Culture as both a risk and protective factor for vicarious traumatisation in nurses working with refugees: a literature review

Assisting refugee survivors of torture and trauma: An existential perspective

Consistent exposure to refugee narratives of trauma and torture can profoundly impact trauma therapists. This secondary analysis reanalyzed data from a narrative inquiry investigating the lived experiences of refugee trauma therapists. We aimed to explore emergent concerns through an existential lens to enrich understanding and provide additional insights into the lived experiences of these individuals. Participants in this purposive sample (N = 19) were therapists who had provided interventions to refugees for 2-34 years. Narrative construction, theory-guided data analysis, and memo writing were used to reanalyze data generated by semistructured interviews augmented by photo elicitation. The findings indicate that being forced to reevaluate familiar beliefs consequent to one's professional roles induced intense existential moments, described as "a dark night of the soul," "the paradox of life and death," "uncanny feelings of not being at home," and "a falling." Acknowledging the complexities of the field, an existential framework to assist refugee trauma therapists in metabolizing and living with the professional challenges they encounter instead of focusing on alleviating decontextualized symptoms of distress is recommended. Research to inform requirements of the space to enable refugee trauma therapists to share their concerns and facilitate transitions toward more authentic, nonevasive sense of "being-in-the-world" is suggested.

Vicarious trauma in nursing: A hybrid concept analysis

BACKGROUND

Vicarious trauma can significantly affect the physical and mental health of nurses, as well as their ability to provide quality of care. However, the concept of vicarious trauma has received limited attention and remains controversial in the nursing context.

OBJECTIVE

The purpose of this study was to clarify and define the concept of vicarious trauma as it pertains to the nursing context.

METHODS

The Schwartz and Kim's three-stage hybrid concept analysis method was used to define the concept. In the theoretical phase, PubMed, CINAHL, OVID, Medline, Embase, Web of Science, Scopus, ProQuest, PsycINFO, CNKI database, VIP database and Wanfang database were used using keywords "nurs*"and "vicarious trauma*", resulting in a total of 25 papers. In the fieldwork phase, we conducted participatory observations in three hospitals and semi-structured in-depth interviews with 18 clinical nurses from seven cities. In the analysis phase, the results of the previous two phases were integrated to develop a comprehensive concept of vicarious trauma in nursing.

RESULTS

Based on the results of the theoretical and field phases, we propose the concept of vicarious trauma in nursing as follows: vicarious trauma is a psychological trauma impacting nurses' cognitive schema which they may experience in clinical settings or on social media, resulting from deeply empathize with the physical or emotional trauma of patients, family, or colleagues, such as patients' physical injuries or death, family's grieving feelings and colleagues' received threats and attacks. Positively, vicarious trauma can transform into vicarious post-trauma growth through repositioning and connection, nourishing nurses and promoting their personal and professional development.

CONCLUSION

The concept of vicarious trauma in nursing is multidimensional and holistic. This study clarifies the concept of vicarious trauma in nursing using the hybrid concept analysis, providing a framework for future research and practice on vicarious trauma in the nursing field.

PATIENT OR PUBLIC CONTRIBUTION

Nurses contributed to the conduct of the study by participating in the data collection via interviews.