Objectives: This study investigates the associations between recommended outcome measures for clinical pain trials, as outlined by The Initiative on Methods, Measurements and Pain Assessment in Clinical Trials (IMMPACT), and work ability among individuals with non-specific musculoskeletal disorders. Specifically, it examines how general health, physical and mental health, pain intensity, functional limitations, depression, and sleep quality relate to work ability in people with musculoskeletal disorders undergoing multimodal rehabilitation.

Methods: In this cross-sectional study, 116 participants were recruited from eight rehabilitation teams and two specialist care centers in central Sweden. The Work Ability Index (WAI), Short Form Health Survey (SF-36), Multidimensional Pain Inventory - Swedish version (MPI-S), and Montgomery-Åsberg Depression Rating Scale - Self-report (MADRS-S) were utilized to measure relevant constructs. Pearson correlations were calculated, followed by multiple linear regression analyses to assess the impact of the independent variables on work ability.

Results: Significant positive correlations were found between work ability and general health (r=0.346; p=0.001) and physical health (r=0.533, p=<0.001), while negative correlations were found with pain intensity (r=-0.423; p=<0.001), limitations in daily life (r=-0.536; p=<0.001), depression (r=-0.500; p=<0.001), and sleep quality (r=-0.431; p=<0.001). Taken together, the multiple linear regression analysis showed that limitations in daily life and depression were significantly associated with work ability, explaining a combined variance of 46.1 %.

Conclusions: This study emphasizes the importance of addressing mental health and daily functioning limitations in rehabilitation programs to enhance work ability among participants with musculoskeletal disorders. Tailored interventions targeting these areas could improve rehabilitation outcomes and support workforce participation in this population. Approved by the regional ethical review board of Uppsala (Dnr 2010/116).

Aim

The rationale for this current study was to assess the factors associated with anxiety and depressive symptoms in a cohort of students from seven universities across the European education system. Furthermore, the research sought to assess the barriers and facilitators for seeking support when students perceive any mental health issues.

Methods

A cross-sectional multicenter study was conducted, which included 4830 higher education students from seven European countries. A sociodemographic questionnaire, the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) were used to assess depressive and anxiety symptoms, respectively. The Mental Health Inventory (MHI-5) assessed general psychological well-being. A questionnaire was used to assess preferences regarding support-seeking behavior and perceived barriers in the event of mental distress. Linear mixed models (LMMs) were used in the statistical analysis.

Results

Swedish students reported lower levels of moderate to severe depressive symptoms (34.1%) and moderate to severe anxiety (27.9%) when compared, for example, with Irish students (63.1% and 52.9%, respectively). Younger students, females, students with a history of mental disorder and lower levels of academic performance, or from a poorer socioeconomic background reported increased rates of depressive and anxiety symptoms. The most valued support-seeking strategies were speaking to friends or engaging in psychotherapy; in contrast, the most cited barrier to seeking support was the expense related to professional therapy and long waiting times for an appointment with professional therapists.

Conclusion

There is a need to develop and/or review mental health promotion strategies for higher education students across Europe. These strategies need to consider the individual and culturally specific needs of higher education students so that they are effective in removing perceived barriers when seeking support in the event of mental distress.

Background

In Sweden, becoming a registered nurse with a Bachelor of Science degree in nursing requires three years of full-time study, including an independent 15-credit thesis. Nursing undergraduates have limited access to ongoing research projects and clinical settings, which often prioritize master’s students and faculty-led studies. Thus, many nursing programs default to a literature-review norm, which reduces methodological diversity. This study focuses solely on non-traditional approaches, such as blog analyses, autobiographical analyses, and other innovative designs. The study seeks to disclose how these methods contribute to understanding patient experiences and advancing nursing education and research.

Aim

The aim of the study was to systematically map and critically analyze the methodological and theoretical diversity within Swedish bachelor’s theses in nursing that employ alternative research methods.

MethodA scoping review was conducted. Searches were performed in the DiVA portal (title-only list of 22 145 records) and in three university repositories (2 861 records), followed by an abstract-inclusive DiVA search (491 records). Screening and full-text review yielded 380 final inclusions. The national digital science archive was used to access theses completed between 2013 and 2023. Descriptive and inferential statistics were employed to analyze the data.

Results

Autobiographical works were the most frequently used sources (n = 220), followed by blogs (n = 126). Dictionaries, internet forums, and combined sources were rare. Few theses used dictionaries, social media or internet forums. A descriptive research design was employed in most of the theses, and the majority focused on adults, primarily women. The theoretical content mainly covered themes related to existential issues and suffering, but several bachelor’s theses lacked a formal theoretical framework.

Conclusion

Descriptive designs predominated, while exploratory and theory-integrated approaches were rare. Addressing these gaps requires pedagogical reforms that support use of diverse data sources and encourage inclusive research.

Objectives: Work stress is a threat to the well-being of nurses in China and also globally, and many studies have been conducted on the risk factors for stress symptoms. However, research on the process and mechanism between work environment risk factors and perceived stress symptoms among nurses remains limited. This study aimed to examine the direct and indirect relationships between nurse-rated structural empowerment, professional competence, thriving and nurses' perceived stress symptoms.

Design: This was a cross-sectional correlational study.

Setting and participants: This study was conducted between April and October 2023, and 2172 nurses at three general hospitals in a Chinese province were recruited.

Method: A questionnaire that included demographic information, the Conditions of Work Effectiveness Questionnaire, the Nurse Professional Competence Scale, the Thriving at Work Scale and one factor from the Psychosomatic Health Aspects Questionnaire that measured perceived stress symptoms was used. The PROCESS macro (model 4) with a parallel mediation model and bootstrapping tests was conducted to examine the direct and indirect relationships of structural empowerment, professional competence and thriving at work on perceived stress symptoms.

Result: The regression analysis showed that structural empowerment, professional competence and thriving at work were negatively related to stress symptoms (β=-0.42, p<0.001; β=-0.06, p=0.009; β=-0.28, p<0.001, respectively), after controlling for marital status (yes/no), clinical experience and night shift (three groups). The results of the bootstrap analysis with a parallel mediator model revealed indirect relationships between structural empowerment and stress symptoms through both professional competence and thriving at work (β=-0.033 (95% CIs -0.059 to -0.009); β=-0.164 (95% CIs -0.204 to -0.126), respectively).

Conclusions: Structural empowerment was related to stress symptoms both directly and indirectly via professional competence and thriving at work. The findings suggest that managers should alleviate nurses' stress symptoms through measures aimed at providing access to empowering structures, strengthening professional competence and promoting thriving at work.

Background

Mental health problems are prevalent among university students, underscoring the need to improve access to effective interventions. Mental healthcare utilization is influenced by general and country-specific factors. This study aimed to identify and compare preferences and barriers to help-seeking for mental health problems among university students in three European countries.

Methods

A cross-sectional, web-based survey was conducted with a sample of 4960 university students from Portugal (n = 3399), Germany (n = 680), and Sweden (n = 881). Depressive symptoms (9-item Patient Health Questionnaire) and overall mental health (5-item Mental Health Index) were assessed. Students responded to questions regarding help-seeking preferences for and barriers to mental health problems.

Results

Rates of moderate to severe depressive symptoms ranged from 37.5 to 51.0 % and were highest among German students. A majority (76.3–89.3 %) of students indicated they would talk to a friend in case of mental health problems. Readiness to seek help was particularly high among Portuguese students. Readiness to use internet-based interventions was low among all students. Up to 51 % of students reported uncertainty regarding where they could seek help. Students with depressive symptoms versus those without were less likely to speak with a friend about emotional problems but were more likely to consider taking medications. Students with depressive symptoms were also more likely to endorse several help-seeking barriers.

Conclusion

Reducing structural barriers, improving awareness of treatment options and increasing acceptance of help-seeking for emotional problems may improve uptake of mental health services among students in these European countries.

Background

The work-related empowerment of nurses is essential for enhancing person-centered care and climate. However, research on more complex relationships that consider mediation remains sparse.

Objective

This study aimed to investigate the relationship between nurse-rated structural empowerment and a person-centered climate, as well as the mediating role of nurse professional competence.DesignA cross-sectional survey study.

Settings and Participants

This study was conducted among 2172 nurses, at three general hospitals in China, between April 2023 and October 2023.

Methods

The Conditions of Work Effectiveness Questionnaire, which measured structural empowerment, the Nurse Professional Competence Scale, and the Person-Centered Climate Questionnaire-Staff Version were employed to collect data. The PROCESS macro (Model 4) and bootstrapping tests were used to examine the relationships and mediation effects.

Results

The results showed that nurse-rated structural empowerment was significantly positively related to the person-centered climate and professional competence of nurses. Nurse professional competence, in turn, was significantly positively related to person-centered climate. Furthermore, the nurse professional competence significantly mediated the relationship between structural empowerment and a person-centered climate. The model explained 49.9% of the variance in person-centered climates.

Conclusions

Structural empowerment and nurses professional competence are both essential for fostering a person-centered climate in hospital wards. Professional competence mediates the relationship between structural empowerment and a person-centered climate.

Background

The mental health of university students is a global concern, with high rates of depression and anxiety that need to be addressed.AimWe aimed to compare the mental health of Portuguese, Swedish and German university students in the health and social sciences following the Covid-19 pandemic and to analyze the factors associated with depressive and anxious symptoms in each country.

Methods

A cross-sectional study with a sample of students from Portugal, Germany and Sweden was conducted. Data from online questionnaires, including a sociodemographic and clinical questionnaire, the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD-7) and the MHI-5 (Mental Health Inventory) was collected from October to December 2022.

Results

The sample was composed of 1670 university students. The prevalence of mild to severe depressive symptoms was 72.7 % in Germany, 62.9 % in Sweden, and 60.3 % in Portugal and the prevalence of mild to severe anxiety symptoms was 78.6 % in Portugal, 73.7 % in Germany, and 66.9 % in Sweden. Being a female student, having a previous mental health disorder diagnosis, and poor academic performance were associated with higher severity of depression and anxiety symptoms in all three countries. Country-specific factors associated with more depressive and/or anxiety symptoms were younger age, smoking, low socioeconomic level and living away from home. Swedish students who do not consume alcohol had more anxiety symptoms and German students who do not consume alcohol had more depressive symptoms.

Conclusion

The high prevalence of depressive and anxiety symptoms among students in the three countries highlights the need to address modifiable factors that contribute to this mental health burden. Our results, which are in line with international trends, underline the need for policy reforms that target the main determinants of mental health, in particular by improving socio-economic conditions. Addressing these factors could play a crucial role in improving mental health outcomes in this population.

Background and aim

Common mental disorders are common reasons for long-term sick leave, especially among women. Return to work is often complex and unsuccessful, why more knowledge is needed regarding women’s health and psychological well-being in the return-to-work process. Therefore, the aim was to describe women’s health and psychological well-being in the return-to-work process, from women’s and first-line managers’ perspectives.

Methods

Individual interviews were conducted with 17 women and 16 first-line managers. Qualitative content analysis was performed based on the content areas “Women’s health (i.e. overall well-being, both physical and psychological) throughout the whole RTW process” and “Women’s psychological well-being (happiness, meaning and a sense of being significant) at work after work resumption” Themes and categories were created.

Results

Women and managers had similar descriptions, i.e. that women’s health and psychological well-being depend on the individual characteristics of women themselves, their private life, work and other stakeholders. However, women described relational work tasks (e.g. meeting patients) as beneficial for health, and highlighted small stressors in the work environment, which the managers did not. Having work that was compatible with private life, being in good health, having stimulating work tasks and strengthening relationships at work were important for the women’s psychological well-being.

Conclusions

Based on women’s and first-line managers experiences, promotion of women’s health and psychological well-being during the return-to-work process requires individually adapted assessments and actions involving women’s entire life situation. First-line managers should know that relational work tasks (e.g., meeting patients) can be beneficial for women’s health as well as that minor stressor in the work environment can put their health at risk.