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

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.