Workplace violence towards health workers in hospitals and in mental health units in particular is increasing. The aim of the present study was to explore the effects of exposure to violence, job stress, staff resilience, and post-traumatic growth (PTG) on the life satisfaction of mental health nurses. A descriptive, cross-sectional design was used. The sample consisted of mental health nurses (n = 118) working in a large mental health centre in Israel. Verbal violence by patients was reported by 88.1% of the nurses, and 58.4% experienced physical violence in the past year. Physical and verbal violence towards nurses was correlated with job stress, and life satisfaction was correlated with PTG and staff resilience. Linear regression analyses indicated that life satisfaction was mainly affected by PTG, staff resilience, and job stress, and less by exposure to verbal and physical violence. The present study is the first to show that, although mental health nurses are frequently exposed to violence, their life satisfaction is affected more by staff resilience, PTG, and job stress than by workplace violence. Therefore, it is recommended that intervention programmes that contribute to PTG and staff resilience, as well as those that reduce job stress among mental health nurses, be explored and implemented.

Professional quality of life (ProQOL) reflects how individuals feel about their work as helpers. Psychiatric ward nurses cope with significant psychological and physical challenges, including exposure to verbal and physical violence. This study was based on two aspects of ProQOL, the positive compassion satisfaction, and the negative compassion fatigue, with the aim of investigating the relation of ProQOL to job stress and violence exposure at a large mental health center. Data were collected from 114 mental health nurses (49/63 M/F) who completed a self-administered questionnaire examining violence exposure, ProQOL, and job stress. The results showed that during the last year, almost all nurses (88.6%) experienced verbal violence, and more than half (56.1%) experienced physical violence. Only 2.6% experienced no violence. ProQOL was not associated with violence exposure but was reduced by work stress and by previous exposure to violence; nurses who perceived their work as more stressful had lower satisfaction from their work. In conclusion, although most mental health nurses are exposed to physical and verbal violence, their ProQOL is more related to job stress than to workplace violence (WPV). Hospital managements should conduct work stress reduction intervention programs and promote strategizes to reduce WPV. Further exploration of (a) factors affecting ProQOL and (b) the effect of violence coping workshops on ProQOL is warranted.

This study makes an important contribution to research on the importance of perceived self-efficacy in the context of disaster planning.

Purpose:The worldwide outbreak of the COVID-19 pandemic has posed challenges for nurses. The aim of this study was to examine the managerial and clinical challenges of nurse managers in mental health centers during the current COVID-19 pandemic. Design: A mixed-methods study based on an analysis of data obtained in focus groups with 25 nurse managers from two mental health centers in Israel. Methods: The quantitative phase was conducted prior to the group sessions using a structured self-administered questionnaire that examined the nurse managers' (a) background data, (b) communication with the staff nurses, (c) perceptions of nurses' functioning, (d) perceptions of their own functioning, and (e) management as impacted by the pandemic. The qualitative phase included three sessions of focus groups in which the nurse managers discussed both their challenging and positive issues during the pandemic. Findings: The most important challenges were related to the need to protect patients from infection and communicating with families and primary caregivers. Work policies and procedures were less well adapted to pandemic conditions; nevertheless, nurse managers felt a sense of purpose, duty, and pride in their work. Three themes emerged: (a) "management complexity" included the change from a familiar routine to a new reality, working in capsules, protecting against infection, functional confusion, and insights into future epidemics; (b) "challenging communication" included communication with patients through glass walls and communication with staff through screens and (c) "bright spots" referred to staff cohesion and the provision of respectful care. Conclusions: Mental health nurse managers have experienced during the pandemic a change in their roles from being less managerial to focusing more on clinical work. Communication between nurse managers and staff nurses and between mental health patients and staff were the main challenges. Nurse managers favorably noted the uniformity and humanity of the staff, sense of cohesion, and shared responsibility. Clinical Relevance: In the first wave of the pandemic, there was confusion as to the functional role of ward nurse managers, as the focus of their activities became more clinical and less managerial. During and after the pandemic, preventive interventions should be carried out in order to assist patients, staff nurses, and nurse managers in mental health centers.

Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a crosssectional study in five countries Nurses' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end-of-life and more comfortable stopping preventive medications at endof-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care.