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Hayajneh AA, Al-Younis MO, Rababa M, Qahah I. Effect of Mindfulness Intervention on Compassion Fatigue Among Nurses: A Randomized Controlled Trial Study. Holist Nurs Pract 2024:00004650-990000000-00037. [PMID: 39166821 DOI: 10.1097/hnp.0000000000000687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Compassion fatigue is a syndrome defined by both mental and physical restlessness. Mindfulness intervention can enhance one's emotions with nonjudgmental awareness and greater consciousness of thoughts and feelings. This study aims to examine the effect of mindfulness intervention on compassion fatigue among nurses. A randomized controlled trial was conducted, recruiting 100 nurses from three hospitals and dividing participants into an intervention and a control group. Increased mindfulness awareness was found in the comparison group in the research. The intervention group's mean burnout level was significantly lower than the comparison group. Age, gender, marital status, household size, and household income were among the sociodemographic factors that significantly correlated with compassion fatigue, which was determined through burnout and secondary traumatic stress. Nurses reported significant levels of compassion fatigue; however, this was significantly decreased through mindfulness intervention.
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Affiliation(s)
- Audai A Hayajneh
- Author Affiliations: Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan (Dr Hayajneh, Ms Al-Younis, and Dr Rababa); The World Islamic Sciences and Education University, Amman, Jordan (Dr Qahah)
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Capuia D, da Cruz M, Masseca A, Marques E, Leite P, Mangus AR, Webb EK, Ravichandran C, Ressler KJ, Moreland-Capuia A. Trauma-informed systems change training has transcultural, transcontinental transformative healing power: An analysis of leaders in the United States and Angola, Africa. J Trauma Stress 2024. [PMID: 38837449 DOI: 10.1002/jts.23062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
The Institute for Trauma-Informed Systems Change (ITISC) facilitated a 2-day, 12-hr trauma-informed workshop, delivered virtually, using the Training for Change curriculum. The workshop took place in Portuguese in September 2021 with a group of Angolan leaders (N = 51) and in May 2022, in English, with neonatal intensive care unit (NICU) workers from the United States (N = 73). Surveys were administered before (Time [T] 0) and after the workshop (T1) and consisted of demographic questions and the Survey for Trauma-Informed Systems Change (STISC), which assesses system-wide knowledge and attitudes about trauma-informed systems change and the intersection of culture, safety, and acceptance in the workplace. At T1, 18 (35.3%) participants in the Angolan leaders' group and 46 (63.0%) in the NICU group completed the surveys. Mean scores on the STISC Self-Assessed Knowledge and Attitudes subscale and STISC System-Wide Knowledge and Attitudes subscale increased significantly in both groups after the training. Effect sizes were large for self-assessed knowledge and attitudes, Angolan leaders: d = 1.11, NICU: d = 1.97, and small-to-medium for system-wide knowledge and attitudes, Angolan leaders: d = 0.52, NICU: d = 0.38. Limitations include the relatively small sample size and low participation rates for survey responses. Future research should examine the efficacy of the curriculum in larger samples that include individuals from diverse professions and additional countries. Together, the findings provide initial support that this training can be directly translated and implemented on a global scale.
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Affiliation(s)
- Daniel Capuia
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Maria da Cruz
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Ana Masseca
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Engracia Marques
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Paulo Leite
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Alexandra R Mangus
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
| | - E Kate Webb
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Caitlin Ravichandran
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Lurie Center for Autism, Lexington, Massachusetts, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Alisha Moreland-Capuia
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Hughes RVV, Hudson KW, Wright E, Swoboda SM, Frangieh J, D'Aoust RF. Cultivating Self-Compassion to Protect Nurses From Burnout and Secondary Traumatic Stress. Nurs Womens Health 2024; 28:159-167. [PMID: 38462229 DOI: 10.1016/j.nwh.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 03/12/2024]
Abstract
Nursing burnout, a result of prolonged occupational stress, has always been a challenge in health care, but recently the COVID-19 pandemic made this issue into a national priority. In fact, burnout among health care workers is one of the four priorities of the U.S. Surgeon General. Health care leaders and organizations are eager to implement strategies to improve nurses' well-being and, thus, enhance their mental health. Much of the literature has focused on the antecedents and consequences of nursing burnout, but there is limited information on strategies that protect perinatal nurses from burnout. Self-compassion is emerging as one strategy that has a positive correlation with nurse well-being and a negative association with burnout, depression, and anxiety. In this article, we identify and translate strategies to promote self-compassion in perinatal nurses.
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Alharbi MF, Alkhamshi AM. Assessing the professional quality of life in the context of pediatric care. PeerJ 2024; 12:e17120. [PMID: 38500534 PMCID: PMC10946390 DOI: 10.7717/peerj.17120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/26/2024] [Indexed: 03/20/2024] Open
Abstract
Background This study examines the professional quality of life (ProQOL), including compassion satisfaction (CS) and compassion fatigue (CF), burnout (BO) and secondary traumatic stress (STS) among registered nurses in the context of pediatric care in Riyadh city in Saudi Arabia. Methods This study utilised a random multistage sampling method and a survey to collect data from 250 participants on personal characteristics, work-related aspects, lifestyle, and professional quality of life. Results The study participants were all female. Only 2.0% were under 25, with 27.2% aged between 25 and 30 years, 24.0% aged between 31 and 35, and 26.4% over 40 years old. The majority, 74%, were non-Saudis. The participants reported low compassion satisfaction (CS) and compassion fatigue (CF) levels. The CS, burnout (BO), and secondary traumatic stress (STS) scores were 3.23 ± 0.764, 2.75 ± 0.68, and 2.69 ± 0.54, respectively. The study found a significant difference in ProQOL level based on factors such as age, nationality, previous experience, department, shift length, overtime work, state of overtime (mandatory versus optional), and salary. Conclusions Working with vulnerable groups poses unique challenges for pediatric nurses. The nationality, salary, and state of overtime were found to be significantly different when compared to CS scores. Additionally, age, department, previous experience, shift length, and overtime work were very different compared to CF scores. However, lifestyle factors did not affect CS and CF scores significantly. Implications To improve their well-being and interest in activities, pediatric nurses should practice self-compassion and utilise available educational resources such as workshops. They should also strive to achieve a work-life balance and adopt healthy habits to reduce CF.
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Affiliation(s)
- Manal F. Alharbi
- Maternal & Child Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Aljawharah M. Alkhamshi
- Nursing Education Department, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
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Civljak M, Stivic I, Puljak L. Secondary traumatic stress in working nurses studying part time in a bachelor or Master's nursing program in Croatia: a cross-sectional study. BMC Nurs 2024; 23:22. [PMID: 38183032 PMCID: PMC10768158 DOI: 10.1186/s12912-023-01691-1] [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: 08/26/2023] [Accepted: 12/25/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Nurses are more likely to be exposed to human suffering than other healthcare professionals. Persons exposed to indirect trauma can experience symptoms of posttraumatic stress disorder, symptoms of avoidance, arousal and intrusion. Secondary traumatic stress (STS) occurs when a person hears about the firsthand traumatic experiences of another. This study aimed to explore the prevalence of STS among working nurses enrolled at a university nursing program. METHODS A cross-sectional study was conducted among nurses working in healthcare enrolled in university bachelor's or Master's nursing studies at the Catholic University of Croatia in November 2017. Data were collected using the Secondary Traumatic Stress Scale (STSS) and two items from the World Health Organization quality of life brief version (WHOQOL-BREF). RESULTS The study included 151 students; the response rate was 70%. The mean STS score was 38, indicating that the students on average suffered from moderate STS. Half of participating nurses met the criteria for STS. Working nurses enrolled in Master's studies had lower STS scores than those enrolled into bachelor studies (t = 4.14, df = 149, p < 0.01). The level of STS had a negative correlation with participants' quality of life assessment (r=-0.392, p < 0.01) and satisfaction with their health (r=-0.387, p < 0.01). We also found a significant positive correlation between subjective assessment of quality of life and satisfaction with personal health (r = 0.432, p < 0.01). We did not find a significant association between the level of STS and sex (r=-0.094) or years of nursing work experience (r=-0.069). Level of STS varied depending on the participants' workplace, years of experience in that workplace and their work shifts. The highest levels of STS were seen in nurses working in the internal medicine department, those with 10-14 years of work experience in the current workplace, and those who work block shifts (12-hr shift followed by 24-hour shift). CONCLUSION Over half of working nurses attending university studies had at least moderate STS. Furthermore, STS was negatively associated with participants' perception of quality of life and satisfaction with their health. Prevention and alleviation interventions could reduce the burden of STS among nurses.
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Affiliation(s)
- Marta Civljak
- Center for Evidence-based Medicine and Health Care, Catholic University of Croatia, Ilica 242, Zagreb, 10000, Croatia
| | - Ines Stivic
- Center for Evidence-based Medicine and Health Care, Catholic University of Croatia, Ilica 242, Zagreb, 10000, Croatia
| | - Livia Puljak
- Center for Evidence-based Medicine and Health Care, Catholic University of Croatia, Ilica 242, Zagreb, 10000, Croatia.
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Dehghan M, Mokhtarabadi S, Rashidi E, Rahiminejad E, Asadi N. Correlation between professional quality of life and alarm fatigue symptoms among intensive care unit nurses. Health Sci Rep 2023; 6:e1583. [PMID: 37822846 PMCID: PMC10563168 DOI: 10.1002/hsr2.1583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/03/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023] Open
Abstract
Introduction Medical devices and equipment are necessary for accurate and continuous monitoring of the patients admitted to intensive care units, one of which is alarm systems. Frequent sounds of alarms can affect nurses' concentration and accuracy when providing care. Complications such as headache, fatigue, and stress occur after repeated alarms, leading to poor quality of professional life among nurses. This study aimed to determine the relationship between quality of professional life and alarm fatigue syndrome among intensive care unit nurses. Methods This cross-sectional study used convenience sampling to select nurses working in intensive care units from three hospitals in southern Iran in 2021 (n = 201). Data were collected using three questionnaires, including sociodemographic form, the professional quality of life questionnaire (ProQOL), and the alarm fatigue symptom (AFS) scale. Results The mean scores of compassion satisfaction (CS), burnout, secondary traumatic stress (STS) (subscales of the ProQOL), and AFS were 34.66 ± 7.54, 28.98 ± 7.59, 27.69 ± 5.87, and 13.48 ± 7.32, respectively. The majority of them had no or mild AFS, moderate CS, burnout, and STS. Among the study variables, only AFS were a significant predictor of CS and STS among ICU nurses. In addition, work experience in ICU, AFS, and a second job were significant predictors of burnout among ICU nurses. Conclusions The study results showed a significant relationship between alarm fatigue syndrome, burnout, STS, and CS. Given that more than half of the nurses in the intensive care unit in the present study experienced some degree of alarm fatigue syndrome, it is necessary to plan and implement interventions to better manage the alarms in the intensive care unit.
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Affiliation(s)
- Mahlagha Dehghan
- Nursing Research CenterKerman University of Medical SciencesKermanIran
| | - Sima Mokhtarabadi
- Nursing Research CenterKerman University of Medical SciencesKermanIran
| | - Elham Rashidi
- Nursing Research CenterKerman University of Medical SciencesKermanIran
| | - Elham Rahiminejad
- Nursing Research CenterKerman University of Medical SciencesKermanIran
| | - Neda Asadi
- Nursing Research CenterKerman University of Medical SciencesKermanIran
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Abstract
Background and Purpose: Secondary traumatic stress (STS) results in detrimental effects in healthcare professionals, impacting the safety of patients and their care. There are multiple instruments being used to measure STS, reflecting the uncertainty on how to best measure STS. The purpose of this review is to present an overview of the state of measurement of STS. Methods: PubMed, CINAHL, and Cochrane Database of Systematic Reviews databases were searched using the terms "secondary traumatic stress" and "measurement." Results: The search resulted in nine applicable articles and four instruments used to measure STS. Utility and psychometric properties of the instruments are examined. Conclusions: The secondary traumatic stress scale is most appropriate to measure STS given that it is the only instrument intended to measure only STS, but psychometric testing with nurses is needed.
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Xu L, Masters GA, Moore Simas TA, Bergman AL, Byatt N. Labor and Delivery Clinician Perspectives on Impact of Traumatic Clinical Experiences and Need for Systemic Supports. Matern Child Health J 2023:10.1007/s10995-023-03708-2. [PMID: 37278845 DOI: 10.1007/s10995-023-03708-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Few studies have elucidated the impact of work-related trauma on labor and delivery clinician or considered whether it may be a cause of burnout. This study aims to elicit labor and delivery clinician perspectives on the impact of exposure to traumatic births on their professional quality of life. METHODS Labor and delivery clinicians (physicians, midwives, nurse practitioners, and nurses; n = 165) were recruited to complete an online questionnaire on experiences with traumatic births. The questionnaire contained measures from the Maslach Burnout Inventory and the professional quality of life scale version 5. Some participants completed an optional free-text prompt to recommend ways to support clinicians after traumatic births (n = 115). Others opted into a semi-structured phone interview (n = 8). Qualitative data was analyzed using a modified grounded theory approach. RESULTS Self-reported adequate institutional support for clinicians after a traumatic birth was positively correlated with compassion satisfaction (r = 0.21, p < 0.01) and negatively correlated with secondary traumatic stress (r = - 0.27, p < 0.01), and burnout (r = - 0.26, p < 0.01). Qualitative themes included lack of system-wide and leadership support, lack of access to mental health resources, and suboptimal workplace culture as contributors toward secondary traumatic stress and burnout. Participants recommended proactive leadership, consistent debriefing protocols, trauma education, and improved access to counseling. CONCLUSIONS FOR PRACTICE Multi-level barriers prevented labor and delivery clinicians from accessing needed mental health support after exposure to traumatic births. Proactive investment in healthcare system supports for clinicians may improve clinician professional quality of life.
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Affiliation(s)
- Lulu Xu
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA.
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA.
- Department of Pediatrics, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
| | - Grace A Masters
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
| | - Tiffany A Moore Simas
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Obstetrics and Gynecology, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Pediatrics, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Obstetrics and Gynecology, UMass Memorial Health Care, 55 N Lake Avenue, Worcester, MA, 01655, USA
| | - Aaron L Bergman
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Emergency Medicine, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
| | - Nancy Byatt
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Obstetrics and Gynecology, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
- Department of Psychiatry, UMass Memorial Health Care, 55 N Lake Avenue, Worcester, MA, 01655, USA
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Bian W, Cheng J, Dong Y, Xue Y, Zhang Q, Zheng Q, Song R, Yang H. Experience of pediatric nurses in nursing dying children - a qualitative study. BMC Nurs 2023; 22:126. [PMID: 37072761 PMCID: PMC10111798 DOI: 10.1186/s12912-023-01274-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/27/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE To explore pediatric nurses' challenges and effective coping strategies in caring for dying children. METHODS A descriptive qualitative study was adopted. Data were collected using a semi-structured interview with ten nurses from the pediatric, pediatric emergency, and neonatology departments. RESULTS Three themes were generated: stressors, consequences, and coping strategies. Ten sub-themes were generalized: negative emotions; helplessness; questioning rescue behavior; fear of communication; lack of workforce for night rescue; compassion fatigue; burnout; changes in life attitudes; self-regulation; leadership approval and no accountability. CONCLUSIONS Through qualitative research, nurses' challenges and effective coping strategies in caring for dying children were found, which provides information for nurses' career development and related policy formulation in China. CLINICAL RELEVANCE While there are many articles in China on hospice care, there is little research on the nurses' experience of caring for dying children. Many studies have mentioned the adverse consequences of caring for dying children in foreign countries, leading to post-traumatic stress disorder (PTSD). However, domestic discussion of such problems is rare, and no corresponding coping strategies exist. This study explores pediatric nurses' challenges and effective coping strategies in caring for dying children.
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Affiliation(s)
- Weina Bian
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Junxiang Cheng
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Shanxi, 030000, China
| | - Yue Dong
- Department of ICU, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, 222000, China
| | - Ying Xue
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Qian Zhang
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Qinghua Zheng
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Rui Song
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Hongwei Yang
- Department of Statistics, Hanzhong Central Hospital, Shaanxi, 723000, China.
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Egami S, Highfield MEF. The Effect of a Mindfulness Phone Application on NICU Nurses' Professional Quality of Life. Adv Neonatal Care 2023; 23:E70-E78. [PMID: 37036941 DOI: 10.1097/anc.0000000000001064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND Evidence suggests that mindfulness training using a phone application (app) may support neonatal intensive care unit (NICU) nurses in their high stress work. If effective, phone apps could improve nurses' professional quality of life (QOL) defined as compassion satisfaction (CS) and compassion fatigue (CF) that includes burnout (BO) and secondary traumatic stress (STS). PURPOSE To test the hypothesis that use of a mindfulness phone app will increase NICU nurses' professional QOL. METHODS Using a single-group, pre/posttest design, investigators invited a convenience sample of 54 NICU nurses from a 377-bed Magnet-recognized, nonprofit hospital to complete a demographic sheet and 2 established scales: the Professional Quality of Life scale, version 5 (ProQOL5), and the Mindfulness Attention Awareness Scale (MAAS). The intervention was nurses' using the mindfulness phone app, Premium Moodfit, for 3 weeks. RESULTS Response rate was 41% (N = 22). A paired t test for the 9 nurses who returned both pre- and posttest questionnaires showed that their STS fell from moderate to low (P = .003), while their low BO scores (P = .12) and moderate CS scores (P = .4) remained stable. Wilcoxon tests confirmed results: only STS decreased (P =.01). The hypothesis was partly supported. IMPLICATIONS FOR PRACTICE AND RESEARCH Using the Premium Moodfit mindfulness phone app may improve or maintain NICU nurses' professional QOL even under heightened stress. Individual nurses may independently access Moodfit and the free ProQOL5. Replication studies are warranted to confirm results and establish trends.
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Affiliation(s)
- Susan Egami
- Providence Holy Cross Medical Center, Mission Hills, California
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Ravaldi C, Mosconi L, Mannetti L, Checconi M, Bonaiuti R, Ricca V, Mosca F, Dani C, Vannacci A. Post-traumatic stress symptoms and burnout in healthcare professionals working in neonatal intensive care units: Results from the STRONG study. Front Psychiatry 2023; 14:1050236. [PMID: 36816403 PMCID: PMC9935564 DOI: 10.3389/fpsyt.2023.1050236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Newborns' deaths and life-threatening conditions represent extremely stressful events for parents and professionals working in NICUs, facilitating the onset of secondary traumatic stress symptoms. The STRONG study aims to better understand the psychological impact on Italian NICUs staff of bereavement care. METHODS The STRONG (STress afteR lOss in NeonatoloGy) study is a cross-sectional study based on a web survey consisted of four sections: sociodemographic, CommuniCARE-Newborn questionnaire, the Maslach Burnout Inventory and the Impact of Event Scale-Revised. RESULTS 227 NICU workers (42.7% nurses, 23.3% midwives, 22.2% physicians, 11.8% other HCPs) answered the survey. The hardest tasks were "communicating baby's death" and "informing on autopsy results"; 44.7% of HCPs did not receive formal training in communicating bad news, 44.2% 'learned from the field' by watching other colleagues; 41.2% declared that they do not have any communication strategy. More than 90% of professionals thought that training on bereavement care is necessary. The majority of HCPs showed some degree of post-traumatic stress symptoms: 34% medium and 35.3% severe. Professionals with training in bereavement care and/or in communication had less probability to develop stress symptoms. A multivariate analysis showed that higher levels of burnout were associated with 4 or more monthly losses and medium or severe stress symptoms. Having a well-defined communication strategy for breaking bad news was independently associated with a better personal accomplishment. CONCLUSION Dealing with newborns' deaths is a highly stressful task; professionals should receive proper support such as debriefing, psychological support and training in order to prevent post-traumatic stress symptoms and reduce professional burnout.
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Affiliation(s)
- C Ravaldi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - L Mosconi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy
| | - L Mannetti
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - M Checconi
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - R Bonaiuti
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - V Ricca
- Department of Health Sciences, Psychiatry Unit, Careggi General Hospital, University of Florence, Florence, Italy
| | - F Mosca
- Department of Pediatrics, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Italian Society of Neonatology (SIN), Milan, Italy
| | - C Dani
- PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - A Vannacci
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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Caricati L, De vito M, Panari C. The role of group identification, self‐ and collective efficacy on secondary traumatic stress and general health in a sample of emergency medical service volunteers. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2022. [DOI: 10.1111/jasp.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Luca Caricati
- Department of Humanities, Social Sciences and Cultural Industries University of Parma Parma Italy
| | - Martina De vito
- Department of Humanities, Social Sciences and Cultural Industries University of Parma Parma Italy
| | - Chiara Panari
- Department of Economics and Management University of Parma Parma Italy
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Fewer Patients per Nurse Does Not Offset Increased Nurse Stress Related to Treatment Uncertainty and Mortality in the Neonatal Intensive Care Unit. Adv Neonatal Care 2022; 22:E152-E158. [PMID: 34743114 DOI: 10.1097/anc.0000000000000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Many inpatient healthcare institutions' nurse staffing plans systematically assign fewer patients to nurses when patient acuity is high, but the impact of this strategy on components of nurse stress has not been thoroughly investigated. PURPOSE To examine the relationship between nurse-to-patient ratio assigned based on NICU patient acuity with the Nurse Stress Scale (NSS) subscales Death and Dying, Conflict with Physicians, Inadequate Preparation, Lack of Support, Conflict with Other Nurses, Work Load, and Uncertainty Concerning Treatment. METHODS A survey including the NSS tool items, demographic questions, and a question about nurse-to-patient ratio during the shift was administered. Cronbach's α, linear regression, and Spearman's correlation were used for data analysis. RESULTS Analysis of the 72 participating NICU nurses' survey responses showed fewer patients per nurse during the shift was negatively correlated with stress related to Death and Dying ( P < .001) and Uncertainty Concerning Treatment ( P = .002) subscale scores. This inverse relationship remained significant after controlling for education and years of experience. IMPLICATIONS FOR PRACTICE The observed higher stress can be inferred to be due to high patient acuity since fewer patients are assigned to nurses caring for high-acuity patients. Improvements in communication to nurses about patients' medical condition, treatment rationale, and information that should be conveyed to the family could reduce nurse stress from treatment uncertainty. Targeted education and counseling could help nurses cope with stress due to patient deaths. IMPLICATIONS FOR RESEARCH Interventions to reduce stress related to treatment uncertainty and death of patients among NICU nurses caring for high-acuity infants should be developed and evaluated.
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Secondary Traumatic Stress and Vigor Among Neonatal Intensive Care Unit Personnel: The Moderator Role of Coping Flexibility. Adv Neonatal Care 2022; 22:E86-E93. [PMID: 34417354 DOI: 10.1097/anc.0000000000000924] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The demanding and highly stressful work environment of the neonatal intensive care unit (NICU) has led to the identification of a possible psychological stress reaction among NICU nurses and physicians, termed secondary traumatic stress (STS). PURPOSE The current study aimed to explore the association between vigor at work (as an energy resource) and STS, while considering their association with the professional role (nurses/physicians-as a condition resource) as well as with coping flexibility (as a personal resource). METHODS In this cross-sectional study physicians and nurses working in NICUs across Israel completed a questionnaire comprising sections on demographics and professional characteristics, self-rated health, STS, coping flexibility, and vigor. RESULTS Of 280 physicians and nurses approached, 70% (195) completed the questionnaire. No significant differences between nurses and physicians were found in STS adjusted for gender, being in a committed relationship, and seniority in the NICU. Vigor was negatively correlated with STS-both in the entire sample and for each professional role alone. Coping flexibility was a statistically significant moderator between vigor and STS, whereas the interaction between vigor and professional role was not significant. Specifically, the negative relationship between vigor and STS was significant when coping flexibility was more than 10.10 (61% of the participants) but not significant at lower values. IMPLICATIONS FOR PRACTICE AND RESEARCH The understanding of the relationship between vigor and STS, with coping flexibility as its moderator, encourages an intervention aimed at reducing stress by increasing these resources.
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Yuan Y, Wang Z, Shao Y, Xu X, Lu F, Xie F, Sun W. Dispositional Mindfulness and Post-traumatic Stress Symptoms in Emergency Nurses: Multiple Mediating Roles of Coping Styles and Emotional Exhaustion. Front Psychol 2022; 13:787100. [PMID: 35391967 PMCID: PMC8982862 DOI: 10.3389/fpsyg.2022.787100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/01/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To explore the relationships between dispositional mindfulness (DM) and their post-traumatic stress symptoms (PTSS) of emergency nurses, and the mediating effects of coping styles and emotional exhaustion (EE). Methods A cross-sectional survey study was conducted to collect data on DM, coping styles, EE, and PTSS among 571 emergency nurses from 20 hospitals in Chongqing, China. Correlation and structural equation models (SEMs) were used to evaluate the relationship among variables. Results Emergency nurses with lower dispositional mindfulness, higher emotional exhaustion and preference for negative coping (NC) revealed more PTSS. The effect of NC on PTSS was partially mediated by emotional exhaustion. Negative coping and emotional exhaustion played concurrent and sequential mediating roles between dispositional mindfulness and PTSS. Conclusion This study has made a significant contribution to existing literature. It was suggested to develop interventions aimed at enhancing mindfulness, reducing negative coping strategies, and alleviating emotional exhaustion, which may be effective at reducing or alleviating post-traumatic stress symptoms of emergency nurses.
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Affiliation(s)
- Yuan Yuan
- First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Zonghua Wang
- School of Nursing, Army Medical University, Chongqing, China
| | - Yanxia Shao
- First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Xia Xu
- Department of Nursing, Army Medical Center of PLA, Chongqing, China
| | - Fang Lu
- School of Nursing, Army Medical University, Chongqing, China
| | - Fei Xie
- School of Nursing, Army Medical University, Chongqing, China
| | - Wei Sun
- First Affiliated Hospital, Army Medical University, Chongqing, China
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Lowe PL, Jakimowicz S, Levett-Jones T. Neonatal nurses’ professional quality of life: An integrative review. Collegian 2022. [DOI: 10.1016/j.colegn.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Factors That Influence NICU Health Care Professionals' Decision Making to Implement Family-Centered Care. Adv Neonatal Care 2022; 22:87-94. [PMID: 33675305 DOI: 10.1097/anc.0000000000000846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Neonatal intensive care unit (NICU) is a multifaceted, technology-driven high stress environment for professionals, infants and families. PURPOSE Examine healthcare professionals' beliefs and perceptions regarding providing FCC within the context of NICU. METHODS This exploratory descriptive study used an online-survey format. The survey comprised several instruments including the Perceived Stress Scale, symptoms of burnout subscale from the Professional Quality of Life scale, and the Family Nurse Caring Belief Scale (FNCBS). Demographic and open-ended items were also included. RESULTS Sample consisted of 115 multidisciplinary participants working in a level IV neonatal intensive care unit. Participants report strong levels of FCC beliefs. Participants strongly agreed (82%) or agreed (18%) that no matter how sick the infant is, he or she needs to be treated as an individual. A significant correlation (r=-0.343, P < .001) exists between participant's stress composite score and FNCBS composite score. There were significant relationships between participant's years of experience (F = 5.35, P < .002) and education levels (F = 2.60, P < .05) and higher FNCBS composite scores. There were also significant relationships between participant's years of experience (F = 4.77, P < .004) and education (F = 2.89, P < .039) with higher Perceived Stress Scale composite scores. IMPLICATIONS FOR PRACTICE Results suggest that while participants agreed that FCC is important, they also believed that inadequate staffing and inappropriate assignments may lead to rationing of care. IMPLICATIONS FOR RESEARCH Further research is needed to explore factors that lead to rationing of FCC.
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Secondary Qualitative Analysis of Moral Injury in Obstetric and Neonatal Nurses. J Obstet Gynecol Neonatal Nurs 2022; 51:166-176. [DOI: 10.1016/j.jogn.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 11/19/2022] Open
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Huang H, Toh RQE, Chiang CLL, Thenpandiyan AA, Vig PS, Lee RWL, Chiam M, Lee ASI, Baral VR, Krishna LKR. Impact of Dying Neonates on Doctors' and Nurses' Personhood: A Systematic Scoping Review. J Pain Symptom Manage 2022; 63:e59-e74. [PMID: 34271142 DOI: 10.1016/j.jpainsymman.2021.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/23/2022]
Abstract
CONTEXT Caring for dying neonates is distressing for healthcare professionals (HCP)s. Yet, the extent of these effects is poorly understood, compromising support of HCPs. To better understand and support HCPs, a systematic scoping review (SSR) of prevailing data is proposed. OBJECTIVES In mapping prevailing data on the impact of caring for dying neonates on HCPs, an SSR proffers new insights on changes to their beliefs, values, coping, actions, relationships and self-concepts of personhood. METHODS Krishna's Systematic Evidenced Based Approach (SEBA) supports a robust, reproducible review whilst its constructivist approach and relativist lens effectively contends with diverse data sources, facilitating a holistic study. RESULTS A total of 9826 abstracts were reviewed and 69 articles were included. Thematic and content analysis were used simultanously. The four categories drawn from the Ring Theory of Personhood (RToP) complements the four themes identified: Emotional and Physical Difficulties, Coping Mechanisms, Conflict and Recommendations. CONCLUSION In highlighting significant longitudinal effects upon all aspects of their lives, this SSR in SEBA reveals a critical need for timely, appropriate and personalized support. We recommend adapting the RToP as an assessment tool to identify and evaluate the needs of these HCPs. It may also be used to structure a holistic support mechanism. Future studies are required to validate its use and appraise other aspects of support available for HCPs.
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Affiliation(s)
- Huixin Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore, Singapore
| | - Rachelle Qi En Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore, Singapore
| | - Christine Li Ling Chiang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore, Singapore
| | - Ashiley Annushri Thenpandiyan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore, Singapore
| | - Prachi Simran Vig
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore, Singapore
| | - Randal Wei Liang Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Center Singapore, Singapore, Singapore
| | - Alexia Sze Inn Lee
- Division of Cancer Education, National Cancer Center Singapore, Singapore, Singapore
| | - Vijayendra Ranjan Baral
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore, Singapore; Duke-NUS Medical School, Singapore, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore, Singapore; Division of Cancer Education, National Cancer Center Singapore, Singapore, Singapore; Duke-NUS Medical School, Singapore, Singapore; Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Center, University of Liverpool, Cancer Research Center, University of Liverpool, Liverpool, United Kingdom; Center of Biomedical Ethics, National University of Singapore, Singapore, Singapore; PalC, The Palliative Care Center for Excellence in Research and Education, Singapore, Singapore.
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Self-Report and Biological Indexes of Work-Related Stress in Neonatal Healthcare Professionals: A Repeated-Measures Observational Study. Adv Neonatal Care 2021; 21:E120-E128. [PMID: 33538493 DOI: 10.1097/anc.0000000000000848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healthcare providers working in neonatal intensive care units (NICUs) are considered at high risk for psychological work-related stress. PURPOSE To evaluate both perceived and biological measures of work-related stress in neonatal healthcare professionals and to compare professionals working in the NICU with their colleagues working in less critical environments (ie, neonatal wards [NWs]). METHODS The salivary cortisol level at the beginning (CORT-B) and at the end (CORT-E) of a daily work shift was collected once a week for 6 weeks and a psychological questionnaire was submitted to NW and NICU workers of a tertiary university center. RESULTS No differences emerged in the overall cortisol secretion between professionals (NW 45 vs NICU 28), but the decrease in the mean cortisol values between CORT-B and CORT-E was less pronounced in NICU professionals (P < .001) who had greater psychological stress (P < .001). Lack of correlation between perceived and biological indexes was observed. IMPLICATIONS FOR PRACTICE NICU professionals reported greater levels of self-perceived psychological stress, especially in terms of professional self-doubt and the complexity of interactions with infants and their parents.The disconnection between psychological and biological indexes raises the issue that work-related stress might be covert to the professionals themselves. Dedicated resources should be developed to address quality of life and the work environment of NICU professionals. IMPLICATIONS FOR RESEARCH The absence of a correlation between perceived and biological indexes highlights the need to incorporate multidimensional physiological and biological measurements in evaluating burnout levels in neonatal healthcare providers.
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Charmer L, Jefford E, Jomeen J. A scoping review of maternity care providers experience of primary trauma within their childbirthing journey. Midwifery 2021; 102:103127. [PMID: 34425458 DOI: 10.1016/j.midw.2021.103127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/21/2021] [Accepted: 08/03/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine and summarise available literature on maternity care practitioners having experienced primary trauma during their childbirthing journey and whether this impacts their mental well-being and/or care provision when subsequently caring for childbearing women. BACKGROUND Birth trauma affects 1 in 3 women; 1 in 20 women show post-traumatic stress disorder symptoms by 12 weeks after birth. However, what is not known is what percentage of these women are maternity care providers experiencing or having experienced personal trauma during their child birthing journey. This scoping review aims to examine and summarise available literature on maternity care practitioners having experienced primary trauma during their childbirthing journey and whether this impacts their mental well-being and/or care provision when subsequently caring for childbearing women. METHODS Arksey and O'Malley (2005) six-stage scoping review framework was revised and utilised. A search of the relevant databases (MEDLINE Embase, CINAHL, APA PsycInfo, Scopus) was undertaken with several keywords related to trauma and personal experience. Reference lists were also searched of studies identified for reading the full text. FINDINGS The search strategy identified 2983 articles. The studies excluded were considered to be unrelated to the topic directly. A total of 352 articles were reviewed by abstract, and 29 additional studies were identified from reference lists; 32 were reviewed by full text. A total of 0 studies met the inclusion criteria for the scoping review. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The scoping review identified a gap in the literature as maternity care practitioners personal experience of trauma during the child birthing journey has not been researched. Research is needed to explore and conceptualise the experiences of maternity care practitioners having experienced trauma and the ongoing implications this may have on their personal and professional lives.
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Affiliation(s)
- Lisa Charmer
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia.
| | - Elaine Jefford
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Julie Jomeen
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
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22
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Beck CT. Perinatal Mood and Anxiety Disorders: Research and Implications for Nursing Care. Nurs Womens Health 2021; 25:e8-e53. [PMID: 34099430 DOI: 10.1016/j.nwh.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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23
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Comparison of Psychological and Physiological Stress in NICU Nurses: Effects of Unit Design and Shift. Adv Neonatal Care 2021; 21:E93-E100. [PMID: 33427752 DOI: 10.1097/anc.0000000000000837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Effects of unit design and shift worked on stress in neonatal intensive care unit (NICU) nurses have not been fully studied. PURPOSE To compare stress in NICU nurses who work in single-family room (SFR) or open bay (OBY) units and on nonrotating day or night shift. METHODS Full-time registered nurses (RNs) (n = 72) from a 42-bed SFR and a 131-bed OBY NICU participated in this comparative cross-sectional study. The Nurse Stress Scale (NSS) and within-shift repeated salivary cortisol levels were used to measure stress. The relationship between NSS score and salivary cortisol level was examined using multiple linear regression. Salivary cortisol levels of day versus night shift were compared with mixed-effects linear models. RESULTS NSS scores were similar for SFR and OBY units (P = .672) and day versus night shift (P = .606). Changes in cortisol level over time (P = .764) and final cortisol level (P = .883) for SFR versus OBY were not significantly different after controlling for shift. Salivary cortisol level of day-shift nurses decreased significantly over time compared with night-shift nurses (P < .001). The final cortisol level was significantly higher for night-shift compared with day-shift nurses (P < .001). IMPLICATIONS FOR PRACTICE Psychological (NSS) and physiologic (salivary cortisol) stress of NICU nurses is similar in established SFR and OBY units. Cortisol levels are higher at the end of shift in nurses who work night shift and may reflect increased physiologic stress. IMPLICATIONS FOR RESEARCH Strategies are needed for reducing stress in NICU nurses who work night shift.
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Nicholls EM, Hermann RM, Giordano NA, Trotta RL. Secondary Traumatic Stress Among Labor and Delivery Nurses. MCN Am J Matern Child Nurs 2021; 46:14-20. [PMID: 33284241 DOI: 10.1097/nmc.0000000000000674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the prevalence and severity of secondary traumatic stress (STS) among labor and delivery nurses within a Northeastern United States academic health system. STUDY DESIGN AND METHODS Using a cross-sectional, descriptive correlational design, a convenience sample of labor and delivery nurses (288 nurses) were invited to complete Secondary Traumatic Stress Scale (STSS), a 17-item Likert-type instrument, that measures intrusion, avoidance, and the arousal symptoms associated with indirect exposure to traumatic events. Five additional questions about potential consequences of STS were also asked. RESULTS N = 144 completed the survey (50% response rate). Average STSS score was 33.74 (SD, 11.8), with 35% of respondents meeting symptom severity scores associated with STS. STSS Scores ≥ 38 were significantly correlated with nurses considering leaving their jobs, calling out sick, or requesting an assignment change after witnessing a traumatic birth (p < 0.001). The majority of respondents (84.7%) reported witnessing a traumatic birth. After witnessing a traumatic birth, respondents used co-workers, family, and friends as sources of support. CLINICAL IMPLICATIONS This study offers insight into the frequency and severity of STS among labor and delivery nurses, as well as the potential workforce-related consequences and provides a foundation for future work aimed at developing interventions to prevent or alleviate STS.
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25
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Beck CT. Perinatal Mood and Anxiety Disorders: Research and Implications for Nursing Care. J Obstet Gynecol Neonatal Nurs 2021; 50:e1-e46. [PMID: 34099348 DOI: 10.1016/j.jogn.2021.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Abstract
Nurses on the front lines of health care are impacted psychologically by their work and may experience secondary traumatic stress. The literature contains several different terms to explore concepts that describe the impact of traumatic patient experiences on the nurse, making it difficult to differentiate the concepts. Using the Walker and Avant method of analysis, the author reviewed nursing-specific publications within the last 10 years and seminal works to develop a purer meaning of secondary traumatic stress and distinguish it from other related terms. A more precise definition of secondary traumatic stress will allow for the advancement of research related to awareness and prevention in nursing.
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Reese SE, Riquino MR, Molloy J, Nguyen V, Smid MC, Tenort B, Gezinski LB. Experiences of Nursing Professionals Working With Women Diagnosed With Opioid Use Disorder and Their Newborns: Burnout and the Need for Support. Adv Neonatal Care 2021; 21:32-40. [PMID: 33055519 PMCID: PMC11160478 DOI: 10.1097/anc.0000000000000816] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND As the rate of opioid use in pregnancy escalates, there are a growing number of women diagnosed with opioid use disorder (OUD) and their newborns being cared for in inpatient settings. PURPOSE In this study, we sought to better understand the experiences of nurses and nursing assistants working with women diagnosed with OUD and their newborns. By identifying the needs of nurses and nursing assistants, the findings from this study may contribute to reductions in stigma and improved patient care. METHODS Nurses and nursing assistants were recruited from a postpartum unit at a large urban hospital in Utah. Participants (n = 30) attended up to 4 semistructured focus groups. We utilized Braun and Clarke's 6-phase approach to thematic analysis to analyze transcribed interviews. FINDINGS/RESULTS Themes identified during the data analysis process included negative feelings and reactions toward patients; preferential concern for the newborn over maternal well-being; and identification of organizational and training needs to overcome these challenges. IMPLICATIONS FOR PRACTICE These findings identify strategies for addressing challenges faced by nurses and nursing assistants in caring for women diagnosed with OUD and their newborns. IMPLICATIONS FOR RESEARCH Future research should examine the effectiveness of approaches to reduce behaviors influenced by stigma among nurses and nursing assistants working with women diagnosed with OUD and their newborns, as well as employee and patient satisfaction, and long-term health outcomes.
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Affiliation(s)
- Sarah E Reese
- School of Social Work, University of Montana, Missoula (Dr. Reese); School of Social Welfare, University of Kansas, Lawrence (Dr Riquino); School of Social Work, University of Montana, Missoula (Dr Molloy); independent researcher, Salt Lake City, UT (Dr. Nguyen); Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City (Dr Smid); and Labor & Delivery and Obstetrical Emergency Services, University of Utah Hospital, Salt Lake City (Ms Tenort). Dr Gezinski is an independent researcher, Amsterdam, the Netherlands
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Scott Z, O'Curry S, Mastroyannopoulou K. Factors associated with secondary traumatic stress and burnout in neonatal care staff: A cross-sectional survey study. Infant Ment Health J 2021; 42:299-309. [PMID: 33449411 DOI: 10.1002/imhj.21907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
INTRODUCTION High rates of secondary traumatic stress and burnout have been found across nursing populations. However, few studies have focused on neonatal staff. OBJECTIVE The objectives of this article are to explore the prevalence and severity of secondary traumatic stress (STS) and burnout in neonatal staff, and identify risk factors and protective factors for STS and burnout within this population with the aim of informing future staff support. METHODS A quantitative, cross-sectional study using a survey design was conducted; 246 neonatal staff reported measures of STS, burnout, self-compassion and satisfaction with ward climate. RESULTS Neonatal staff reported high rates of moderate-severe STS and burnout. STS and burnout were negatively associated with self-compassion and satisfaction with ward climate, suggesting them to be protective factors against STS and burnout. STS was found to be a risk factor for burnout and vice versa. CONCLUSION Interventions that increase understanding of STS and burnout, nurture self-compassion, provide support and enhance stress management could help mitigate the impact of STS and burnout amongst neonatal staff.
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Affiliation(s)
- Zoe Scott
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Sara O'Curry
- Addenbrookes Hospital, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
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A Mixed-Methods Study to Investigate Barriers and Enablers to Nurses' Implementation of Nonpharmacological Interventions for Infants With Neonatal Abstinence Syndrome. Adv Neonatal Care 2020; 20:450-463. [PMID: 33252500 DOI: 10.1097/anc.0000000000000794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The incidence of neonatal abstinence syndrome has increased significantly as a result of the opioid epidemic. A lengthy hospitalization is often required to treat the infant's withdrawal symptoms. A comprehensive understanding of factors that influence nurses' implementation of nonpharmacological interventions for infants with neonatal abstinence syndrome is needed. PURPOSE To investigate barriers and enablers to nurses' implementation of nonpharmacological interventions for infants with neonatal abstinence syndrome through the lens of the Theoretical Domains Framework, which provides a structure to examine factors that influence healthcare providers' behavior related to the implementation of evidence-based practice and interventions in clinical practice. METHODS A convergent parallel mixed-methods study was conducted. Qualitative data were collected using semistructured interviews and quantitative data were collected using a tailored Determinants of Implementation Behavior Questionnaire with neonatal nurses. Findings from the interviews and surveys were merged through joint review to compare and contrast themes. RESULTS Enablers and barriers to nurses' implementation of nonpharmacological interventions included education, experience, ability to implement nonpharmacological interventions, parental participation, stigmatization, lack of managerial/organizational support, staffing ratios, internal and external resources, and stress. Knowledge, Skills, Beliefs About Capabilities, Social/Professional Role and Identity, Organization, and Emotion of the Theoretical Domains Framework aligned with these themes. IMPLICATIONS FOR PRACTICE AND RESEARCH Findings from this study will inform the development of programs to improve nurses' implementation of nonpharmacological interventions and health and utilization outcomes in infants with neonatal abstinence syndrome. Furthermore, future work should focus on the development of programs to improve nurses' implementation of nonpharmacological interventions, with specific strategies aimed to mitigate marginalization of vulnerable patient populations.
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30
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Mufato LF, Gaiva MAM. Reasons why of nurses empaty with newborn families in neonatal ICU. ACTA ACUST UNITED AC 2020; 41:e20190508. [PMID: 33111830 DOI: 10.1590/1983-1447.2020.20190508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/28/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To understand the empathic conduct and the reasons why nurses empathize with relatives of newborns in a Neonatal Intensive Care Unit. METHODS Phenomenological research, performed in a hospital in Mato Grosso, Brazil. Data were collected between May and August 2018, through interviews with 11 nurses experienced in neonatal care, and analyzed through the lens of Alfred Schutz's Social Phenomenology. RESULTS Presented by two categories: nurses' empathy with family members of newborns in Neonatal ICU: empathic conduct; and, the reasons why the empathic conduct of nurses with family members in neonatal ICU. FINAL CONSIDERATIONS Empathy occurred centrally with the mother of newborns, expressed in communication, identification and construction of bonds. The reasons why the nurses' personal experiences are linked to motherhood, grief and suffering.
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Affiliation(s)
- Leandro Felipe Mufato
- Universidade do Estado de Mato Grosso (UNEMAT), Departamento de Enfermagem. Tangará da Serra, Mato Grosso, Brasil.,Universidade Federal de Mato Grosso (UFMT), Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem. Cuiabá, Mato Grosso, Brasil
| | - Maria Aparecida Munhoz Gaiva
- Universidade Federal de Mato Grosso (UFMT), Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem. Cuiabá, Mato Grosso, Brasil
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Okoli CTC, Seng S, Lykins A, Higgins JT. Correlates of post-traumatic growth among nursing professionals: A cross-sectional analysis. J Nurs Manag 2020; 29:307-316. [PMID: 32901448 DOI: 10.1111/jonm.13155] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/22/2020] [Accepted: 08/31/2020] [Indexed: 11/30/2022]
Abstract
AIMS Among nursing professionals, our aims were to examine (a) self-reported traumatic experiences, (b) differences in post-traumatic growth (i.e. positive psychological growth after experiencing a traumatic event) by nursing professional level and (c) demographic, work-related, behavioural and traumatic experience covariates of post-traumatic growth. BACKGROUND Trauma experience among nursing professionals is higher than observed in the general population. Due to the nature of their work environment, workplace trauma rates are particularly alarming. Understanding post-traumatic growth among nursing professionals may guide interventions to enhance well-being. METHOD A secondary analysis of cross-sectional survey data from nursing professionals (N = 299). Demographic, work-related, behavioural, trauma experience categories and post-traumatic growth variables were examined. RESULTS Advanced practice nurses and clinical nurses reported higher rates of workplace trauma, as compared to nursing assistants. Higher post-traumatic growth scores were associated with having a postgraduate degree, serving the paediatric population and lower frequency of alcohol use. Lower post-traumatic growth scores were associated with being married/widowed, being an advanced practice provider or clinical nurse, working in the intensive care unit and reporting workplace, family/personal stress and undisclosed trauma. CONCLUSIONS Nursing professionals have several demographic, work-related, behavioural and traumatic experience-related variables associated with and that explain variances in post-traumatic growth. IMPLICATION FOR NURSING MANAGEMENT Targeted screening and individualized treatment based on nursing professional level should be considered to support trauma recovery and post-traumatic growth.
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Affiliation(s)
- Chizimuzo T C Okoli
- University of Kentucky College of Nursing, Lexington, KY, USA.,Eastern State Hospital, Lexington, KY, USA
| | - Sarret Seng
- University of Kentucky College of Nursing, Lexington, KY, USA.,Eastern State Hospital, Lexington, KY, USA
| | - Amanda Lykins
- University of Kentucky College of Nursing, Lexington, KY, USA.,Eastern State Hospital, Lexington, KY, USA.,UK HealthCare, Lexington, KY, USA
| | - Jacob T Higgins
- University of Kentucky College of Nursing, Lexington, KY, USA.,UK HealthCare, Lexington, KY, USA
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Abstract
BACKGROUND When posttraumatic growth occurs in clinicians as a result of their caring for patients and families who are traumatized, it is termed vicarious posttraumatic growth. PURPOSE (1) To determine the level of vicarious posttraumatic growth and the disruption of core beliefs in neonatal intensive care unit (NICU) nurses who have cared for critically ill infants and their families. (2) To explore those quantitative findings through nurses' qualitative descriptions of their growth. METHODS A mixed method with a convergent parallel design was used to address the study aims. A targeted sample of neonatal nurses was recruited from the National Association of Neonatal Nurses (NANN) through the MyNANN Community message board. The sample consisted of 109 NICU nurses who completed the quantitative strand and 61 (55%) who completed the qualitative strand. Nurses completed the Posttraumatic Growth Inventory, the Core Beliefs Inventory, and described their experiences of any positive changes in their beliefs or life as a result of caring for critically ill infants. IBM SPSS 25.0 and Krippendorff's content analysis were used to analyze the quantitative and qualitative data, respectively. RESULTS NICU nurses reported a moderate degree of vicarious posttraumatic growth and disruption of their assumptive world. Appreciation of Life was the Posttraumatic Growth Inventory dimension that reflected the highest growth and Spiritual Change the lowest. IMPLICATIONS FOR PRACTICE Providing posttraumatic growth interventions has the potential to help NICU nurses find meaning through their experience. IMPLICATIONS FOR RESEARCH Future surveys need to include a higher response rate to generalize the findings. A video abstract is available.Video Abstract available at: https://journals.na.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=36.
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Abstract
BACKGROUND Infants who are admitted to a neonatal intensive care unit (NICU) may experience significant symptom burden. Parents are often distressed by these symptoms, which can affect their long-term coping and distress. There is limited research examining nurse perceptions of infant well-being (symptoms, suffering, and quality of life [QOL]) and associations with nurse distress. OBJECTIVE The objective of this descriptive study was to explore associations between nurse perceptions of infant well-being and self-reported distress. METHODS Nurses caring for infants with potentially life-threatening/life-limiting conditions were recruited from a Level IV NICU in the Midwestern United States as a part of a study on infant symptom burden. Nurses reported their perceptions of infant well-being and their own distress on a 5-point Likert scale. Surveys were administered at the bedside weekly for up to 12 weeks, depending on length of stay. Infant suffering and QOL were examined in relation to nurse distress. A cross-classified multilevel model was used to account for dependence within nurse and within patient. RESULTS A total of 593 surveys were collected from nurses. Using a cross-classified multilevel model with variables entered simultaneously, nurse perceptions of greater infant suffering and lower infant QOL were significantly associated with greater nurse distress. DISCUSSION Preliminary evidence shows that greater perceived infant suffering and lower perceived infant QOL may be associated with greater levels of self-reported distress in NICU nurses. Further work is needed to better understand factors related to symptom management in the NICU and the potential role of caregiver distress and compassion fatigue in NICU nurses.
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Doede M, Trinkoff AM. Emotional Work of Neonatal Nurses in a Single-Family Room NICU. J Obstet Gynecol Neonatal Nurs 2020; 49:283-292. [PMID: 32298637 DOI: 10.1016/j.jogn.2020.03.001] [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] [Accepted: 03/01/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To describe the emotional work of neonatal nurses in a single-family room NICU. DESIGN Qualitative interpretive description. SETTING A single-family room NICU in the mid-Atlantic region of the United States. PARTICIPANTS Fifteen nurses who worked in the single-family room NICU. METHODS Data were collected from 110 hours of direct observation and 11 interviews over a 6-month period. We focused on emotional demands using triangulation between interviews and observations to identify themes. Conceptualization of emotional work informed interpretation. RESULTS Four themes emerged: Parents Living on the Unit, Isolation of Infants in Rooms, Nurses' Ability to Form Bonds and Establish Trust With Parents, and Sheltering Nurses and Parents From Stressful Events on the Unit. Parents living on the unit and the isolation of infants in private rooms increased the emotional work of nurses. Forming trust and bonds with parents and sheltering parents and themselves from stressful events on the unit decreased nurses' emotional work. CONCLUSION Care should be taken in NICU design because unit layout can affect the emotional work of nurses. Understanding how neonatal nursing practice is affected by unit layout can help nurses and those who design NICUs to create and promote optimal practice environments.
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Bock C, Heitland I, Zimmermann T, Winter L, Kahl KG. Secondary Traumatic Stress, Mental State, and Work Ability in Nurses-Results of a Psychological Risk Assessment at a University Hospital. Front Psychiatry 2020; 11:298. [PMID: 32395109 PMCID: PMC7197484 DOI: 10.3389/fpsyt.2020.00298] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/25/2020] [Indexed: 12/19/2022] Open
Abstract
Psychological risk assessment is a legal obligation for companies and part of occupational safety and employment protection in Germany. However, data from psychological risk assessments in nursing staff are scarce, although this population is at increased risk for secondary traumatic stress by patient experienced trauma. Therefore, our study aimed at examining the frequency of reported secondary trauma events, secondary traumatic stress, and its possible consequences for psychological well-being and work ability in nurses. N = 320 nurses (n = 280 female) were assessed at a University Hospital in Germany as part of the psychological risk assessment. Secondary traumatic events, secondary traumatic stress, and symptoms of depression and anxiety were measured using self-report questionnaires (PHQ-2, GAD-2), and work ability was assessed using a modified version of the questionnaire for workplace analysis (KFZA). Of 320 nurses, 292 (91.2%) experienced secondary trauma, and 74 nurses (25.3%) reported secondary traumatic symptoms. Nurses with secondary traumatic symptoms reported higher depression (p < 0.001) and anxiety scores (p < 0.001) compared to nurses without secondary trauma experience, and to nurses with secondary trauma experience but without secondary traumatic stress (both p < 0.001). Further, nurses with secondary traumatic stress reported significantly reduced work ability, social support and control over work, and increased emotional strain and labor time. Nurses with secondary traumatic stress may be at increased risk of developing major depression and anxiety disorders, and particularly need support in overcoming secondary traumatic experiences. Psychological risk assessment is a useful tool to identify groups at risk, and pave the way to implement strategies to improve mental well-being and prevent work ability in high risk groups.
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Affiliation(s)
- Christian Bock
- Department of Occupational Safety, Hannover Medical School, Hannover, Germany
| | - Ivo Heitland
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Lotta Winter
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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Beck CT. Secondary Traumatic Stress in Maternal-Newborn Nurses: Secondary Qualitative Analysis. J Am Psychiatr Nurses Assoc 2020; 26:55-64. [PMID: 31747860 DOI: 10.1177/1078390319886358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Secondary traumatic stress can be the cost for clinicians when caring for persons who have been traumatized. Secondary traumatic stress is a syndrome of symptoms similar to posttraumatic stress disorder (PTSD). AIMS: To conduct a secondary qualitative data analysis of three primary data sets of secondary traumatic stress in nurses. METHODS: Cross validation was the type of qualitative secondary analysis used to compare qualitative findings across these multiple data sets. In the three primary studies, the data were analyzed for themes. In this secondary qualitative analysis, a different defining unit was chosen. This time, the four categories of PTSD symptoms (intrusions, avoidance, arousal, and negative alterations in cognitions and mood) were used to analyze the data sets using content analysis. RESULTS: For all three groups of maternal-newborn nurses, the intrusions category was ranked first and the negative cognitions and mood category was ranked second. The remaining two symptom categories were where their rankings differed. The labor and delivery and neonatal intensive care unit nurses ranked arousal symptoms third and avoidance symptoms fourth. For the nurse-midwives, the rankings for these two categories were reversed. The neonatal intensive care unit nurses comprised the one group that did not report any avoidance symptoms. CONCLUSIONS: This secondary qualitative analysis confirmed the presence of PTSD symptoms that maternal-newborn nurses struggled with as a result of caring for either critically ill infants or women during traumatic births. Hospital preventive strategies and interventions for secondary traumatic stress in nurses are discussed.
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Affiliation(s)
- Cheryl Tatano Beck
- Cheryl Tatano Beck, DNSc, CNM, FAAN, University of Connecticut, Storrs, CT, USA
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Evaluation of Interprofessional Teaching Strategy for Nursing Students on Perinatal Trauma-Informed Care. Nurs Educ Perspect 2019; 41:174-176. [PMID: 31232873 DOI: 10.1097/01.nep.0000000000000537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Little research exists on secondary traumatic stress for obstetric nurses and best educational strategies. Mixed-methods analysis was conducted to evaluate use of interprofessional panel debriefing to prepare nursing students for trauma-informed care. A pretest and posttest paired-samples design evaluated student experience and internalization of communication techniques. Students (n = 54) gained communication techniques from the learning activity; they felt simulations were realistic and applicable and described the learning activity as emotional with support from faculty. This innovative learning activity is a valuable teaching method and may be applicable to clinical agencies for new staff.
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LoGiudice JA, Phillips KE. Female Nursing Students' Experience With and Exposure to Sexual Assault. J Nurs Educ 2018; 57:662-667. [DOI: 10.3928/01484834-20181022-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/22/2018] [Indexed: 11/20/2022]
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Barr P. Personality Traits, State Positive and Negative Affect, and Professional Quality of Life in Neonatal Nurses. J Obstet Gynecol Neonatal Nurs 2018; 47:771-782. [PMID: 30253129 DOI: 10.1016/j.jogn.2018.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To explore the relationships of core self-evaluations of personality (self-esteem, generalized self-efficacy, emotional stability, and internal locus of control), the five-factor model personality traits (neuroticism, agreeableness, extraversion, conscientiousness, and openness), and positive and negative affect with neonatal nurses' professional quality of life (burnout, secondary traumatic stress, and compassion satisfaction). DESIGN Cross-sectional cohort study. SETTING Four Level 3-4 NICUs in New South Wales, Australia. PARTICIPANTS One hundred forty-two (35%) of 405 eligible neonatal nurses. METHODS Online self-report measures of personality traits, positive and negative affect, and professional quality of life. RESULTS Core self-evaluations explained 33%, 21%, and 26% of the variance in burnout, secondary traumatic stress, and compassion satisfaction, respectively. After controlling for core self-evaluations, agreeableness, neuroticism, and extraversion contributed to the respective variances in burnout, secondary traumatic stress, and compassion satisfaction. After controlling for core self-evaluations and the five-factor model personality traits, positive affect contributed to the variance in burnout and compassion satisfaction, whereas negative affect contributed to the variance in secondary traumatic stress. No five-factor model personality trait contributed to the variance in professional quality of life in the final regression models. Positive affect mediated the effect of core self-evaluations on burnout and compassion satisfaction, whereas negative affect mediated the effect of core self-evaluations on secondary traumatic stress. CONCLUSION Neonatal nurses should be aware of and accept responsibility for personality traits and moods that benefit or detract from their professional quality of life. NICU nurse managers should ensure that neonatal nurses have ready access to psychological support services.
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