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Qian YF, Liu Y, Wang L, Li Q, Sun RQ. Current status of post-traumatic stress disorder among emergency nurses and the influencing factors. Front Psychiatry 2023; 14:1203782. [PMID: 37732073 PMCID: PMC10507613 DOI: 10.3389/fpsyt.2023.1203782] [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: 04/11/2023] [Accepted: 08/03/2023] [Indexed: 09/22/2023] Open
Abstract
Objective To gain a better understanding of the current state of traumatic stress experienced by emergency nurses of Grade III Level A hospitals in Jiangsu Province, as well as their coping styles after experiencing such traumatic events. Additionally, this study aims to identify the primary factors that influence the responses of these nurses to traumatic events. Methods Using a cluster random sampling method, we enrolled 265 nurses working in the emergency departments of five Grade III Level A hospitals in Jiangsu Province. These nurses participated in a questionnaire survey that included inquiries regarding general information, previous traumatic experiences, and a post-traumatic stress disorder self-assessment scale (PCL-C) for emergency department nurses. Results A total of 290 questionnaires were distributed, resulting in 265 valid questionnaires and an effective rate of 91.38%. These findings indicated that emergency nurses who participated in public health emergencies such as the COVID-19 pandemic (45.66%) and sudden health deterioration and death of patients (43.77%) encountered the most traumatic events. The top two traumatic events that had a moderate or greater impact on emergency nurses were verbal abuse from patients or their family members (39.24%) and verbal or physical threats by patients or their family members (35.09%). The mean PCL-C score of nurses who experienced traumatic events was 33.62 ± 11.37, with a positive rate of 26.04%. Results from the one-way analysis of variance and multiple linear regression analysis demonstrated that the working years, monthly income, and personal health status of emergency nurses were the main factors contributing to post-traumatic stress disorder. Conclusion Emergency nurses are susceptible to severe traumatic stress following traumatic events, and effective interventions are necessary to address the diverse factors that contribute to their psychological well-being.
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Affiliation(s)
- Yu-Fei Qian
- Department of Emergency, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Ying Liu
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Li Wang
- Department of Emergency, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Qing Li
- Department of Emergency, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Rong-Qian Sun
- Department of Emergency, The Second Affiliated Hospital of Nantong University, Nantong, China
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Velasco J, Sanmartín FJ, Gálvez-Lara M, Cuadrado F, Moriana JA. Psychological Effects of Professional Exposure to Trauma and Human Suffering: Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1656-1676. [PMID: 35202557 DOI: 10.1177/15248380221074314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Over the past decades, a growing interest has emerged toward understanding the impact that the exposure to human suffering produces in mental health professionals, leading to the identification of three constructs: vicarious traumatization (VT), compassion fatigue (CF), and secondary trauma (ST). However, little is known about how these conditions affect psychologists. A systematic review and a meta-analysis were conducted to examine the evidence about the effects of occupational exposure to trauma and suffering in studies that included psychologists among their samples. Fifty-two studies were included comprising 10,233 participants. Overall, the results showed that most professionals did not experience relevant distress due to their work, yet some of them developed clinically significant symptoms (i.e., PTSD). However, solid conclusions could not be drawn due to the numerous methodological difficulties found in this research field (i.e., group heterogeneity, lack of comparison groups, and conceptual overlap). Thus, it is necessary to further investigate this topic with scientific rigor to understand these stressors and develop evidence-based interventions.
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Affiliation(s)
- Judith Velasco
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | | | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | - Fátima Cuadrado
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | - Juan A Moriana
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
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Salameh B, Daibes AG, Qaddumi J. Assessing the Prevalence, Predictors, and Consequences of Secondary Traumatic Stress Among Emergency Nurses in Palestine During the COVID-19 Pandemic. SAGE Open Nurs 2023; 9:23779608231207224. [PMID: 37830081 PMCID: PMC10566272 DOI: 10.1177/23779608231207224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/09/2023] [Accepted: 09/23/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction Emergency nurses who are working in direct contact with COVID-19 patients are at an increased risk of developing secondary traumatic stress disorder. This study aimed to assess the prevalence, predictors, and consequences of secondary traumatic stress among emergency nurses in Palestine during the COVID-19 pandemic. Methods The study utilized a cross-sectional design and recruited a total of 189 emergency nurses from multiple healthcare centers in Palestine. Data collected from January 21, 2021, to March 31, 2021. Results The study revealed that emergency nurses had a high degree of secondary traumatic stress with the prevalence of high to severe symptoms of secondary traumatic stress being 61% of the total participants. In terms of predictors, the results showed that years of experience, level of education, burnout, and organizational support were significantly correlated with secondary traumatic stress and thus that years of experience and burnout are predictors of secondary traumatic stress. Conclusion Based on our findings, nurses in emergency departments in Palestine have a high degree of secondary traumatic stress disorder which impacts their lives on a personal and professional level.
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Affiliation(s)
- Basma Salameh
- Department of Nursing, Arab American University of Jenin, Jenin, Palestine
| | - Abdalla Ghassen Daibes
- ICU Department, Palestinian Ministry of Health-Jenin Hospital, ICU department, Jenin, Palestine
| | - Jamal Qaddumi
- Nursing Department, An-Najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine
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Liu W, Sun L, Yin X, Zhao H, Zhu G, Lian B, Sun H. Relationship between job stress, thinking style and symptoms of post-traumatic stress disorder in mental health nurses. Front Public Health 2022; 10:979138. [PMID: 36187683 PMCID: PMC9521599 DOI: 10.3389/fpubh.2022.979138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/26/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Mental health nurses are often exposed to stressful events which may lead to feeling of stress in their daily work, and this feeling has a profound impact on nurses' mental health. Aim This study aimed to evaluate the relationship between job stress, thinking style and symptoms of post-traumatic stress disorder (PTSD) of mental health nurses, and to explore the mechanism of job stress and thinking style on symptoms of PTSD. Method This cross-sectional study collected related data of 351 mental health nurses in China, and the data was analyzed by PROCESS macro for SPSS. Results The results showed that 18.2% of mental health nurses had the symptoms of PTSD. Thinking style (monarchic thinking style, anarchic thinking style and external thinking style) played a moderating role in the predictive effects of job stress on the symptoms of PTSD. Discussion The research pointed out the relationship between job stress and symptom of PTSD, and clarified the critical role of thinking style among mental health nurses. Implications for practice It is recommended that organizations should enact effective policy and intervention programs to reduce job stress and PTSD symptoms of mental health nurses which may improve their mental health level.
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Affiliation(s)
- Wuyi Liu
- School of Public Health, Weifang Medical University, Weifang, China
| | - Lin Sun
- School of Psychology, Weifang Medical University, Weifang, China
| | - Xunbao Yin
- School of Teacher Education, Weifang University, Weifang, China
| | - Huan Zhao
- School of Psychology, Weifang Medical University, Weifang, China
| | - Guohui Zhu
- Depression Treatment Center, Weifang Mental Health Center, Weifang, China
| | - Bo Lian
- School of Biological Sciences and Technology, Weifang Medical University, Weifang, China
| | - Hongwei Sun
- School of Psychology, Weifang Medical University, Weifang, China,*Correspondence: Hongwei Sun
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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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Zeiher W, Sego E, Trimmer D, Bowers C. Posttraumatic Stress Disorder in Nurses During a Pandemic: Implications for Nurse Leaders. J Nurs Adm 2022; 52:E3-E8. [PMID: 35060955 DOI: 10.1097/nna.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to explore the association between nurses' practice environment (NPE), posttraumatic stress disorder (PTSD), and intent to leave among nurses working during the COVID-19 pandemic. BACKGROUND High levels of physiological and psychological stress in the workplace render nurses susceptible to PTSD. To date, little research has focused on the relationship between NPE, PTSD, and intent to leave during a major health crisis such as the COVID-19 pandemic. METHODS A cross-sectional online survey was completed by nurses who were members of northeastern and midwestern state nurses' associations. RESULTS Approximately 44% of nurses sampled indicated a preference for leaving their position. Significant associations were identified between NPE and PTSD and between NPE and intent to leave. CONCLUSION This assessment of nurses working during the COVID-19 pandemic may inform future mental health strategies and stress management interventions that support nurses continuing to work during a major health crisis.
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Affiliation(s)
- Wendy Zeiher
- Author Affiliations: University of Indianapolis (Dr Zeiher); President (Dr Sego), Indiana State Nurses Association; and Assistant Professor (Mr Trimmer) and Associate Professor (Dr Bowers), University of Indianapolis
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Muehlhausen BL. Spirituality and Vicarious Trauma Among Trauma Clinicians: A Qualitative Study. J Trauma Nurs 2021; 28:367-377. [PMID: 34678805 PMCID: PMC8594510 DOI: 10.1097/jtn.0000000000000616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There has been a lack of research so far on spirituality and trauma. There has been some indication that religion and spirituality are resources in protection against burnout. OBJECTIVE The aim of this study was to understand the phenomenon of spirituality in the context of vicarious trauma among trauma clinicians. METHODS This was a qualitative study based on hermeneutic phenomenological methodology. Individual interviews were conducted with 36 physicians, nurse practitioners, and physician assistants on the relationship between their spirituality and trauma work. RESULTS Participants were recruited from a large Midwest metropolitan Level I trauma center and attendees at the 2018 Eastern Association for the Surgery of Trauma annual conference. Four patterns emerged from the interviews that transcended religious or spiritual affiliation and medical specialty. These included (1) the world of trauma; (2) religious or spiritual beliefs guiding their work; (3) the need for support systems; and (4) the importance of coping mechanisms. CONCLUSION Religion or spirituality plays a role in underlying meaning making and, in the moment, coping for trauma professionals.
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Affiliation(s)
- Beth L. Muehlhausen
- Researcher for Spiritual Care and Mission Integration, Ascension, St Louis, Missouri
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Association of Nursing Work Environment, Relationship with the Head Nurse, and Resilience with Post-Traumatic Growth in Emergency Department Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062857. [PMID: 33799692 PMCID: PMC8000108 DOI: 10.3390/ijerph18062857] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 01/17/2023]
Abstract
Emergency department nurses are confronted with unpredictable diseases and disasters and work-related traumatic stress events. This study aimed to examine the relationship between nursing work environment, relationship with the head nurse, resilience, and posttraumatic growth among emergency department nurses. Data were collected from December 2018 to February 2019 through a self-administered survey questionnaire. Participants comprised 127 nurses working in the emergency department. The collected data were analyzed using t-test, analysis of variance with Scheffé’s test, Pearson’s correlations, and hierarchical multiple regression. The mean posttraumatic growth score of emergency department nurses was 2.59 ± 0.64 out of a possible 5.00. The posttraumatic growth showed a statistically significant difference according to age in the emergency department nurse. Resilience was the most significant variable controlling other variables, accounting for 29% of the variability. The findings support that intervention programs should be developed to encourage a positive relationship with the head nurse and enhance resilience in emergency department nurses.
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Woo MJ, Kim DH. Factors Associated With Secondary Traumatic Stress Among Nurses in Regional Trauma Centers in South Korea: A Descriptive Correlational Study. J Emerg Nurs 2020; 47:400-411. [PMID: 33229000 DOI: 10.1016/j.jen.2020.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/14/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Trauma is a leading cause of death in South Korea. This study aimed to identify the factors associated with secondary traumatic stress of nurses working at regional trauma centers. METHODS A survey-based cross-sectional design was utilized. Data were collected through a structured questionnaire consisting of 5 rating scales and demographic data. Data were analyzed via descriptive statistics, t test, analysis of variance, Pearson's correlation, and multiple regression. RESULTS One hundred eighty-six nurses participated, and most (84.4%) reported moderate to severe secondary traumatic stress. Exposure to traumatic events averaged 34.33 (SD = 6.25) out of 65 points. Average problem-focused coping was 3.00 (SD = 0.37), emotion-focused coping was 2.57 (SD = 0.26), and dysfunctional coping was 2.17 (SD = 0.41) out of 4 points. Social support from family and friends averaged 5.85 (SD = 0.75), social support from coworkers was 5.78 (SD = 0.83), and social support from supervisors was 4.65 (SD = 1.18) out of 7 points. The factors affecting the respondents' secondary traumatic stress were type D personality (β = 0.39, P < .001), dysfunctional coping (β = 0.28, P < .001), problem-focused coping (β = 0.19, P < .01), desire for job rotation (β = 0.17, P < .01), and social support from supervisors (β = -0.12, P = < .05). This regression model was statistically significant and the explanatory power was 46.7% (F = 33.47, P < .001, Adj R2 = 0.47). DISCUSSION Along with a personal effort to engage in stress management programs, administrators, managers, and supervisors should prioritize developing practical strategies for reducing secondary traumatic stress of nurses.
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Suzuki M, Yanagawa Y, Sakamoto A, Sugiyama H, Nozawa Y. Prevalence and risk factors for post-traumatic stress disorder in Japanese relatives of out-of-hospital cardiac arrest patients after receiving a pamphlet concerning the grieving process. Acute Med Surg 2020; 7:e544. [PMID: 32695428 PMCID: PMC7366519 DOI: 10.1002/ams2.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/20/2020] [Accepted: 06/18/2020] [Indexed: 12/04/2022] Open
Abstract
Aim To investigate the prospective frequency of post‐traumatic stress disorder (PTSD) among relatives of sudden death patients following provision of a pamphlet explaining the stages of the complicated grief process and self‐regulating techniques. Methods From May 2017 to February 2018, we prospectively and consecutively provided a pamphlet to relatives of out‐of‐hospital sudden cardiac arrest victims who failed to obtain spontaneous circulation. We investigated the psychiatric status of the bereaved relatives using the Impact of Event Scale – Revised (IES‐R). An IES‐R score over 24 was defined as PTSD. Results Fifty‐four relatives of the 54 dead patients (victims) provided permission of entry to this research. All subjects and victims were Japanese. Among them, 24 subjects had an IES‐R score of 0 and 5 (9.3%) had PTSD approximately 1 month after their bereavement. There were no relatives who received spontaneous psychiatric treatment. The IES‐R scores for non‐medical cardiac arrest, death inquests, and parent variables were significantly higher compared with medical cardiac arrest, no inquest, and no parent, respectively. The IES‐R scores in those who were a child of the victim were significantly lower than in those who were not. Conclusion The present study showed that the frequency of PTSD was 9.3% at 1 month following bereavement among Japanese relatives of sudden death victims after an intervention. This frequency was minimal compared with previous reports.
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Affiliation(s)
- Megumi Suzuki
- Acute Critical Care Center Shizuoka Hospital Juntendo University Izunokuni Japan
| | - Youichi Yanagawa
- Acute Critical Care Center Shizuoka Hospital Juntendo University Izunokuni Japan
| | - Aya Sakamoto
- Acute Critical Care Center Shizuoka Hospital Juntendo University Izunokuni Japan
| | - Haruka Sugiyama
- Acute Critical Care Center Shizuoka Hospital Juntendo University Izunokuni Japan
| | - Yoko Nozawa
- Acute Critical Care Center Shizuoka Hospital Juntendo University Izunokuni Japan
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Kim H, Kim E, Yu Y. Traumatic Events and Factors Affecting Post-traumatic Growth of Nurses in General Hospitals. ACTA ACUST UNITED AC 2020. [DOI: 10.11111/jkana.2020.26.3.218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Haesook Kim
- Professor, Department of Nursing, College of Health Sciences, Cheongju University, Korea
| | - Eunsook Kim
- Assistant Professor, Department of Nursing, College of Health Sciences, Cheongju University, Korea
| | - Younghee Yu
- NSICU Unit Manager, Nursing Department, Cheongju St. Mary's Hospital, Korea
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