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Discrimination & Psychological Health of Minority Nursing Staff amidst COVID-19

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In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination contributed to the health inequities of people of color in the US, exacerbated by COVID-19-related racism and xenophobia. There is…

In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination contributed to the health inequities of people of color in the US, exacerbated by COVID-19-related racism and xenophobia. There is little research regarding the effects of COVID-19 and related and/or concurring discrimination upon minority nursing staff, despite their importance in supporting the diverse American patient population with culturally competent, tireless care amid the pandemic. This cross-sectional survey study aimed to examine 1) the relationships between discrimination, social support, resilience, and quality of life among minority nursing staff in the US during COVID-19, and 2) the differences of discrimination, social support resilience, and quality of life among minority nursing staff between different racial/ethnic groups during COVID-19. The sample (n = 514) included Black/African American (n = 161, 31.4%), Latinx/Hispanic (n = 131, 25.5%), Asian (n = 87, 17%), Native American/Alaskan Native (n = 69, 13.5%), and Pacific Islander (n = 65, 12.7%) nursing staff from 47 US states. The multiple regression results showed that witnessing discrimination was associated with a lower quality of life score, while higher social support and resilience scores were associated with higher quality of life scores across all racial groups. Furthermore, while participants from all racial groups witnessed and experienced discrimination, Hispanic/Latinx nursing staff experienced discrimination most commonly, alongside having lowest quality of life and highest resilience scores. Native American/Alaskan Native nursing staff had similarly high discrimination and low quality of life, although low resilience scores. Our findings suggest that minority nursing staff who have higher COVID-19 morbidity and mortality rates (Hispanic/Latinx, Native American/Alaskan Native) were left more vulnerable to negative effects from discrimination. Hispanic/Latinx nursing staff reported a relatively higher resilience score than all other groups, potentially attributed to the positive effects of biculturality in the workplace, however, the low average quality of life score suggests a simultaneous erosion of well-being. Compared to all other groups, Native American and Alaskan Native nursing staff’s low resilience and quality of life scores suggest a potential compounding effect of historical trauma affecting their well-being, especially in contrast to Hispanic/Latinx nursing staff. This study has broader implications for research on the lasting effects of COVID-19 on minority healthcare workers’ and communities’ well-being, especially regarding Hispanic/Latinx and Native American/Alaskan Native nursing staff.
ContributorsLaufer, Annika Noreen (Author) / Chen, Angela (Thesis director) / Fries, Kathleen (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Benefits of high intelligence: Potential moderating effects of emotion regulation and friendship quality

Description
Depression, anxiety, and suicidal thoughts or actions are on the rise in adolescents (National Institute of Mental Health, 2015; Bridge, Asti, & Horowitz, 2015). Parents, school administrators, and therapists are searching for resiliency factors with in at-risk groups to aid students in need. In previous work, Luthar and Zigler (1992)…

Depression, anxiety, and suicidal thoughts or actions are on the rise in adolescents (National Institute of Mental Health, 2015; Bridge, Asti, & Horowitz, 2015). Parents, school administrators, and therapists are searching for resiliency factors with in at-risk groups to aid students in need. In previous work, Luthar and Zigler (1992) reported that intelligent youth are more resilient than less intelligent youth under low stress conditions but they lose their advantage under high stress conditions. This study examined whether intelligence (reflected in grade point average; GPA) and maladaptive (internalizing and externalizing symptoms) behaviors are negatively related in adolescents, and tested whether level of stress, reflected in emotion regulation and friendship quality, moderated that association. It also probed whether the relationships differ by gender. Sixth-graders (N=506) were recruited with active parental consent from three middle schools. Adolescents completed self-report questionnaires Regarding demo graphics, maladaptive behaviors, emotion regulation, and friendship quality, and GPA data were collected from the school. Regression analyses found that GPA was negatively related to externalizing symptoms. Girls with poor friendship communication report significantly higher maladaptive behaviors. This relation was more pronounced for girls with high GPAs, as predicted. Results support the theory that intelligent female adolescents are more reactive under adverse circumstances. Future efforts should follow students through middle school into high school to evaluate whether friendships remain important to adjustment, hold for boys as well as girls, and have implications for relationship interventions.
ContributorsGonzales, Ashlyn Carol (Author) / Luthar, Suniya (Thesis director) / Davis, Mary (Committee member) / Infurna, Frank (Committee member) / Department of Psychology (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
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Resilience-Oriented Education on Secondary Trauma: Impacts on Secondary Traumatic Stress Scores among Psychiatric Registered Nurses

Description
Secondary traumatic stress (STS) is the natural, consequent behaviors and emotions that result from the individual’s knowledge about traumatizing events experienced by another. Psychiatric registered nurses (RN), due to the nature of their jobs, are frequently exposed to significant amount of secondary trauma during nurse-patient interactions. Secondary traumatic stress impacts…

Secondary traumatic stress (STS) is the natural, consequent behaviors and emotions that result from the individual’s knowledge about traumatizing events experienced by another. Psychiatric registered nurses (RN), due to the nature of their jobs, are frequently exposed to significant amount of secondary trauma during nurse-patient interactions. Secondary traumatic stress impacts the physical and emotional health of the nurse, compromises patient outcomes and organizational success. Evidence acknowledges the significant extent of secondary traumatic stress among nurses and is insistent on the necessity for effective interventions to mitigate the impacts of secondary trauma on healthcare professionals. A review of literature suggests that knowledge is a protective factor against secondary traumatic stress, and that nurse resilience also moderates the effects of secondary trauma and other work related stressors. These findings have led to the initiation of an evidence-based project that seeks to assess the efficacy of a resilience-oriented educational intervention in decreasing secondary traumatic stress scores and improving resilience among hospital-based psychiatric registered nurses. This project was guided by the Theory of Cognitive Appraisal and Rosswurm and Larabee’s model for evidence-based practice. Results from this project, despite being non-statistically significant, showed a decrease in STS scores from time-point zero (T0) to time-point one (T1) and increased resilience scores from time-point one (T1) to time-point two (T2), and from time-point zero (T0) to time-point two (T2). This project highlighted a deficit in knowledge of concepts of ST, STS and resilience among psychiatry RNs and inspired an open discussion on STS and other types of work-related stress among psychiatry RNs.
ContributorsOjeme, Anthony (Author) / Chen, Angela (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
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How Childhood Trauma Shapes Future Health Prospects

Description

I did a literature review on how childhood trauma causes health issues in the future. Based on the information gathered, I did a clinical proposal for trauma informed care to help address this problem.

ContributorsShanavas, Yuktha (Author) / Infurna, Frank (Thesis director) / Ha, Thao (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor)
Created2022-05
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An Evidence-Based Education to Improve Children's Mental Health

Description
An alarming number of youth have mental health concerns, but of those who are diagnosed, only half receive treatment. Using Bandera's social cognitive theory, one can achieve behavioral changes through self-efficacy and control their actions by self-regulation. Mindfulness activities, when implemented early, can decrease stress, and improve well-being in youth.…

An alarming number of youth have mental health concerns, but of those who are diagnosed, only half receive treatment. Using Bandera's social cognitive theory, one can achieve behavioral changes through self-efficacy and control their actions by self-regulation. Mindfulness activities, when implemented early, can decrease stress, and improve well-being in youth. Methods: This project was implemented among students attending an alternative high school in Arizona. Nine students participated in four different mindfulness, hands-on activities during two classes- 1 hour each. Participants completed a pre and a post-test with the 10-item questionnaire Perceived Stress Scale (PSS), and a 3-question survey to evaluate the program at the end of the second week. Results: Among the 9 participants (mean age = 16 SD=2.06), the stress levels were considered low to moderate in the pretest (mean=16.56) and the post-test (mean=15.89). Stress level scores were reduced after the education although the difference was not statistically significant. Furthermore, all participants agreed that the content and activities were appropriate, 88.9% agreed they had a "better understanding of how to reduce stress," and 77.8% stated their "knowledge of stress has improved." Discussion/Conclusion: This project aimed to help reduce vulnerable adolescents' stress level through mindfulness activities. Mental health education like this may help adolescents better manage stress and consequently promote their overall well-being. Future projects should recruit a larger sample and implement a longer time for larger and longer effects.
ContributorsQualman, Stephanie (Author) / Chen, Angela (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-10
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Redefining Situation Schema Under Chronic Stress: A Mixed Methods Construct Validation of Positive Cognitive Shift

Description
Cognitive reappraisal, or redefining the meaning of a stressful circumstance, is useful in regulating emotional responses to acute stressors and may be mobilized to up- or down- regulate the stressors’ emotional salience. A conceptually-related but more targeted emotion regulation strategy to that offered by cognitive reappraisal, termed positive cognitive shift,…

Cognitive reappraisal, or redefining the meaning of a stressful circumstance, is useful in regulating emotional responses to acute stressors and may be mobilized to up- or down- regulate the stressors’ emotional salience. A conceptually-related but more targeted emotion regulation strategy to that offered by cognitive reappraisal, termed positive cognitive shift, was examined in the current study. Positive cognitive shift (“PCS”) is defined as a point of cognitive transformation during a chronic, stressful situation that alters the meaning and emotional salience of the situation for the individual. Key aspects of the PCS that differentiate it from the broader reappraisal construct are that it 1) is relevant to responses to chronic (versus acute) aversive events, 2) is deployed when there is a mismatch between coping and stressors, and 3) involves insight together with redefinition in meaning of the situation generating stress. The current study used qualitative and quantitative analyses to 1) examine whether PCS is an observable, reliable, and valid experience in response to a stressful event that occurred in the past year, and 2) test whether PCS moderates the relations between the number of past-year stressful life circumstances and subsequent emotional well-being and functional health. A community sample of 175 middle-aged individuals were interviewed regarded a past chronic stressor and completed questionnaires regarding number of past year stressors and health outcomes. Theory-based coding of interviews was conducted to derive reliable scores for PCS, and findings indicated that PCS was evident in 37.7 % of participant responses. Furthermore, PCS scores were related positively to openness, personal growth from one’s most difficult lifetime event, and affect intensity-calm, in line with predictions. Also in line with prediction, PCS moderated the relations between number of past-year life events and health outcomes, such that the deleterious relations between past year stressful events and cognitive functioning, wellbeing, positive affect, and negative affect were weaker among individuals higher versus lower in PCS. Of note, PCS moderation effects diminished as the number of stressful events increased.
ContributorsRivers, Crystal (Author) / Davis, Mary (Thesis advisor) / Luecken, Linda (Committee member) / Infurna, Frank (Committee member) / Robinson Kurpius, Sharon (Committee member) / Arizona State University (Publisher)
Created2018
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The Interplay of Mindfulness and Effortful Control with the Emotional Dynamics of Everyday Life

Description
Research on self-regulatory variables like mindfulness and effortful control proposes strong links with physical and mental health outcomes across the lifespan, from childhood and adolescence to adulthood and old age. One pathway by which self-regulation may confer health benefits is through individual differences in reports of and emotional responses to…

Research on self-regulatory variables like mindfulness and effortful control proposes strong links with physical and mental health outcomes across the lifespan, from childhood and adolescence to adulthood and old age. One pathway by which self-regulation may confer health benefits is through individual differences in reports of and emotional responses to daily negative and positive events. Mindfulness is broadly defined as non-reactivity to inner experiences, while effortful control is broadly defined as attentional and behavioral regulation. Mindfulness and effortful control have both been conceptualized to exert their beneficial effects on development through their influence on exposure/engagement and emotional reactivity/responsiveness to both negative and positive events, yet few empirical studies have tested this claim using daily-diary designs, a research methodology that permits for examining this process. With a sample of community-dwelling adults (n=191), this thesis examined whether dispositional mindfulness (i.e., non-reactivity of inner experience) and effortful control (i.e., attention and behavioral regulation) modulate reports of and affective reactivity/responsiveness to daily negative and positive events across 30 days. Results showed that mindfulness and effortful control were each associated with reduced exposure to daily stressors but not positive events. They also showed that mindfulness and effortful control, respectively, predicted smaller decreases in negative affect and smaller increases in positive affect on days that positive events occurred. Overall, these findings offer insight into how these self-regulatory factors operate in the context of middle-aged adults’ everyday life.
ContributorsCastro, Saul (Author) / Infurna, Frank (Thesis advisor) / Doane, Leah (Committee member) / Davis, Mary (Committee member) / Arizona State University (Publisher)
Created2018