Vicarious Posttraumatic Growth in NICU Nurses

A Randomized Controlled Feasibility Study to Evaluate the Online Delivery of Storytelling Through Music With Oncology Nurses

BACKGROUND

Oncology nurses frequently contend with intense work-related emotions stemming from their roles, which include bearing witness to suffering, managing end-of-life care, and navigating ethical dilemmas. These emotional challenges can lead to burnout, compassion fatigue, and overall psychological distress.

OBJECTIVE

To determine the feasibility, acceptability, and preliminary effect of implementing Storytelling Through Music (STM) online with oncology nurses.

INTERVENTION/METHODS

This study (trial registration: NCT04775524) was a 2-group, randomized wait-list controlled trial, utilizing quantitative and qualitative methods. STM is a 6-week intervention that combines storytelling, reflective writing, songwriting, and psychoeducation. Data were collected in both groups at 3 timepoints and analyzed with descriptive statistics, conventional content analysis, and nonparametric tests.

RESULTS

The oncology nurses (n = 24) were primarily female (96%) and White (79%), with an average of 15.98 (range, 2-51) years of nursing experience. All STM participants completed the intervention and found it acceptable. STM participants had greater improvements in burnout, secondary traumatic stress, anxiety, depression, and posttraumatic growth.

CONCLUSION

The online delivery of STM proved feasible and acceptable, demonstrating potential scalability across diverse geographic locations, and showed promise in reducing psychological distress and burnout. Future research should consider larger-scale studies with diverse participant demographics and settings to validate these findings further.

IMPLICATIONS FOR PRACTICE

Results highlight the potential value of integrating expressive arts into comprehensive support programs for nurses. By implementing interventions that acknowledge and support the emotional demands of their work, healthcare organizations can better equip oncology nurses to navigate the complexities of their roles while maintaining their well-being.

Spirituality, Resilience and Vicarious Posttraumatic Growth Among Orthopedic Nurses in Nigeria

We examined whether the salutogenic nature of resilience is the pathway of association, as well as a moderating factor, between spirituality and vicarious posttraumatic growth (VPTG). Two hundred Nigerian orthopedic nurses completed the Resilience Scale (RS-14), Spiritual Involvement and Belief Scale-Revised (SIBS-R), and Posttraumatic Growth Inventory-Short Form (PTGI-SF). We found that greater spirituality and resilience were directly associated with high VPTG. Resilience helped to explain (mediated) the relationship between spirituality and VPT such that spirituality was linked to VPTG by virtue of high resilience. Moderation analysis indicated that resilience was most robustly associated with increased VPTG for nurses with high spirituality compared to those with moderate and low levels of spirituality. Findings may be relevant in integrative/complementary approaches to trauma work.

Scoping Review of Vicarious Post-Traumatic Growth Among Nurses: Current Knowledge and Research Gaps

Background

Nurses frequently experience both direct and indirect trauma, leading to significant psychological challenges. While much research has focused on the negative impacts of such trauma, less attention has been given to vicarious post-traumatic growth (VPTG). Given the high levels of indirect trauma that nurses face, understanding VPTG is crucial for mitigating its adverse effects and enhancing mental health and work efficiency.

Objective

To map and synthesize the literature on vicarious post-traumatic growth and identify key knowledge gaps in vicarious post-traumatic growth research.

Methods

This scoping review follows the approach proposed by Arksey and O'Malley. We conducted this scoping review using the methodology recommended by the Joanna Briggs Institute, supported by the PAGER framework. We searched 7 databases and gray literature on May 19, 2023 to obtain relevant research.

Results

Finally, we included 29 studies from 9 countries. There are currently no reliable data on the incidence of vicarious post-traumatic growth among nurses worldwide. There are multiple instruments available to investigate vicarious post-traumatic growth in nurses, and the vicarious post-traumatic growth inventory is more recommended. Factors affecting nurses' vicarious post-traumatic growth include coping styles, psychological factors, and social support. Indirect trauma exposure and vicarious post-traumatic growth coexist. There are currently three intervention strategies for vicarious post-traumatic growth, but none have been proven in clinical trials.

Conclusion

This is the first scoping review on vicarious post-traumatic growth, there are a lot of research deficiencies and gaps in current research on vicarious post-traumatic growth for nurses. In view of the impact of secondary traumatic events on nurses, future research should pay more attention to nurses' vicarious post-traumatic growth and promote the development of vicarious post-traumatic growth.

Cross-cultural adaptation and reliability of the inventory of vicarious posttraumatic growth and research of its influencing factors: a cross-sectional study

OBJECTIVE

The purpose of this study was to translate the Vicarious Posttraumatic Growth Inventory (VPTGI) into Chinese and to assess its reliability and validity in Nurses, Additionally, it explored the correlations between vicarious posttraumatic growth (VPTG), Secondary Traumatic Stress (STS) and demographic variables.

METHODS

The Brislin translation model was used to translate the VPTGI into Chinese. Validity analysis involved exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent validity, discriminant validity, and content validity. Reliability analysis included split-half reliability, internal consistency reliability, and test-retest reliability. Item analysis employed the Critical Ratio Decision Value (CR) method, item-total correlation method, and reliability change method. Single-factor analysis was conducted to examine the relationship between demographic variables and VPTG, while correlation analysis explored the association between STS and VPTG.

RESULTS

The Chinese version VPTGI demonstrated robust content validity (I-CVI: 0.83-1, S-CVI: 0.97), supported by EFA (KMO: 0.933) and significant Bartlett's test (p < 0.001). Four factors explained 67.82% variance, CFA confirmed the model fit (χ2/df = 2.255, RMSEA = 0.079, IFI = 0.931, TLI = 0.914, CFI = 0.930, NFI = 0.882). The Chinese version VPTGI demonstrated high internal consistency (Cronbach's α = 0.951), with dimensions' Cronbach's α ranging from 0.806 to 0.912. Overall, nurses demonstrated a moderate to low level of VPTG and a severe level of STS. Furthermore, there was a significant negative correlation between STS and VPTG.

CONCLUSION

The Chinese version of VPTGI demonstrated satisfactory reliability, validity, and factor structure, making it a reliable tool to assess VPTG in Chinese nurses. These findings underscore the importance of promoting VPTG and addressing STS among healthcare professionals. Further research in this area is warranted to better understand and support the psychological well-being of nurses.

Secondary traumatic stress and vicarious posttraumatic growth in oncology nurses: the mediating role of empathy

Background

The relationship between secondary traumatic stress (STS), empathy, and vicarious post-traumatic growth (VPTG) in oncology nurses is unclear. Understanding these links is crucial for improving nurse well-being and patient care quality.

Objective

This study aimed to investigate the relationships between STS, empathy, and VPTG among oncology nurses.

Methods

This cross-sectional study was conducted in a multicentric setting. Data collection involved oncology nurses completing questionnaires assessing STS, empathy, and VPTG levels. Data analysis included correlation analyses, multiple stepwise regression analysis, and structural equation modeling (SEM) to examine the interrelationships between these variables. The study adhered to the STROBE checklist.

Results

A total of 391 oncology nurses participated in the study. They showed moderate to low levels of VPTG and high levels of STS. STS exhibited a negative association with VPTG, while empathy demonstrated a positive direct association with both VPTG and STS. Moreover, SEM indicated that empathy mediated the relationship between STS and VPTG, with a partial mediating effect of 0.127. Factors such as receiving psychological training, educational attainment, STS, and empathy collectively explained 24% of the variance in VPTG.

Conclusion

Our findings highlighted the negative correlation between STS and VPTG among oncology nurses. Additionally, empathy was found to mediate the relationship between STS and VPTG, suggesting it plays a significant role in influencing VPTG.

Implications for practice

To aid oncology nurses, interventions should focus on reducing STS and enhancing empathy. Strategies like resilience workshops, peer support, and stress management can foster VPTG. Creating a supportive work environment is crucial for nurses' well-being and quality patient care.

The prevalence and factors of posttraumatic growth among nurses based on the PTGI: A systematic review and meta-analysis

BACKGROUND

The urgency and risk of clinical nursing may cause nurses to experience traumatic stress, but it may also lead to posttraumatic growth. However, no study has comprehensively analyzed the prevalence of posttraumatic growth among nurses using a unified outcome measure and a validated assessment tool.

AIM

This study aims to systematically assess the prevalence and factors of posttraumatic growth among nurses based on the Posttraumatic Growth Inventory (PTGI).

METHODS

Ten databases, including The Cochrane Library, PubMed, Web of Science, CINAHL, Springerlink, Embase, Chinese Biomedical (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases, were searched as of December 31, 2022. The prevalence of posttraumatic growth was pooled using Stata 17.0 software. The PRISMA guideline was used to report the systematic review and meta-analysis. PROSPERO registration number: CRD42022365620.

RESULTS

A total of 30 studies were included in this systematic review and meta-analysis, consisting of 14,022 nurses worldwide from four countries. In our study, the pooled mean score of posttraumatic growth among nurses was 66.34 (95% CI: 61.25-71.43). From 2015 to 2022, nurses' posttraumatic growth levels gradually increased. In addition, Turkey nurses have the lowest posttraumatic growth levelnurses who experienced workplace violence have a lower posttraumatic growth level compared with other nurses; while nurses aged over 30 and male have higher posttraumatic growth levels.

CONCLUSIONS

While several studies on the prevalence of posttraumatic growth among nurses have been published, the reported data are quite different. Our systematic review and meta-analysis found that nurses' posttraumatic growth level was "moderate," and nurses' posttraumatic growth may vary based on publication year, country, traumatic event, age, and gender.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Our findings may provide a theoretical basis for hospital administrators and policy makers to scientifically manage human resources, comprehensively evaluate nurses' mental health, and promote nurses' posttraumatic growth in different traumatic events, which is conducive to the formulation and implementation of relevant policy guidelines.

Posttraumatic growth in eating disorder recovery

OBJECTIVE

To investigate posttraumatic growth in individuals recovering from an eating disorder.

DESIGN

A convergent parallel mixed methods design was used.

PARTICIPANTS

The sample consisted of 28 participants who completed the entire study and an additional 10 who completed only the quantitative portion of this mixed methods study.

METHODS

The National Eating Disorders Association (NEDA) provided a link to the electronic survey via their website. Participants were asked to complete the Posttraumatic Growth Inventory (PTGI) and the Core Beliefs Inventory (CBI) in the quantitative strand. For the qualitative strand, participants were asked to describe any positive changes in their beliefs or life as the result of their eating disorder (ED).

RESULTS

Participants reported a high amount of posttraumatic growth as indicated by their mean score on the CBI (30.39, SD 7.89) and (71.26, SD 16.58) on the PTGI. Qualitative categories included relating to others, personal strength, new possibilities, appreciation of life, and spiritual change.

CONCLUSION

Participants described the transformation they experienced in the recovery process, with recovery from an eating disorder facilitating an opportunity for growth. Providing posttraumatic growth interventions may have the potential to help individuals with eating disorders find meaning in their pathway through recovery.

Changes in Posttraumatic Growth After a Virtual Contemplative Intervention During the COVID-19 Pandemic

OBJECTIVE

The aim of this study was to describe the effects of an intervention called "Compassion & Growth Workshops" on reported posttraumatic growth (PTG) using the Posttraumatic Growth Inventory-Expanded (PTGI-X).

BACKGROUND

Few studies measure the impact of interventions, such as contemplative practices, on nurse PTG.

METHODS

We delivered a series of three 2-hour microretreats to nurses and advanced practice nurses and measured their impact on PTG scores. Using multivariate logistic regression, we identified cofactors predictive of 25% overall improvement on the PTGI-X.

RESULTS

Overall PTG increased among participants, with the greatest improvement in relating to others, new possibilities, and personal strength. Posttraumatic growth improved as workshop attendance increased; nurses providing direct patient care also benefitted the most.

CONCLUSIONS

Contemplative interventions can substantively improve PTG. This may be particularly relevant for coping with COVID pandemic stress among nurses on the frontlines and for healthcare leaders seeking to strengthen psychological support within their teams and reform the workplace environment.

Vicarious trauma and nursing: An integrative review

Nursing requires empathic engagement, within therapeutic relationships, to ensure the delivery of compassionate care. Empathic engagement with people who have experienced trauma is known to potentially lead to experiences of vicarious trauma occurring in the caregiver. However, relatively little is known about the implications of vicarious trauma for nurses. This integrative review aimed to explore what is known about vicarious trauma and consider its implications for nursing. Twenty-two articles were included in the review, with findings considering how vicarious trauma is conceptualized and applied to nursing in the literature, what implications of vicarious trauma, specific to nursing, are identified in the literature, and what vicarious trauma interventions are identified to apply to nursing. The findings highlight clear articulation of the concept of vicarious trauma and its relevance to nursing, including its pervasive and significant personal and professional effects. Vicarious trauma was identified to be a workplace hazard for nurses working across settings, which also impacts upon organizations. The review highlighted that at individual, team, organizational, and social levels, awareness and preventative approaches are recommended. These approaches require systemic supports that foster individual coping mechanisms, self-care and support networks for nurses, education about vicarious trauma, screening for vicarious trauma, and formalized access to clinical supervision and peer support for all nurses. With increasing awareness of trauma across health care settings, and a move towards the delivery of 'trauma informed care', recognition of vicarious trauma amongst nurses as a likely 'cost' of the delivery of compassionate care to trauma survivors, is essential.

Posttraumatic Growth as a Model to Measure and Guide Implementation of COVID-19 Recovery and Resiliency

The COVID-19 pandemic has forced leaders to reconsider the various factors that attribute to work-life balance, a healthy work environment, and resilience among nurses. Posttraumatic growth (PTG) provides a lens through which clinicians and leaders can measure, articulate, and espouse resilient recovery through unprecedented times. This article suggests the use of PTG as a framework, measured by the Posttraumatic Growth Inventory to guide leaders as they implement job-specific resiliency interventions for professional nurses. This article also suggests 3 science-based interventions intended to increase PTG. Published data support the efficacy of these interventions: resilience retreats, resilience rounds, and "The Pause," while longitudinal impacts of PTG following these interventions remain currently unknown.

Prevalence and determinants of secondary posttraumatic growth following trauma work among medical personnel: a cross sectional study

Background: People helping trauma victims as a part of their work may experience positive results, known as Secondary Posttraumatic Growth (SPTG). Aim: The present study aimed to determine the prevalence and determinants of SPTG among medical personnel, considering occupational load, job satisfaction, social support, and cognitive processing of trauma, understood as cognitive coping strategies. Methods: Subjects comprised 419 representatives of the medical profession, including paramedics and nurses. The age of the subjects varied from 19 to 65 (M = 39.60; SD = 11.03). Four standard measurement tools were utilized: the Secondary Posttraumatic Growth Inventory, the Job Satisfaction Scale, the Social Support Scale, which measured four support sources, and the Cognitive Processing of Trauma Scale to assess five cognitive coping strategies. Pearson's correlation coefficients were applied to analyse the connections between the variables. A linear stepwise regression analysis was used to identify the determinants of SPTG. Pearson's correlation coefficients with confidence intervals were applied to analyse the connections between the variables. Results: As many as 40% of participants experienced high levels of growth, with only 27.4% indicating a low level. The obtained results showed positive links between job satisfaction, all social support dimensions (from supervisors, co-workers, family, friends), all cognitive coping strategies (positive cognitive restructuring, downward comparison, resolution/acceptance, denial, regret), and SPTG. No significant connection between workload and SPTG total was discovered. The primary determinant of SPTG in the examined group of medical personnel is the cognitive processing of trauma, chiefly the strategy of positive cognitive restructuring. Conclusions: Paramedics and nurses, despite their exposure to secondary trauma, experience positive posttraumatic consequences of the profession that entails helping the injured parties. It is advisable to encourage the medical personnel to apply positive coping strategies, find satisfaction in their work, and benefit from social support to promote posttraumatic growth.