含參考文獻.
保密資料：3年
Supervisior : SIT Wing Hung, Janet adjunct Associate Professor
Co-Supervisior ：AU, Mio Leng Assistant Professor

Objective: The Coronavirus Diseases 2019 (COVID-19) pandemic has severely affected healthcare systems. Nurses have played a vital role in this pandemic. However, increases in stress levels from exposure to high-risk environments can negatively impact nurses’ mental health, affecting their performance. This study aims to explore the prevalence of perceived stress levels and the factors associated with psychological stress among nurses during the COVID-19 pandemic in Macau. Methods: This cross-sectional descriptive study recruited registered nurses in Macau to participate in an online questionnaire through nurses’ social media platforms using a convenience sampling method in August and September 2022. Self-administered questionnaires consisting of sociodemographic characteristics and working conditions, the 10-item Perceived Stress Scale (PSS-10), Brief Coping Orientation to Problems Experienced Inventory (Brief COPE), and Social Support Questionnaire (SSQ6) were used. Descriptive statistics were used to analyze the sociodemographic characteristics and working conditions, level of perceived stress, coping strategies, and current status of social support. Multivariate regression analysis was used to analyze factors associated with perceived stress among nurses in Macau. Results: A total of 167 nurses participated in this study; 90% of the respondents were female, and 63% were under the age of 40. The prevalence of perceived stress was 20.05±6.4 (70.1% reported moderate levels of stress) among Macau nurses. The top five coping strategies respondents tended to use were acceptance, active coping, positive reframing, planning, and the use of instrumental support. The support number of the participants was 1.89±1.45 persons (0–9 persons), and the support satisfaction score was 2.51±1.02 (1–6 scores). Bivariate correlational analyses found that smoking, alcohol drinking, insomnia, poor appetite, fatigue, confidence to work in an isolated ward, time to join the infectious control training, and fear of being infected had a statistically significant association with perceived stress (all p<0.05). The PSS score had a significantly positive correlation with support satisfaction, substance use, behavioral disengagement, denial, humor, and self-blame (p<0.05; r=0.208–0.518), and a significantly negative correlation with support number, active coping, use of instrumental support, positive reframing, planning, and acceptance (p<0.05; r=-0.222–-0.362). Finally, multivariate regression analysis found that eight independent variables (fatigue, support satisfaction, self-blame, denial, insomnia, fear of being infected, smoking, and active coping) explained the 59.5% variance in PSS scores. Conclusion: The perceived stress level of nurses during the COVID-19 pandemic in Macau is moderate to high. Fatigue, support satisfaction, self-blame, denial, insomnia, fear of being infected, and smoking are risk factors for higher perceived stress levels among nurses, while active coping strategies reduce perceived stress levels. Nurses should be aware of the importance of stress management and effective coping strategies. Healthcare organizations should consider periodic infection control refreshment courses to alleviate nurses’ fear of being infected. In addition, psychological and physical intervention programs should be developed for nurses to help them reduce stress during the COVID-19 pandemic.

含參考文獻.
保密資料：3年
Supervisior：SIT Wing Hung,Janet
Supervisior：LOK Ka In,Grace

Objective: Globally, Mental Well-being is an important issue. For female secondary school students, mental distress during puberty is challenging. However, there is little evidence from local studies on protective or risk factors of Mental Well-being among puberty females. Therefore, it is imminent to investigate the levels of and relationships between perceived stress, psychological resilience, social support, self-esteem and self-efficacy on Mental Well-being of female secondary school students in Macao. Methods: Through convenience sampling, invitation letters were sent to six secondary schools, and only one female school accepted the invitation eventually. Students who studied at the participating secondary school were recruited. A self-administered questionnaire was used to collect data from participants anonymously. Total 624 questionnaires were collected, and the response rate was 91.53%. The study was approved by the Ethics Committee of Research Management and Development Department in Kiang Wu Nursing College of Macau. Written informed consents were obtained from the participating school, parents and students. Results: Mean scores of the twelve-item General Health Questionnaire (GHQ-12), ten-item Chinese Perceived Stress Scale (CPSS-10), Rosenberg Self-Esteem Scale (CRSES), General Self Efficacy Scale (GSE), Chinese Positive Youth Development Scale Resilience Subscale (RE-CPYDS), and Social Support Rating Scale (SSRS) were 15.069 (SD =7.377), 22.833 (SD=5.971), 25.465 (SD=5.378), 21.792 (SD=5.683), 23.905 (SD=5.457) and 32.97 (SD=5.746) respectively. 64.2% participant scored≥12 in GHQ-12 which indicates impaired Mental Well-being in the sampled female secondary school students. Moreover, 69.6% participants scored ≥20 in CPSS-10 which is considered as high perceived stress level. Bivariate analysis found impaired Mental Well-being was positively correlated with perceived stress (r=0.616, p<0.01) and negatively correlated with self-esteem (r=-0.517, p<0.01), self-efficacy (r=-0.381, p<0.01), psychological resilience (r=-0.415, p<0.01), and social support (r=-0.334, p<0.01). Moreover, multivariate regression analysis found study variables can explain 43.3% of variance in participants’ impaired Mental Well-being. The regression coefficient value of perceived stress, social support and self-esteem are 0.568(t=11.703, p<0.01), -0.110 (t=-2.409, p<0.05) and -0.302 (t=-5.451, p<0.01) respectively. However, relationships between psychological resilience and self-efficacy, and Mental Well-being were not established in this study. Conclusion: Level of impaired Mental Well-being and Perceived Stress is high for female secondary school students in Macao. Level of Psychological Resilience is relatively low, while Social Support, Self-esteem and Self-efficacy are found to be moderate. The results of this study suggest there being urgent need to strengthen protective factors (i.e. self-esteem and social support level) and reducing risk factor (i.e. perceived stress level) for effective mental health promotion strategies among female secondary school students in Macao.