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Gillespie GL, Meyer HA, Daugherty M, Puthoff D, Fryman LJ, Howard PK. Stress and Coping in Emergency Nurses Following Trauma Patient Care: A Qualitative Grounded Theory Approach. J Trauma Nurs 2024; 31:136-148. [PMID: 38742721 DOI: 10.1097/jtn.0000000000000787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
BACKGROUND Experiencing symptoms of traumatic stress may be the cost of caring for trauma patients. Emergency nurses caring for trauma patients are at risk for traumatic stress reactions. OBJECTIVE This study explored the stress and coping behaviors experienced by emergency nurses who provide trauma care. METHODS Focus groups were held at three urban trauma centers in the Midwestern United States: a Level I pediatric trauma center, a Level I adult trauma center, and a Level III adult trauma center. Data were collected between December 2009 and March 2010. Data analysis was guided by the principles of grounded theory. Line-by-line coding and constant comparative analysis techniques were used to identify recurring constructs. RESULTS A total of 48 emergency nurses participated. Recurring constructs emerged in the data analysis and coding, revealing four major themes: care of the trauma patient, professional practice, personal life, and support. CONCLUSIONS Nurse job engagement, burnout, and professional and personal relationships are influenced by trauma patient care. The study's resulting themes of care of the trauma patient, professional practice, personal life, and support resulted in the development of the "trauma nursing is a continual experience theory" that can be used as a framework to address these effects. Intentional support and timely interventions based on this new theory can help mitigate the effects of traumatic stress experienced by trauma nurses.
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Affiliation(s)
- Gordon L Gillespie
- Author Affiliations: University of Cincinnati College of Nursing (Drs Gillespie and Meyer), Cincinnati, Ohio; Trauma Services, Cincinnati Children's Hospital Medical Center (Ms Daugherty), Cincinnati, Ohio; Emergency Medicine & Hospitalist Medicine/Critical Care Medicine, Trauma Services, Bethesda North Hospital (Ms Puthoff), Cincinnati, Ohio; and Trauma/Surgical Services (Dr Fryman) and Emergency Services (Dr Howard), University of Kentucky Healthcare, Lexington, Kentucky
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Rigas N, Kyritsis Z, Dagla M, Soldatou A, Orovou E, Tzitiridou-Chatzopoulou M, Eskitzis P, Antoniou E. Post-Traumatic Stress Disorder Symptoms among Pediatric Healthcare Workers. NURSING REPORTS 2024; 14:115-127. [PMID: 38251188 PMCID: PMC10801477 DOI: 10.3390/nursrep14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Post-traumatic stress disorder symptoms related to work in pediatric departments aremajor public health problems, as they directly affect health organizations, healthcare workers, and, due to the poor quality of care, the patients as well. The post-traumatic symptoms that a healthcare worker may experience are related to intrusion, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. The aim of the present investigation was to identify risk factors that contribute to the development of PTSD in pediatric healthcare workers, in order to implement necessary workplace measures. A sample of four hundred and forty-five pediatric workers at seven Greek public hospitals consented to participate in the survey. Socio-demographic data and a post-traumatic checklist (5th edition) were used to diagnose post-traumatic stress disorder. According to the results, risk factors for the development of post-traumatic symptoms include medical or nursing errors, threats to a child's life, and incidents of workplace bullying. More specifically, 25.2% of the participants had a provisional PTSD diagnosis, 72.8%of the sample experienced an incident involving a medical or nursing error in their workplace related to the treatment or care of a child, 56% experienced an incident involving a child's death or a threat to a child's life due to a serious illness or injury, and 55.5% experienced an incident of workplace bullying. In addition, it was found that having a university-level education, master's, or PhD, working in a circular shift, being assigned to a department by management rather than the worker, and dissatisfaction with salary were associated with post-traumatic stress disorder. The high rates of PTSD symptoms among participants highlight the need for prevention and management measures to protect and support the mental health of workers in pediatric departments. We propose frequent evaluations of the mental health of employees, more time for rest, incentives for professional development, utilization of their specializations and specialties, support from mental health specialists when symptoms are diagnosed, and the option for employees to change departments if they wish or if they show symptoms of mental trauma.
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Affiliation(s)
- Nikolaos Rigas
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| | - Zacharias Kyritsis
- Department of Mathematics, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Maria Dagla
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| | - Alexandra Soldatou
- Faculty of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Eirini Orovou
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece; (E.O.); (M.T.-C.); (P.E.)
| | | | - Panagiotis Eskitzis
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece; (E.O.); (M.T.-C.); (P.E.)
| | - Evangelia Antoniou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
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Abu-Alhaija DM, Gillespie GL. Critical Clinical Events and Resilience Among Emergency Nurses in 3 Trauma Hospital-Based Emergency Departments: A Cross-Sectional Study. J Emerg Nurs 2022; 48:525-537. [PMID: 35660061 PMCID: PMC10729101 DOI: 10.1016/j.jen.2022.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/06/2022] [Accepted: 05/08/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Emergency nurses experience occupational stressors resulting from exposures to critical clinical events. The purpose of this study was to identify the critical clinical events for emergency nurses serving 3 patient populations (general, adult, pediatric) and whether the resilience of these nurses differed by the patient population served. METHODS This study used a cross-sectional survey design. A total of 48 emergency nurses were recruited from 3 trauma hospital-based emergency departments (general, adult, pediatric). Clinical Events Questionnaire, Connor-Davidson Resilience scale, and an investigator-developed demographic questionnaire were used to collect data from respondents. RESULTS All respondents were female (n = 48, 100%), and most were White (n = 46, 96%). The average age of participants was 39.6 years, the average number of years as a registered nurse was 12.7 years, and the average number of years as an emergency nurse was 8.8 years. Clinical events considered most critical were providing care to a sexually abused child, experiencing the death of a coworker, and lack of responsiveness by a colleague during a serious situation. The least stress-provoking event was incidents with excessive media coverage. Nurses were less affected by the critical events they experienced more frequently at work. Nurses in the 3 trauma settings had high level of resilience, with no statistically significant differences between groups. DISCUSSION The occupational stress from exposure to significant clinical events varied with the patient population served by emergency nurses. It is important that interventions be adopted to alleviate the effect of work-related stressors and promote the psychological health of emergency nurses.
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Wang J, Mao F, Wu L, Yang X, Zhang X, Sun Y, Huang Y, Lu YE, Luan X, Cao F. Work-related potential traumatic events and job burnout among operating room nurses: Independent effect, cumulative risk, and latent class approaches. J Adv Nurs 2021; 78:2042-2054. [PMID: 34850448 DOI: 10.1111/jan.15114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/04/2021] [Accepted: 11/15/2021] [Indexed: 12/25/2022]
Abstract
AIMS The objective of this study is to explore and compare the strength of associations between work-related potential traumatic events and burnout among operating room nurses based on three different approaches. DESIGN The study followed a multisite cross-sectional design. METHODS A stratified sampling method was conducted. Cities in the Shandong Province were divided into four groups, and two tertiary hospitals were randomly selected from all tertiary hospitals in cities of each group. A total of 361 eligible operating room nurses provided valid questionnaires between June and November 2019. Work-related potential traumatic events questionnaire and the Chinese version of the Maslach Burnout Inventory were conducted. Associations between individual, cumulative potential traumatic events, as well as latent class analysis-derived patterns of potential traumatic experiences with burnout were examined using logistic regression analysis. RESULTS Specific traumatic events (e.g., patients' sudden death, bullying and ostracism from colleagues) were independently associated with an increased risk of burnout. Work-related potential traumatic events had a cumulative effect on burnout, whereby operating room nurses exposed to cumulative potential traumatic events carried a higher risk for burnout than others. The "multiple work-related potential traumatic events" pattern derived by latent class analysis was related to an increased risk of high depersonalization. CONCLUSION Operating room nurses who reported specific or multiple work-related potential traumatic events were at high risk for burnout. It is of great significance to provide qualified and timely counselling or support. IMPACT This study is the first to focus on work-related potential traumatic events among operating room nurses and examine their relationship with burnout based on three perspectives. The findings could help identify those operating room nurses who are at high risk of burnout in clinical practice. Hospital managers should develop targeted interventions to prevent or mitigate the harmful impact of potential traumatic events on occupational health.
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Affiliation(s)
- Juan Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Fangxiang Mao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Liuliu Wu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Xiaomei Yang
- Linyi People' s Hosipital, Linyi, Shandong Province, China
| | - Xuan Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yaoyao Sun
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yongqi Huang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yan' E Lu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Xiaorong Luan
- Qilu Hospital, Cheloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
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Shimoinaba K, McKenna L, Copnell B. Nurses' experiences, coping and support in the death of a child in the emergency department: A qualitative descriptive study. Int Emerg Nurs 2021; 59:101102. [PMID: 34823111 DOI: 10.1016/j.ienj.2021.101102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND A child's death in the Emergency Department (ED) is usually unexpected and traumatic. Understanding nurses' experiences encountering such death is crucial in determining how they cope to provide quality nursing care to dying children and their families. PURPOSE To report ED nurses' experiences with children's death, coping strategies and support needs. PROCEDURES A qualitative descriptive design. Twenty-four registered nurses who had cared for a child who died in the ED took part in semi-structured interviews. Interviews were audiorecorded, and analyzed using thematic analysis. FINDINGS Three themes were generated: 'nature of emergency department work', 'working with families' and 'coping and support'. This paper reports on the theme 'coping and support'. Although children's deaths were traumatizing and affected nurses personally and professionally, constant time pressure allowed limited reflection time. Common individual coping mechanisms used by participants included external strategies through support from other staff members including peer-support and informal supervision, and internal strategies through personal coping strategies. Participants expressed need for greater support and education/training to effectively deal with pediatric death, children's families, and their own grief. CONCLUSIONS Children's deaths and nature of ED care affected nurses. Adequate support and deathrelated education were urged by participants to promote high-quality care provision.
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Affiliation(s)
- Kaori Shimoinaba
- Nursing and Midwifery, Monash University, PO Box 527, Frankston VIC 3199, Australia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora VIC 3086, Australia.
| | - Beverly Copnell
- School of Nursing and Midwifery, La Trobe University, 185 Cooper St., Epping VIC 3076, Australia.
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de Wijn AN, van der Doef MP. Patient-related stressful situations and stress-related outcomes in emergency nurses: A cross-sectional study on the role of work factors and recovery during leisure time. Int J Nurs Stud 2020; 107:103579. [PMID: 32446016 DOI: 10.1016/j.ijnurstu.2020.103579] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/21/2020] [Accepted: 03/13/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Emergency nurses are frequently exposed to patient-related stressful situations, making them susceptible to emotional exhaustion and symptoms of post-traumatic stress disorder. The current study aims to assess differential effects of patient-related stressful situations (emotionally demanding situations, aggression/conflict situations, and critical events) on stress-related outcomes in emergency nurses, and to identify moderating factors based on the Job Demands-Resources model and the Effort-Recovery model (job demands, job resources, and recovery experiences during leisure time). METHOD A cross-sectional study was carried out among nurses working in the emergency departments of 19 hospitals in the Netherlands (N = 692, response rate 73%). Data were collected by means of an online survey. Multiple hierarchical regression analyses were performed, controlling for sociodemographic variables. RESULTS The frequency of exposure to patient-related stressful situations was positively related to stress-related outcomes, with emotionally demanding situations and aggression/conflict situations mainly explaining variance in emotional exhaustion (β = 0.16, p < .01, ∆R² = 0.08, and β = 0.22, p < .01, ∆R² = 0.13), whereas critical events mainly explained variance in post-traumatic stress symptoms (β = 0.29, p < .01, ∆R² = 0.11). Moderating effects were found for within worktime recovery and recovery during leisure time. Work-time demands, autonomy and social support from the supervisor were predictive of stress-related outcomes irrespectively of exposure to patient-related stressful situations. CONCLUSION As patient-related stressful situations are difficult if not impossible to reduce in an emergency department setting, the findings suggest it would be worthwhile to stimulate within worktime recovery as well as recovery experiences during leisure time, to protect emergency nurses from emotional exhaustion and symptoms of post-traumatic stress. Furthermore, this study underscores the importance of reducing work-time demands and enhancing job resources to address stress-related outcomes in emergency nurses. Practical implications, strengths and limitations are discussed.
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Affiliation(s)
- A N de Wijn
- Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
| | - M P van der Doef
- Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
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Campillo-Cruz M, González-Gutiérrez JL, Ardoy-Cuadros J, Fernández-Muñoz JJ. The Development and Exploratory Psychometric Properties of the Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061963. [PMID: 32192115 PMCID: PMC7143067 DOI: 10.3390/ijerph17061963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/13/2020] [Accepted: 03/15/2020] [Indexed: 01/05/2023]
Abstract
Emergency nurses are exposed to traumatic events and routine stressors, both of which can lead to the development of PTSD (Post Traumatic Stress Disorder) symptomatology. However, there are currently no instruments designed to assess the impact and frequency of such sources of stress in nurses. The Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN) was built for this purpose. A sample of 147 emergency nurses from three hospitals in Madrid (Spain) completed this 13-item scale. The analyses showed a factorial structure composed of two factors. The first is characterized by items regarding traumatic and stressful events and procedures of severe magnitude (traumatic stressors), and the second by items related to stressful events and procedures of moderate magnitude (routine stressors) but hypothesized to possess a substantial traumatic potential. Analyses provided evidence of both adequate internal consistency (Cronbach’s α = 0.92; first factor α = 0.91 and second factor α = 0.86) and test–retest reliability. In addition, concurrent validity also proved to be satisfactory. In short, TRSS-EN seems to be a reliable and valid tool in a healthcare emergency nursing setting for screening the frequency and impact of exposure to everyday work-related traumatic stressors, either event-related or routine.
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8
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Implementing an ED Critical Incident Stress Management Team. J Emerg Nurs 2016; 42:474-480. [DOI: 10.1016/j.jen.2016.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/24/2016] [Accepted: 04/25/2016] [Indexed: 11/20/2022]
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9
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The Relationship Between Secondary Traumatic Stress and Personal Posttraumatic Growth: Personality Factors as Moderators. JOURNAL OF ADULT DEVELOPMENT 2016. [DOI: 10.1007/s10804-016-9228-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Gosselin E, Bourgault P, Lavoie S. Association between job strain, mental health and empathy among intensive care nurses. Nurs Crit Care 2015; 21:137-45. [PMID: 26581404 DOI: 10.1111/nicc.12064] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/12/2013] [Accepted: 09/30/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nursing shortage is a worldwide issue. It could influence factors such as job strain, nurses' mental health and nurse empathy towards patients. AIM The aim of the study is to explore the associations between job strain, psychological distress, psychological well-being and empathy in intensive care units (ICUs). DESIGN A cross-sectional descriptive correlational design. METHODS Data were collected using questionnaires and an observation tool completed by three observers during a standardized clinical simulation (SCS). A total of 26 nurses practicing in three ICUs participated in the study, which took place over 3 days in December 2011. RESULTS One dimension of job strain, psychological demand, was associated with two subscales of mental health (psychological distress positively and psychological well-being negatively). Positive correlations were demonstrated between psychological distress and nurse empathy as perceived by both the observers and the actor who played the role of patient. CONCLUSION Some associations have been confirmed between job strain, psychological distress, psychological well-being and empathy in the ICU while others needs further investigation. RELEVANCE TO CLINICAL PRACTICE It is important to reduce psychological demand among intensive care nurses in order to prevent psychological distress. The exploration of the connection between empathy and psychological distress should be advanced. This study suggests that SCSs provide an innovative approach that is useful for research.
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Affiliation(s)
- Emilie Gosselin
- École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada.,Centre hospitalier universitaire de Sherbrooke, Québec, Canada
| | - Patricia Bourgault
- École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada
| | - Stephan Lavoie
- École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada
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11
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Lavoie S, Talbot LR, Mathieu L, Dallaire C, Dubois MF, Courcy F. An exploration of factors associated with post-traumatic stress in ER nurses. J Nurs Manag 2015; 24:174-83. [DOI: 10.1111/jonm.12294] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Stéphane Lavoie
- École des sciences infirmières; Faculté de médecine et des sciences de la santé; Université de Sherbrooke; Sherbrooke QC Canada
| | - Lise R. Talbot
- École des sciences infirmières; Faculté de médecine et des sciences de la santé; Université de Sherbrooke; Sherbrooke QC Canada
| | - Luc Mathieu
- École des sciences infirmières; Faculté de médecine et des sciences de la santé; Université de Sherbrooke; Sherbrooke QC Canada
| | - Clémence Dallaire
- Faculté des sciences infirmières; Université Laval; Québec QC Canada
| | - Marie-France Dubois
- Département des sciences de la santé communautaire; Faculté de médecine et des sciences de la santé; Université de Sherbrooke; Sherbrooke QC Canada
| | - François Courcy
- Département de psychologie; Faculté des lettres et sciences humaines; Université de Sherbrooke; Sherbrooke QC Canada
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12
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Smith Z, Leslie G, Wynaden D. Australian perioperative nurses' experiences of assisting in multi-organ procurement surgery: a grounded theory study. Int J Nurs Stud 2014; 52:705-15. [PMID: 25577305 DOI: 10.1016/j.ijnurstu.2014.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 12/08/2014] [Accepted: 12/16/2014] [Indexed: 01/10/2023]
Abstract
INTRODUCTION/BACKGROUND Multi-organ procurement surgical procedures through the generosity of deceased organ donors, have made an enormous impact on extending the lives of recipients. There is a dearth of in-depth knowledge relating to the experiences of perioperative nurses working closely with organ donors undergoing multi-organ procurement surgical procedures. AIM The aim of this study was to address this gap by describing the perioperative nurses experiences of participating in multi-organ procurement surgical procedures and interpreting these findings as a substantive theory. DESIGN This qualitative study used grounded theory methodology to generate a substantive theory of the experiences of perioperative nurses participating in multi-organ procurement surgery. SETTING Recruitment of participants took place after the study was advertised via a professional newsletter and journal. The study was conducted with participants from metropolitan, rural and regional areas of two Australian states; New South Wales and Western Australia. PARTICIPANTS Thirty five perioperative nurse participants with three to 39 years of professional nursing experience informed the study. METHODS Semi structured in-depth interviews were undertaken from July 2009 to April 2010 with a mean interview time of 60 min. Interview data was transcribed verbatim and analysed using the constant comparative method. RESULTS The study results draw attention to the complexities that exist for perioperative nurses when participating in multi-organ procurement surgical procedures reporting a basic social psychological problem articulated as hiding behind a mask and how they resolved this problem by the basic social psychological process of finding meaning. CONCLUSION This study provides a greater understanding of how these surgical procedures impact on perioperative nurses by providing a substantive theory of this experience. The findings have the potential to guide further research into this challenging area of nursing practice with implications for clinical initiatives, management practices and education.
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Affiliation(s)
- Zaneta Smith
- Princess Margaret Hospital for Children, Department of Health, WA, Australia; School of Nursing & Midwifery, Griffith University, QLD, Australia.
| | - Gavin Leslie
- Critical Care Nursing, School of Nursing & Midwifery, Curtin Health Innovation Research Institute, Curtin University, WA, Australia
| | - Dianne Wynaden
- Mental Health, School of Nursing & Midwifery, Curtin Health Innovation Research Institute, Curtin University, WA, Australia
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The impact of traumatic events on emergency room nurses: Findings from a questionnaire survey. Int J Nurs Stud 2012; 49:1411-22. [DOI: 10.1016/j.ijnurstu.2012.07.003] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 06/23/2012] [Accepted: 07/06/2012] [Indexed: 11/13/2022]
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Nurses’ early experiences with patient death: The results of an on-line survey of Registered Nurses in New Zealand. Int J Nurs Stud 2012; 49:1255-65. [DOI: 10.1016/j.ijnurstu.2012.04.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 04/10/2012] [Accepted: 04/14/2012] [Indexed: 11/24/2022]
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Czaja AS, Moss M, Mealer M. Symptoms of posttraumatic stress disorder among pediatric acute care nurses. J Pediatr Nurs 2012; 27:357-65. [PMID: 22703683 PMCID: PMC3381608 DOI: 10.1016/j.pedn.2011.04.024] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 04/14/2011] [Accepted: 04/20/2011] [Indexed: 10/18/2022]
Abstract
In their work, pediatric acute care nurses may encounter traumatic events and be at risk for posttraumatic stress disorder (PTSD). This survey-based study examines the potential diagnosis of PTSD among nurses at a tertiary children's hospital with a Level 1 trauma center. Twenty-one percent of respondents had strong PTSD symptoms without significant difference between units. Nurses with potential PTSD had more comorbid symptoms of anxiety, depression, and burnout and were more often considering a career change. Furthermore, symptoms affected not only their work but also their personal lives. Future research should focus upon identifying pediatric nurses with PTSD to provide therapeutic interventions and reducing high-risk events and their potential impact.
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Affiliation(s)
- Angela S Czaja
- Division of Critical Care, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
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Komachi MH, Kamibeppu K, Nishi D, Matsuoka Y. Secondary traumatic stress and associated factors among Japanese nurses working in hospitals. Int J Nurs Pract 2012; 18:155-63. [PMID: 22435979 DOI: 10.1111/j.1440-172x.2012.02014.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nurses can experience secondary traumatic events while caring for patients. However, the severity of this issue is underestimated in Japan. To evaluate the prevalence and factors associated with secondary traumatic stress among general hospital nurses, we carried out a cross-sectional study at a general hospital in August 2006. The rate of experiencing secondary trauma was 90.3% (159 of 176 nurses; 52.1% response rate). The median score of the Impact of Event Scale-Revised was 4.0 (range, 0-56). In multiple regression analyses, variables correlated with the Impact of Event Scale included neuroticism, trauma severity and feelings of self-reproach. It is necessary to develop support systems for nurses at risk for secondary traumatic stress.
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Affiliation(s)
- Miyuki H Komachi
- Department of Family Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
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Blacklock E. Interventions following a critical incident: developing a critical incident stress management team. Arch Psychiatr Nurs 2012; 26:2-8. [PMID: 22284076 DOI: 10.1016/j.apnu.2011.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 04/15/2011] [Accepted: 04/22/2011] [Indexed: 10/18/2022]
Abstract
This article describes the development and implementation of a stress management model for assisting hospital staff after critical incidents using an adaptation of Mitchell's model (J. Mitchell, 1983). A survey was conducted following the first major incident using M. Horowitz, N. Wilner, and W. Alvarez's (1979) Impact of Event Scale 10 days after and again 6 weeks following the incident to measure its emotional impact on staff. Outcomes included being symptom-free of critical incident stress after a 3-month period. The interventions were intended to help staff at a large metropolitan multispecialty hospital in Queensland in the immediate period following critical incidents. The implications of this program indicated the importance of emotional support at critical times for health professionals.
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Affiliation(s)
- Eddie Blacklock
- Griffith University, Nathan Campus, Brisbane, Queensland, Australia.
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Lavoie S, Talbot LR, Mathieu L. Post-traumatic stress disorder symptoms among emergency nurses: their perspective and a ‘tailor-made’ solution. J Adv Nurs 2011; 67:1514-22. [DOI: 10.1111/j.1365-2648.2010.05584.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Declercq F, Meganck R, Deheegher J, Van Hoorde H. Frequency of and subjective response to critical incidents in the prediction of PTSD in emergency personnel. J Trauma Stress 2011; 24:133-6. [PMID: 21351174 DOI: 10.1002/jts.20609] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In this study, the authors compared the respective contribution of an individual's subjective response and the frequency of exposure to critical incidents to the development of symptoms of posttraumatic stress disorder (PTSD) in a sample of 136 nurses and ambulance personnel working in military facilities. They found no relationship between the frequency of encountered critical incidents and the occurrence of PTSD symptoms. The subjective response to a stressor contributed to the development of PTSD symptoms and was most strongly associated with intrusion, partial eta squared =.23, and hyperarousal symptoms, partial eta squared =.16. Stressors that elicited the most intense affects within this population were those involving children and those where workers encountered limitations in supplies and resources.
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Affiliation(s)
- Frédéric Declercq
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, B-9000 Ghent, Belgium.
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Koukia E, Madianos MG, Katostaras T. "On the spot" interventions by mental health nurses in inpatient psychiatric wards in Greece. Issues Ment Health Nurs 2009; 30:327-36. [PMID: 19437252 DOI: 10.1080/01612840902754586] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The objective of this research was to explore the "on-the spot" clinical interventions mental health nurses make in critical incidents on inpatient psychiatric wards. Mental health nurses play a key role in the management of psychiatric critical incidents. Nurses' autonomy, decision-making, and training in clinical interventions are important issues in psychiatric nursing practice. A descriptive study was conducted among mental health nurses working on inpatient wards of three major psychiatric hospitals in the greater Athens area, using semi-structured interviews. Nurses' personal views also were documented. Semi-structured interviews were conducted with 103 mental health nurses, who were encouraged to make personal remarks. The results of this study show that in the majority of critical incidents, the nurses were found to be in contact with the psychiatrist on call; physical restraints were used frequently in violent episodes; reassurance and support were common interventions; the majority of nurses would have preferred not to intervene with critical incidents; and nurses expressed a need for skills training and higher autonomy. The nurses implemented a specific number of interventions in confronting the various types of crises. The need for specialized training was noticed and problems like accountability, autonomy, and medication administration, were considered crucial by the mental heath nurses.
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Affiliation(s)
- Evmorfia Koukia
- Lecturer in Psychiatric Nursing, University of Athens, Greece
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Gates DM, Gillespie GL. Secondary Traumatic Stress in Nurses Who Care for Traumatized Women. J Obstet Gynecol Neonatal Nurs 2008; 37:243-9. [DOI: 10.1111/j.1552-6909.2008.00228.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Korst LM, Signer JMK, Aydin CE, Fink A. Identifying organizational capacities and incentives for clinical data-sharing: the case of a regional perinatal information system. J Am Med Inform Assoc 2007; 15:195-7. [PMID: 18096916 DOI: 10.1197/jamia.m2475] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The development of regional data-sharing among healthcare organizations is viewed as an important step in the development of health information technology (HIT), but little is known about this complex task. This is a case study of a regional perinatal data system that involved four hospitals, together responsible for over 10,000 births annually. Using standard qualitative methods, we chronicled project milestones, and identified 31 "critical incidents" that delayed or prevented their achievement. We then used these critical incidents to articulate six organizational capacity domains associated with the achievement of project milestones, and a seventh domain consisting of organizational incentives. Finally, we analyzed the relationship of milestone achievement to the presence of these capacities and incentives. This data center case suggests four requirements for sharing data across organizations: 1) a readiness assessment; 2) a perceived mandate; 3) a formal governance structure; and 4) a third party IT component.
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Affiliation(s)
- Lisa M Korst
- Childbirth Research Associates, LLC Los Angeles, CA, USA.
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Abstract
AIM This paper reports a review analysing the use of factor analysis in papers in Journal of Advanced Nursing. BACKGROUND Factor analysis is a multivariate statistical method for reducing large numbers of variables to fewer underlying dimensions. There are several methods of factor analysis with principal components analysis being the most commonly applied. Factor analysis has been used by researchers in nursing for many years but the standards for use and reporting are variable. METHOD Papers using factor analysis in Journal of Advanced Nursing were retrieved from 1982 to the end of 2004. The search term 'factor analysis' was used in the CINAHL database and applied specifically to Journal of Advanced Nursing in December 2004. Retrieved papers were included in the review if they came from Journal of Advanced Nursing and used factor analysis as part of the method of the reported study. RESULTS One hundred and twenty-four papers were retrieved as a result of the initial search criteria of which 116 were from Journal of Advanced Nursing. Screening of papers for the use of factor analysis left 100 papers for review. Principal components analysis was the most commonly used method of factor analysis; Eigenvalues greater than one was the most commonly applied criterion for selecting the number of factors followed by orthogonal rotation to achieve simple structure. The majority of papers did not report the whole factor solution and there were papers that did not specify anything beyond the fact that they carried out factor analysis. Confirmatory factor analysis was rarely used and exploratory methods other than principal components analysis were also rarely used. CONCLUSIONS Factor analysis is quite commonly used in nursing research reported in Journal of Advanced Nursing. While some papers are exemplary there is room for improvement in the reporting of all aspects of factor analysis.
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Affiliation(s)
- Roger Watson
- Graduate Division of Nursing and Midwifery School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK.
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French B. Evidence-based practice and the management of risk in nursing. HEALTH RISK & SOCIETY 2005. [DOI: 10.1080/13698570500108735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lane P, O'Brien U, Gooney MA, Reid T. The Progression of Holism Into Postgraduate Curricula in Critical Care Nursing. Dimens Crit Care Nurs 2005; 24:131-8. [PMID: 15912063 DOI: 10.1097/00003465-200505000-00007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Critical care education is an important part of the professional development of a competent critical care nurse. Interdependence between physiological and psychosocial theories and concepts is a key consideration in the development of critical care educational programs. This multidisciplinary educational framework fosters a deeper understanding of factors contributing to ill health. Establishing a strategic framework where research, education, clinical excellence, and quality assurance are interlinked is central to enhancing the efficacy of patient care outcomes.
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MESH Headings
- Adaptation, Psychological
- Attitude of Health Personnel
- Critical Care/organization & administration
- Critical Care/psychology
- Critical Illness/nursing
- Critical Illness/psychology
- Curriculum/trends
- Education, Nursing, Graduate/organization & administration
- Holistic Health
- Holistic Nursing/education
- Holistic Nursing/trends
- Humans
- Ireland
- Knowledge
- Models, Educational
- Models, Nursing
- Nurse's Role
- Nursing Education Research
- Nursing Research/education
- Nursing Research/organization & administration
- Nursing Staff, Hospital/education
- Nursing Staff, Hospital/organization & administration
- Patient Care Team/organization & administration
- Philosophy, Nursing
- Program Development
- Program Evaluation
- Quality Assurance, Health Care/organization & administration
- Spirituality
- Students, Nursing/psychology
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Affiliation(s)
- Paula Lane
- Waterford Regional Hospital, Dunmore Rd, Waterford, Republic of Ireland.
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