Factors Associated With Post-traumatic Stress Disorder Among Nurses During COVID-19

The prevalence and risk factors of PTSD symptoms among nurses during the COVID-19 pandemic-A systematic review and meta-analysis

Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID-19) has raised serious concerns globally. The COVID-19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta-analysis aims to summarise extant literature on the effects of the COVID-19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post-traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random-effect meta-analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta-regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID-19 pandemic in twenty-six different countries, globally. Risk factors associated with PTSD include having prior mental health co-morbidities, being a female, having high exposure/contact with COVID-19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random-effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID-19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses.

The prevalence of post traumatic and associated factors among nurses during COVID_19 pandemics: a systematic review and meta-analysis

BACKGROUND

Despite the negative outcomes, exposure to a crisis may cause people to experience positive changes. This study aims to analyze the prevalence of post-traumatic growth (PTG) and its relevant factors among nurses during the COVID-19 pandemic.

METHOD

The research protocol was registered with PROSPERO (CRD42022329671), and PRISMA steps were taken in this study. PubMed, Scopus and ProQuest were explored on 1/9/2022 to create the research database. According to the inclusion criterion, all studies analyzing the prevalence of post-traumatic growth through the PTG Inventory were considered eligible. They were all qualitatively assessed through the modified version of the Quality Assessment Checklist for prevalence studies.

RESULTS

A total of 15 papers met the inclusion criterion (n = 22756). According to the research results, the prevalence of PTG was randomly calculated ES [95% Conf. Interval = 0.15 [0.12-0.17]), and heterogeneity was reported I2 = 98.52% (P = 0.000). The results also indicated that the mean score of PTGI decreased in nurses as their work experience and mean age increased. However, the effect was not statistically significant for the mean age (P = 0.06). According to the results, the PTGI score decreased in nurses with more work experience, a finding which was statistically significant (P = 0.04).

CONCLUSION

This meta-analysis determined a 15% prevalence rate of PTG in nurses. Psychological interventions should be developed and applied to older nurses with more work experience in order to mitigate the harm caused by the pandemic and its consequent crises.

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.

The levels and related factors of posttraumatic growth among nurses: A systematic review and meta-analysis

WHAT IS KNOWN ON THE SUBJECT?: Nurses often encounter traumatic events in their clinical practice. Trauma can have both negative effects, such as post-traumatic stress disorder and positive effects, such as growth and positive emotions. Posttraumatic growth is beneficial for nurses, as it contributes to positive mental health outcomes and increases life satisfaction. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Our study confirms that nurses commonly experience posttraumatic growth after being exposed to traumatic events, and the level of growth is moderate. We have identified individual, work-related, and social and organizational factors that may influence the occurrence of posttraumatic growth among nurses. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Our findings provide valuable insights for interventions aimed at promoting posttraumatic growth among nurses. It is crucial to consider individual factors, work-related factors, and social and organizational factors when designing these interventions. By addressing these factors, healthcare professionals can support nurses in coping with trauma and facilitate their posttraumatic growth.

ABSTRACT

INTRODUCTION: While the negative effects of trauma on nurses have been well-documented, it is equally important to focus on ways to promote posttraumatic growth (PTG) among nurses.

AIM

This study aims to explore the levels and related factors of PTG among nurses.

METHOD

A comprehensive search was conducted across nine databases up to 26 December 2022. The pooled mean score for PTG was calculated and presented with a 95% confidence interval. Subgroup and meta-regression analyses were performed to identify potential moderators of PTG among nurses.

RESULTS

A total of 55 studies, involving 35,621 nurses from 11 countries and regions, were included in this review. The pooled scores of the PTG indicated that nurses experienced a moderate level of PTG (55.69, 95% CI: 50.67-60.72).

DISCUSSION

Nurses commonly experience PTG following exposure to traumatic events, with a moderate level of PTG. Our systematic review highlights the potential determinants of PTG among nurses, including individual, work-related, and social and organizational factors.

IMPLICATIONS FOR PRACTICE

Targeting these factors in interventions can provide nurses with the necessary resources and support to effectively cope with stress and trauma, and potentially facilitate PTG.

Latent profile analysis of nurses' perceived professional benefits in China: a cross-sectional study

OBJECTIVE

To identify profiles of nurses' perceived professional benefits as well as their predictors.

DESIGN

Cross-sectional study.

SETTING

The study was carried out online in China.

METHODS

From 6 July to 27 July 2022, a total of 1309 registered nurses participated in the survey by convenient sampling. We collected the Nurses' Perceived Professional Benefits Questionnaire and demographic data. Using latent profile analysis (LPA), subgroups of nurses' perceived professional benefits were identified. Moreover, univariate and multinomial logistic regression analyses were conducted to find the factors that were linked with the profiles.

RESULTS

The survey was validly completed by 1309 nurses, with a 92.9% effective return rate. The findings of the LPA demonstrated three unique profiles: low-perceived professional benefits (11.8%), moderate-perceived professional benefits (57.1%) and high-perceived professional benefits (31.1%). There was a correlation between marital status, the number of night shifts per month and leadership role.

CONCLUSIONS

According to our research, registered nurses have three unique professional benefit profiles. In order to sustain the nursing workforce, despite the fact that nurses get a high level of professional benefits, interventions are necessary to increase nurses' perception of their professional value.

Risk factors for post-traumatic stress disorder in nurses from the regional medical alliance during the COVID-19 epidemic: A prospective cross-sectional study

Mental health issues among nursing professionals have been increasingly reported during the coronavirus disease (COVID-19) pandemic. However, there is a paucity of research on post-traumatic stress disorder (PTSD) among nurses working in Medical Alliances. In this study, we aimed to investigate the risk factors associated with PTSD in the Regional Medical Alliance (MA) in Shantou (China) during the COVID-19 pandemic. A total of 1286 nurses from four MA hospitals participated in the study from February to March 2020. Our findings revealed that the incidences of PTSD, depression, anxiety, and sleep disorders among nurses from MA were 15.6%, 35.5%, 18.3%, and 36.4%, respectively. Moreover, PTSD was positively correlated with depression, anxiety, and sleep disorders. In addition, the results of logistic regression analysis showed that working in a tertiary hospital, older age, more severe depression, more severe anxiety, and prevalent sleep disorders were independent risk factors for PTSD among nurses. Therefore, mental health interventions targeting high-risk nurses in MA with an incidence of PTSD are urgently needed.

Tragedy or transformation? Online survey of nurse spirituality during the COVID pandemic

AIM

To describe positive and negative spiritual responses to providing COVID-related nursing care among nurses working in hospitals.

BACKGROUND

The COVID pandemic has intensified and publicised the threats to nurse well-being. Absent from the recommendations for promoting nurse well-being is recognition of how nurses' spirituality and/or religiosity is affected by the strain of COVID caring or how it may be affecting their well-being.

DESIGN

Cross-sectional, descriptive observational, mixed methods study.

METHODS

Data were collected from 523 registered nurses employed in three Southern California hospitals during March-May, 2022 when these hospitals' COVID case counts were <15%. Using Online survey methods, data were obtained using the Religious/Spiritual Struggles Scale-Short Form, Moral Injury Symptom Scale-Healthcare Professionals, Post-traumatic Growth Inventory and demographic and work-related items. STROBE guidelines for cross-sectional observational studies were observed.

RESULTS

The mean for religious/spiritual struggles was 1.98 (range of 1-5, comparable to a little bit). Although roughly half of the sample reported the struggles were not experienced/did not apply, 23%-36.5% reported experiencing these struggles at least somewhat. The most frequent struggle was to find ultimate meaning. The mean observed for moral injury was 6.5 (range of 1-10); applying established criteria indicated it was troubling for at least 50%. The mean for post-traumatic growth was 4 (on a scale of 0-6); using established criteria, 41% experienced PTG. Quantitative findings were illustrated by the qualitative responses that occasionally expressed spiritual tragedy and transformation concurrently.

CONCLUSION

The professional work of nursing impacts nurses in invisible, spiritual ways that can be tragic and/or transformative.

RELEVANCE TO CLINICAL PRACTICE

Interventions to address nurses' mental health challenges must include attention to these invisible struggles. Nurses' mental health challenges must be met in part by addressing how they can surmount spiritual tragedy-and allow spiritual transformation.

Post-Traumatic Stress Disorder among Polish Healthcare Staff in the Era of the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic has brought many adverse phenomena, particularly in the area of health for both individuals and society as a whole. Healthcare staff also suffered dire consequences.

AIM

The aim of this study was to assess whether the COVID-19 pandemic increased the risk of post-traumatic stress disorder among healthcare professionals in Poland.

MATERIAL AND METHOD

The survey was conducted between 4 April 2022 and 4 May 2022. The study applied the Computer Assisted Web Interview (CAWI) technique using the standardised Peritraumatic Distress Inventory (PDI) questionnaire.

RESULTS

The average score obtained by the respondents on the PDI was 21.24 ± 8.97. There was a statistically significant difference between the average PDI score obtained based on the gender of the subject (Z = 3.873, p = 0.0001.) The score obtained amongst nurses was statistically significantly higher compared to the paramedic group (H = 6.998, p = 0.030). There was no statistically significant difference between the average PDI score obtained based on the age of the participants (F = 1.282, p = 0.281), nor with their length of service (F = 0.934, p = 0.424). A total of 82.44% of the respondents received 14 PDI points, the cut-off point indicating the risk of PTSD that was adopted in the study. It was concluded that 6.12% of respondents did not require intervention (<7 PDI score); 74.28% of respondents needed further follow-up for PTSD and a reassessment of the PDI approximately 6 weeks after the initial testing; and 19.59% required coverage for PTSD prevention and mitigation (>28 PDI score).

CONCLUSIONS

The study has shown a high risk of post-traumatic stress disorder among healthcare professionals in Poland. This risk is related to the gender of the respondents, with an indication of a higher risk of PTSD among women. The results have also shown a correlation between increased risk of post-traumatic stress disorder and occupation, with nurses being the most affected group. In contrast, no association has been found in terms of age and length of service for an increase in the risk of PTSD, following exposure to trauma in relation to healthcare services during the COVID-19 pandemic.

Knowledge mapping analysis of mental health research on COVID-19

OBJECTIVE

A bibliometric analysis of COVID-19 is conducted to examine the developmental context, research hotspots, and frontiers of mental health.

METHODS

Using the Web of Science Core Collection (WOSCC), we have retrieved articles on mental health research related to COVID-19 which were published between 2019 and 2021. The coauthorship of countries, institutes, and authors was analyzed using VOSviewer 1.6.17, and the co-citation map of authors/references was analyzed as well. CiteSpace version 5.8.R3 was used to analyze keyword clusters and forecast research frontiers.

RESULTS

There were 8,856 articles retrieved, including 10,559 research institutes and 1,407 academic journals. The most published country and institutes were the United States (2190) and the University of London (373). Wang, Chengyu owned the highest co-citations (1810). Frontier topics can be identified by trending keywords, including "anxiety," "depression," "psychological distress," "quarantine," "post-traumatic stress disorder (PTSD)," "insomnia," and "Healthcare workers."

CONCLUSION

The most common psychological problems of people during the epidemic are anxiety and depression. Insomnia and PTSD need to be solved under the normalization of the epidemic. GAD-7 and PHQ-9 scales are the most convenient and effective for screening anxiety and depression. Healthcare workers, older adults, and college students should be concerned, and social and family support is essential.