Mental Health and Occupational Functioning in Nurses: An investigation of anxiety sensitivity and factors affecting future use of an mHealth intervention

项目总结/摘要 护士经历高水平的压力，由于他们的职业要求，并不奇怪，他们 与普通人群相比，情感障碍的患病率明显更高。此外 护士的心理健康状况不佳，对他们的护理质量产生负面影响。 患者抑郁症和出勤率之间有着充分的关系（即，减少工作 由于健康状况的影响）。此外，护士的出勤率与受损的患者有关 护理，包括增加患者福尔斯和用药错误。职业倦怠是护士们的另一个主要担忧， 多达64%的护理人员都有过这种经历，而且还与受损的患者有关。 护理和降低患者安全性。虽然护士对精神保健的需求很高，但参与 传统的心理健康服务水平低。时间限制、耻辱感和缺乏利益相关者等因素 参与导致护士所需的心理健康资源与其他资源之间存在严重差距 这些都是他们可以利用的。 本申请提出，焦虑敏感性（AS），一个有据可查的精神病理学风险因素，可能 是护士职业功能障碍的潜在机制。循证自主 针对AS的移动健康干预措施，如认知焦虑敏感性治疗（CAST）干预， 可以充分解决治疗差距。与行为干预的NIH阶段模型一致 发展，拟议的研究将涉及护士的评估和使用中介结构 方程模型，以检查AS，心理健康（焦虑，倦怠和抑郁）之间的关系， 职业结果（出勤率和病人护理质量）。行政利益相关者的样本将 还应进行调查，以确定可能促进或阻碍采用的组织和系统层面因素， CAST在护理人员队伍中的可持续性。由护士组成的第三个样本将完成CAST 干预和提供反馈 干预形式、内容和参与。总之，这些目标将 直接为未来干预措施的定制和优化提供信息， 利益相关者的参与，并最大限度地提高护士及其患者的福利。 申请人正在申请F31奖，以接受认知治疗方面的高素质培训- 情感脆弱性焦虑敏感性（目标1），跨诊断治疗的实施和优化 (Goal 2），测量和数据分析策略的理论和应用（目标3），以及跨学科 研究传播技能（目标4）。研究和培训计划将为申请人的 未来追求在情感精神病理学的治疗和预防的转化研究倡议。 获得F31奖学金将使申请人从时间密集的助教职位中解脱出来， 在转化临床科学领域开展研究并建立强大的跨学科网络。

PROJECT SUMMARY/ABSTRACT Nurses experience high levels of stress due to the demands of their occupation, and, unsurprisingly, they evidence significantly greater prevalence of affective disorders compared to the general population. In addition to the personal toll, impoverished mental health of nurses negatively impacts the quality of care of their patients. There is a well-documented relation between depression and presenteeism (i.e., reduced work productivity due to a health condition). Furthermore, presenteeism in nurses is associated with impaired patient care, including increased patient falls and medication errors. Burnout is another major concern for nurses, experienced by as many as 64% of the nursing workforce, and has also been linked to compromised patient care and decreased patient safety. Although the need for mental healthcare in nurses is high, engagement in traditional mental health services is low. Factors including time limitations, stigma, and lack of stakeholder engagement have contributed to a critical gap between the mental health resources nurses need, and those that are actually available to them. This application proposes that Anxiety Sensitivity (AS), a well-documented risk factor for psychopathology, may be a mechanism underlying occupational functional impairments in nurses. Evidence-based autonomous mHealth interventions that target AS, such as the Cognitive Anxiety Sensitivity Treatment (CAST) intervention, may adequately address the treatment gap. Aligned with the NIH Stage Model of behavioral intervention development, the proposed study will involve the assessment of nurses and use of mediational structural equation modelling to examine the relations among AS, mental health (anxiety, burnout, and depression), and occupational outcomes (presenteeism and quality of patient care). A sample of administrative stakeholders will also be surveyed to identify organizational and system level factors that may promote or impede uptake and sustainability of CAST in the nursing workforce. A third sample, comprised of nurses, will complete the CAST intervention and provide feedback on intervention format, content, and engagement. Together, these aims will directly inform future intervention tailoring and optimization of intervention dissemination strategies to enhance stakeholder engagement and maximize the benefits to the wellbeing of nurses and their patients. The applicant is applying for an F31 award to receive high caliber training in the treatment of the cognitive- affective vulnerability anxiety sensitivity (Goal 1), transdiagnostic treatment implementation and optimization (Goal 2), theory and application of measurement and data analytic strategies (Goal 3), and interdisciplinary research dissemination skills (Goal 4). The research and training plan will lay the foundation for the applicant’s future pursuit of translational research initiatives in the treatment and prevention of affective psychopathology. Receiving an F31 award will relieve the applicant from her time-intensive teaching assistantship to effectively conduct research and establish a strong interdisciplinary network in the translational clinical science field.