2023 May;42(5):842-851.
    PMID: 36437798 DOI: 10.1177/07334648221141408
    This study examined the effects of life review therapy on the life satisfaction levels of older adults in day care centers in Taiwan. A quasi-experimental design was adopted. A total of 88 adults aged 65 and older were recruited from day care centers through convenience sampling and assigned to two groups based on their level of life satisfaction on Life Satisfaction Index A. The intervention groups participated in a life review therapy for eight weeks in addition to their daily activities. Data were collected at the baseline point and immediately after post-intervention. Generalized estimating equations were used to examine the effect of the intervention on the outcomes. At week eight, the intervention group showed a significantly higher level of life satisfaction than the comparison group. These findings suggest that life review programs may improve general life satisfaction among older adults.
  4. Yudianto K, Sekawarna N, Susilaningsih FS, Ramoo V, Somantri I
    Healthcare (Basel), 2023 Feb 04;11(4).
    PMID: 36832987 DOI: 10.3390/healthcare11040454
    The high number of nursing staff in Indonesia requires optimal management skills, one of which comes from the leadership domain. The succession planning program can be an option to prepare nurses who have leadership potential to carry out a management function. This study aims to identify the nurse succession planning model and its application in clinical practice. This study uses a narrative review of the literature approach. Article searches were carried out using electronic databases (PubMed and Science Direct). Researchers obtained 18 articles. Three main themes emerged: (1) the factors that influence the efficient implementation of succession planning, (2) the benefits of succession planning, and (3) the implementation of succession planning in clinical practice. Training and mentoring related to leadership, support from human resources, and adequate funding are the main factors in implementing effective succession planning. Succession planning also can help nurses find competent leaders. However, in its application in clinical practice, the process of recruitment and planning for nurse managers that occurs in the field is not optimal so that succession planning must exist and be integrated with organizational needs and provide guidance and assistance for the younger generation who will become leaders in the future.
  5. Lee WL, Ramanathan S, Danaee M, Zaini NH, Ramoo V
    Orthop Nurs, 2023 11 22;42(6):354-362.
    PMID: 37989155 DOI: 10.1097/NOR.0000000000000985
    The benefits of isometric strengthening exercises (ISEs) are compromised when patient teaching on ISEs is delayed and/or ineffectively delivered due to healthcare resources constraint, especially when health resources are stretched, as occurred during the COVID-19 pandemic. This study aims to examine the effect of a video-assisted ISE program on pain and muscle strength of patients following surgical stabilization of lower limb fracture. A quasi-experimental study with repeated measures was employed. Primary study outcomes were assessed using the Brief Pain Inventory and Manual Muscle Test. Effects over time were analyzed using generalized estimating equations. In comparison with usual care group (n = 32), the intervention group (n = 33) showed better pain reduction over time (p < .001, effect size [ES] = 0.39-1.77) and muscle strength preservation (p < .05; ES = 0.8-0.9). Patient acceptance of the intervention was favorable. Integration of video clips into patient teaching on ISEs is potentially beneficial in managing pain and muscle strength; it can be easily deployed to aid early ISE initiation.
  6. Lyu FF, Ramoo V, Chui PL, Ng CG
    Clin Nurs Res, 2024 Jan;33(1):40-50.
    PMID: 37970808 DOI: 10.1177/10547738231198561
    Exercise is significantly beneficial for patients with osteoporosis. However, physiological and psychological factors such as pain and kinesiophobia prevent patients from participating in exercise. Therefore, it is important to understand how these patients perceive participation in exercise. This qualitative study was conducted in China using conventional content analysis. Using a purposeful sampling method, 17 patients with primary osteoporosis were recruited. Data were collected through a semi-structured interview and managed using ATLAS.ti 21. Nine generic categories were developed from 26 subcategories and two main categories were identified: Barriers and facilitators, support systems, network resources, positive emotions, and reactions were the facilitators for exercise in this study. In addition, mindful exercise was positively viewed by the patients. Inefficient awareness, weak support systems, and burdens were identified as barriers. To improve compliance in clinical practice, targeted exercise protocols should be developed for patients based on these perceptions.
  7. Ramoo V, Abdullah KL, Tan PS, Wong LP, Chua PY
    Nurs Crit Care, 2016 Sep;21(5):287-94.
    PMID: 25271143 DOI: 10.1111/nicc.12105
    BACKGROUND: Sedation management is an integral component of critical care practice. It requires the greatest attention of critical care practitioners because it carries significant risks to patients. Therefore, it is imperative that nurses are aware of potential adverse consequences of sedation therapy and current sedation practice recommendations.

    AIMS AND OBJECTIVES: To evaluate the impact of an educational intervention on nurses' knowledge of sedation assessment and management.

    DESIGNS AND METHODS: A quasi-experimental design with a pre- and post-test method was used. The educational intervention included theoretical sessions on assessing and managing sedation and hands-on sedation assessment practice using the Richmond Agitation Sedation Scale. Its effect was measured using self-administered questionnaire, completed at the baseline level and 3 months following the intervention.

    RESULTS: Participants were 68 registered nurses from an intensive care unit of a teaching hospital in Malaysia. Significant increases in overall mean knowledge scores were observed from pre- to post-intervention phases (mean of 79·00 versus 102·00, p < 0·001). Nurses with fewer than 5 years of work experience, less than 26 years old, and with a only basic nursing education had significantly greater level of knowledge improvement at the post-intervention phase compared to other colleagues, with mean differences of 24·64 (p = 0·001), 23·81 (p = 0·027) and 27·25 (p = 0·0001), respectively. A repeated-measures analysis of variance revealed a statistically significant effect of educational intervention on knowledge score after controlling for age, years of work and level of nursing education (p = 0·0001, ηp (2) = 0·431).

    CONCLUSION: An educational intervention consisting of theoretical sessions and hands-on sedation assessment practice was found effective in improving nurses' knowledge and understanding of sedation management.

    RELEVANCE TO CLINICAL PRACTICE: This study highlighted the importance of continuing education to increase nurses' understanding of intensive care practices, which is vital for improving the quality of patient care.

  8. Ramoo V, Abdullah KL, Tan PS, Wong LP, Chua YP, Tang LY
    Nurs Crit Care, 2017 May;22(3):141-149.
    PMID: 25913373 DOI: 10.1111/nicc.12180
    BACKGROUND: Inappropriate sedation assessment can jeopardize patient comfort and safety. Therefore, nurses' abilities in assessing and managing sedation are vital for effective care of mechanically ventilated patients.

    AIMS AND OBJECTIVES: This study assessed nurses' sedation scoring and management abilities as primary outcomes following educational interventions. Nurses' perceived self-confidence and barriers to effective sedation management were assessed as secondary outcomes.

    DESIGN: A post-test-only quasi-experimental design was used. Data were collected at 3 and 9 months post-intervention.

    METHODS: A total of 66 nurses from a 14-bed intensive care unit of a Malaysian teaching hospital participated. The educational interventions included theoretical sessions, hands-on sedation assessment practice using the Richmond Agitation Sedation Scale, and a brief sedation assessment tool. Nurses' sedation scoring and management abilities and perceived self-confidence level were assessed at both time points using self-administered questionnaires with case scenarios. Sedation assessment and management barriers were assessed once at 9 months post-intervention.

    RESULTS: Median scores for overall accurate sedation scoring (9 months: 4·00; 3 months: 2·00, p = 0·0001) and overall sedation management (9 months: 14·0; 3 months: 7·0, p = 0·0001) were significantly higher at 9 months compared to 3 months post-intervention. There were no significant differences in the perceived self-confidence level for rating sedation level. Overall perceived barrier scores were low (M = 27·78, SD = 6·26, possible range = 11·0-55·0). Patient conditions (M = 3·68, SD = 1·13) and nurses' workload (M = 3·54, SD = 0·95) were the greatest barriers to effective sedation assessment and management. Demographic variables did not affect sedation scoring or management abilities.

    CONCLUSIONS: Positive changes in nurses' sedation assessment and management abilities were observed, indicating that adequate hands-on clinical practice following educational interventions can improve nurses' knowledge and skills.

    RELEVANCE TO CLINICAL PRACTICE: Educational initiatives are necessary to improve ICU practice, particularly in ICUs with inexperienced nurses.

  9. Ramoo V, Abu H, Rai V, Surat Singh SK, Baharudin AA, Danaee M, et al.
    J Clin Nurs, 2018 Nov;27(21-22):4028-4039.
    PMID: 29775510 DOI: 10.1111/jocn.14525
    AIMS AND OBJECTIVES: To assess intensive care unit nurses' knowledge of intensive care unit delirium and delirium assessment before and after an educational intervention. In addition, nurses' perception on the usefulness of a delirium assessment tool and barriers against delirium assessment were assessed as secondary objectives.

    BACKGROUND: Early identification of delirium in intensive care units is crucial for patient care. Hence, nurses require adequate knowledge to enable appropriate evaluation of delirium using standardised practice and assessment tools.

    DESIGN: This study, performed in Malaysia, used a single-group pretest-posttest study design to assess the effect of educational interventions and hands-on practices on nurses' knowledge of intensive care unit delirium and delirium assessment.

    METHODS: Sixty-one nurses participated in educational intervention sessions, including classroom learning, demonstrations and hands-on practices on the Confusion Assessment Method-Intensive Care Unit. Data were collected using self-administered questionnaires for the pre- and postintervention assessments. Analysis to determine the effect of the educational intervention consisted of the repeated-measures analysis of covariance.

    RESULTS: There were significant differences in the knowledge scores pre- and postintervention, after controlling for demographic characteristics. The two most common perceived barriers to the adoption of the intensive care unit delirium assessment tool were "physicians did not use nurses' delirium assessment in decision-making" and "difficult to interpret delirium in intubated patients".

    CONCLUSIONS: Educational intervention and hands-on practices increased nurses' knowledge of delirium assessment. Teaching and interprofessional involvements are essential for a successful implementation of intensive care unit delirium assessment practice.

    RELEVANCE TO CLINICAL PRACTICE: This study supports existing evidences, indicating that education and training could increase nurses' knowledge of delirium and delirium assessment. Improving nurses' knowledge could potentially lead to better delirium management practice and improve ICU patient care. Thus, continuous efforts to improve and sustain nurses' knowledge become relevant in ICU settings.

  10. Chong LT, Chong MC, Tang LY, Ramoo V, Chui PL, Hmwe NTT
    J Pediatr Nurs, 2019 06 15;48:e15-e20.
    PMID: 31213340 DOI: 10.1016/j.pedn.2019.05.016
    STUDY PURPOSE: This study was conducted to examine the relationship between religious practice, religious coping methods and psychological distress among parents caring for children with transfusion-dependent thalassemia.

    DESIGN AND METHODS: This is a cross-sectional survey. Data were collected on 162 parents of children diagnosed with thalassemia aged 12 years and younger in thalassemia day care centers of three public hospitals in Sabah, Malaysia. Data were collected using questionnaires, including General Health Questionaire-12 (GHQ-12), Duke University Religion Index (DUREL) and Brief RCOPE.

    RESULTS: Forty-two percent of parents had psychological distress with GHQ score ≥ 3 (mean score of 2.85 ± 3.17). Ninety-five percent of parents used positive religious coping methods (mean P-COPE score 22.35 ± 2.33) more than negative religious coping methods (mean N-COPE score was 12.19 ± 5.23). They used Organized Religious Activities (mean ORA score of 4.20 ± 1.27), and Non-Organized Religious Activities (NORA, the mean was 4.17 ± 1.37). Positive and negative religious coping methods were significantly related to parents' psychological distress (P-COPE and GHQ-12 scores (rs (df) = 0.19, p 

  11. Setiawan HW, Pratiwi IN, Nimah L, Pawanis Z, Bakhtiar A, Fauzinigtyas R, et al.
    Inquiry, 2021 12 10;58:469580211060291.
    PMID: 34879719 DOI: 10.1177/00469580211060291
    COVID-19 pandemic raises various challenges faced by health workers in hospitals. This study explored strategies for overcoming challenges in caring for COVID-19 patients at hospitals in Indonesia based on healthcare workers' experience. In-depth interviews were employed with 28 healthcare workers (physicians and nurses) who were purposively sampled. Data were collected via phone and analysed using the Colaizzi method. Five following challenges were found: difficulties in working with personal protective equipment (PPE), offline training for handling Covid and using PPE not being implemented evenly for all health workers, physical and psychological fatigue, difficulties in carrying out health education and assessment towards patients and families, and limited resources to cope with the COVID-19 pandemic. Meanwhile, some barriers require support from the government, public and hospital managers. The information gained from research on the strategies for caring for COVID-19 patients can contribute to better preparedness for hospitals and health workers facing the COVID-19 pandemic.
  12. Mong I, Ramoo V, Ponnampalavanar S, Chong MC, Wan Nawawi WNF
    J Clin Nurs, 2022 Jan;31(1-2):209-219.
    PMID: 34105196 DOI: 10.1111/jocn.15899
    BACKGROUND: Healthcare-associated infection (HAI) is one of the major threats to patients' safety besides being among the principal causes of patient morbidity and mortality. Catheter-associated urinary tract infection (CAUTI) is reported to be the most common HAI worldwide. CAUTI can be prevented with appropriate practice and care by healthcare personnel, especially nurses, who play the main role in urinary catheter care. Nurses' knowledge and attitude are considered to be important factors that influence their practice.

    OBJECTIVES: To assess nurses' level of knowledge, attitude and perceived practice regarding CAUTI and its preventive measures.

    METHODS: A cross-sectional design was adopted, and a self-administered questionnaire was used to collect data. Nurses from the medical and surgical inpatient wards of a tertiary teaching hospital in Malaysia were recruited in two stages using the stratified and simple random sampling methods. A total of 301 nurses participated. Descriptive analysis, an independent t test, ANOVA and hierarchical multiple regression were employed to analyse the data using SPSS software version 25. In addition, a STROBE checklist was used to report the results of this study.

    RESULTS: Nurses were found to have good knowledge, a positive attitude and good perceived practice regarding CAUTI prevention. Nurses aged above 30 and who had more than ten years of experience reported higher knowledge levels. Knowledge was found to be positively correlated with attitude and perceived practice; however, attitude explained a higher variance in perceived practice of CAUTI prevention compared with knowledge.

    CONCLUSION: Attitude was found to have a higher significant influence on perceived practice in this study. Educators need to emphasise the inculcation of a positive attitude among nurses rather than just knowledge for CAUTI prevention. Since this study assessed perceived practice, examining nurses' actual practice and its impact on patient outcomes is recommended in future studies.

  13. Ying LY, Ramoo V, Ling LW, Nahasaram ST, Lei CP, Leong LK, et al.
    Nurs Crit Care, 2021 11;26(6):432-440.
    PMID: 32929840 DOI: 10.1111/nicc.12551
    BACKGROUND: Retaining experienced critical care nurses (CCNs) remains a challenge for health care organizations. Nursing practice environment and resilience are both seen as modifiable factors in ameliorating the impact on CCNs' intention to leave and have not yet been explored in Malaysia.

    AIMS AND OBJECTIVES: To assess the association between perceived nursing practice environment, resilience, and intention to leave among CCNs and to determine the effect of resilience on intention to leave after controlling for other independent variables.

    DESIGN: This was a cross-sectional survey.

    METHODS: The universal sampling method was used to recruit nurses from adult and paediatric (including neonatal) critical care units of a large public university hospital in Malaysia. Descriptive analysis and χ2 and hierarchical logistic regression tests were used to analyse the data.

    RESULTS: A total of 229 CCNs completed the self-administrated questionnaire. Of the nurses, 76.4% perceived their practice environment as being favourable, 54.1% were moderately resilient, and only 20% were intending to leave. The logistic regression model explained 13.1% of variance in intention to leave and suggested that being single, an unfavourable practice environment, and increasing resilience were significant predictors of nurses' intention to leave.

    CONCLUSION: This study found that an unfavourable practice environment is a strong predictor of intention to leave; however, further exploration is needed to explain the higher likelihood of expressing intention to leave among CCNs when their resilience level increases.

    RELEVANCE TO CLINICAL PRACTICE: Looking into staff allocation and equality of workload assignments may improve the perception of the work environment and help minimize intention to leave among nurses.

  14. Murugiah UR, Ramoo V, Jamaluddin MFH, Yahya A, Baharudin AA, Abu H, et al.
    Nurs Crit Care, 2021 09;26(5):363-371.
    PMID: 33569880 DOI: 10.1111/nicc.12600
    BACKGROUND: Nurses play a key role in the proper management of endotracheal tube (ETT) cuff pressure, which is important for patients' safety, so it is vital to improve nurses' knowledge on safe cuff management practices.

    AIMS AND OBJECTIVES: This study aimed to evaluate the effectiveness of an educational intervention related to ETT cuff pressure management on improving and retaining critical care nurses' knowledge.

    DESIGN: A single group pre-post interventional study was conducted involving 112 registered nurses (RNs) from a 24-bed adult general intensive care unit at a teaching hospital in Malaysia.

    METHODS: The educational intervention included a theoretical session on endotracheal cuff pressure management and demonstration plus hands-on practice with the conventional cuff pressure monitoring method. Nurses' knowledge was measured using a self-administered questionnaire pre- and post-intervention. Data were analysed using repeated measure analysis of variance and bivariate analysis.

    RESULTS: In this study, 92% of the total number of RNs in the unit participated. A significant difference in mean knowledge score was noted between the pre- (mean = 8.13; SD = 1.53) and post-intervention phases (3 months [mean = 8.97; SD = 1.57) and 9 months post-intervention [mean = 10.34; SD = 1.08), P 

  15. Abu Dalal HJ, Ramoo V, Chong MC, Danaee M, Aljeesh YI
    J Nurs Manag, 2022 Jan;30(1):214-225.
    PMID: 34590378 DOI: 10.1111/jonm.13476
    AIM: To assess the impact of organisational communication satisfaction (OCS) on the work engagement of health care professionals (HCPs).

    BACKGROUND: Organisational communication can influence employees' work engagement, which is an essential component of an organisation's effectiveness. However, these concepts have not been broadly investigated in health care organisations.

    METHODS: A cross-sectional survey was administered to 235 HCPs in the Gaza Strip, Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data.

    RESULTS: The HCPs reported a moderate level of OCS (M = 4.96, SD = 0.94) and work engagement (M = 5.56, SD = 0.96). The impact of OCS on work engagement was found to be positive and statistically significant (β = .524, p 

  16. Dalal HJA, Ramoo V, Chong MC, Danaee M, Aljeesh YI, Rajeswaran VU
    Healthcare (Basel), 2023 Mar 09;11(6).
    PMID: 36981463 DOI: 10.3390/healthcare11060806
    The factors that influence the organizational commitment of healthcare professionals, particularly organizational communication and work satisfaction, are essential for all healthcare organizations. This is particularly important for those who are under the pressure of high demand, economic constraints, and staff shortages. This study examined the relationship between organizational communication satisfaction and organizational commitment among healthcare professionals and the mediating role of work satisfaction in the relationship. A validated self-administered questionnaire and a universal sampling approach were used to conduct a cross-sectional survey of 235 healthcare professionals in the Gaza Strip, Palestine. The data were analyzed using SPSS version 25 and SmartPLS software to perform partial least squares structural equation modeling (PLS-SEM). A STROBE checklist was used to report the results. The results show a significant positive correlation between all measured variables. Work satisfaction partially mediates the relationship between organizational communication satisfaction and organizational commitment. The results of the PLS-SEM analyses suggest that communication satisfaction and work satisfaction account for 61% of the variation in organizational commitment. This study reveals that work satisfaction and communication satisfaction are imperative to building a sense of commitment in healthcare professionals. These results reinforce the existing evidence on the factors that influence the organizational commitment of healthcare professionals. Strategies to better shape internal communication practices and improve the work environment through regular feedback to healthcare professionals are essential to strengthening their organizational commitment.
  17. Ramoo V, Kamaruddin A, Wan Nawawi WNF, Che CC, Kavitha R
    Florence Nightingale J Nurs, 2023 Feb;31(1):2-10.
    PMID: 36751711 DOI: 10.5152/FNJN.2022.22061
    AIM: This study aims to assess the perception and satisfaction of nurses toward the electronic medical record system in a teaching hospital.

    METHOD: A cross-sectional study was conducted among 350 nurses in a teaching hospital via a self-administered questionnaire between May to October 2019. Descriptive analysis, independent t-test, analysis of variance, and hierarchical multiple regression were used to analyze the data using Statistical Package for Social Sciences software version 25. In addition, a The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used as guide in reporting the results of this study.

    RESULTS: Almost all the nurses (98%, n = 343) had a positive perception toward the electronic medical record system, though their perceptions significantly differ across work units, computer or laptop ownership, and daily time spent on the system (all p < .05). Nurses who had received training reported better satisfaction with the system.

    CONCLUSION: Among the issues highlighted by the participants that warrant attention were system development and connectivity. This study, therefore, emphasizes the involvement of nursing personnel in system development to ensure an appropriate approach for nursing care delivery.

  18. Lee HF, Hsu HC, Efendi F, Ramoo V, Susanti IA
    PLoS One, 2023;18(10):e0291073.
    PMID: 37816005 DOI: 10.1371/journal.pone.0291073
    The primary frontline healthcare providers who have frequent contact with COVID-19 patients are nurses. Many nurses have been infected with COVID-19 and have experienced severe emotional exhaustion and burnout. It is essential to assess nurses' psychological health during the COVID-19 pandemic. This study aimed to analyze the factors associated with burnout, resilience, and empowerment among Indonesian COVID-19 nurse survivors. In this cross-sectional study, 182 COVID-19 survivor nurses participated from September to November 2022 with convenience sampling. An online survey using the Copenhagen Burnout Inventory (CBI), the Connor-Davidson Resilience Scale (CD-RISC), and the Psychological Empowerment Scale (PES) were used to collect data. The data were analyzed using descriptive and binary logistic regression analyses. The majority of the nurses were aged between 30-45 years (61.6%), and females (67.4%) experienced burnout. Higher resilience was found among nurses contracting COVID-19 (83.1%). In the multivariate logistic regression analysis, the absence of psychological impact (OR = 0.44, 95% CI = 0.21-0.93) is significantly related to higher burnout experience. In addition, workplace, especially in hospital (OR = 4.32, 95% CI = 1.09-17.09) was associated with resilience, and a gap time after receiving negative COVID-19 result (OR = 3.90, 95% CI = 1.27-12.03) was correlated with psychological empowerment, in our results 4-6 month after had a negative result was at higher risk. To maintain a positive psychological aspect for COVID-19 nurse survivors, it needs to implement psychological support in the workplace and ensure an appropriate workload of nurse professionals.
  19. Chui PL, Chong MC, Abdullah KL, Ramoo V, Tang LY, Lee WL, et al.
    Healthcare (Basel), 2021 Sep 24;9(10).
    PMID: 34682939 DOI: 10.3390/healthcare9101259
    The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well as the coping strategies that they employed. This is a cross-sectional national online survey. A total of 859 nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia participated in the study. More than three-quarters of the nurses experienced stress (77.2%). A total of 88.7% and 7.2% of nurses revealed a moderate and high stress level, respectively. Approximately one in eight (12.1%) nurses reported feeling depressed. Nurses working in the outpatient departments reported significantly higher stress levels than nurses working in inpatient care departments. Nurses having chronic health problems reported significantly higher depression levels than nurses with no chronic health problem. Highly stressed or depressed nurses tend to adopt avoidance coping strategies while religion and emotional support were used regardless of the stress or depression levels experienced. The findings of the study provide insight into the mental health and coping strategies of nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia. This would be of tremendous help to nursing administrators in implementing mental health services for nurses during and following the COVID-19 global pandemic.
  20. Wong LP, Alias H, Md Fuzi AA, Omar IS, Mohamad Nor A, Tan MP, et al.
    PLoS One, 2021;16(3):e0248916.
    PMID: 33765039 DOI: 10.1371/journal.pone.0248916
    Since the first nationwide movement control order was implemented on 18 March 2020 in Malaysia to contain the coronavirus disease 2019 (COVID-19) outbreak, to what extent the uncertainty and continuous containment measures have imposed psychological burdens on the population is unknown. This study aimed to measure the level of mental health of the Malaysian public approximately 2 months after the pandemic's onset. Between 12 May and 5 September 2020, an anonymous online survey was conducted. The target group included all members of the Malaysian population aged 18 years and above. The Depression Anxiety Stress Scale (DASS-21) was used to assess mental health. There were increased depressive, anxiety and stress symptoms throughout the study period, with the depression rates showing the greatest increase. During the end of the data collection period (4 August-5 September 2020), there were high percentages of reported depressive (59.2%) and anxiety (55.1%) symptoms compared with stress (30.6%) symptoms. Perceived health status was the strongest significant predictor for depressive and anxiety symptoms. Individuals with a poorer health perception had higher odds of developing depression (odds ratio [OR] = 5.68; 95% confidence interval [CI] 3.81-8.47) and anxiety (OR = 3.50; 95%CI 2.37-5.17) compared with those with a higher health perception. By demographics, young people-particularly students, females and people with poor financial conditions-were more vulnerable to mental health symptoms. These findings provide an urgent call for increased attention to detect and provide intervention strategies to combat the increasing rate of mental health problems in the ongoing COVID-19 pandemic.
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