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Babakhani M, Aghabarary M, Norouzinia R. Perceived stress and coping strategies after unsuccessful cardiopulmonary resuscitation among pre-hospital emergency technicians: A multicenter cross-sectional study. Heliyon 2024; 10:e31418. [PMID: 38803903 PMCID: PMC11128499 DOI: 10.1016/j.heliyon.2024.e31418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 05/02/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
Background Effective stress management after unsuccessful cardiopulmonary resuscitation (CPR) requires the determination of perceived stress and identification and reinforcement of effective coping strategies. Therefore, the present study was conducted to determine perceived stress and coping strategies after unsuccessful CPR for the first time among Iranian pre-hospital emergency technicians. Methods A cross-sectional, descriptive, correlational, multicenter study was conducted in 2022. The research population included all pre-hospital emergency technicians working in 44 urban, road, and aerial pre-hospital emergency stations in 22 counties of Ilam Province, west of Iran. A total of 374 technicians worked in these stations, which were included in the study by census method according to the inclusion criteria. The data collection tools were the Questionnaire of perceived stress after unsuccessful CPR and Brief Coping Orientation to Problems Experienced (COPE) Inventory. The collected data were analyzed with SPSS software version 27 using descriptive and analytical statistics (Pearson correlation test, multiple linear regression analysis, independent sample T-test, and ANOVA) at a significance level of p ≤ 0.05. Results The perceived stress was at a moderate level with a mean score of 65.56 ± 14.21. Among six coping strategies, problem-focused coping had the highest (3.01 ± 0.59) and denial had the lowest mean value (1.94 ± 0.79). Perceived stress had a significant direct relationship with 5 coping strategies, including problem-focused coping, support-focused coping, emotion-focused coping, self-distraction, and religion (p < 0.05). The strongest relationship was found between perceived stress and self-distraction followed by emotion-focused coping. According to the results of multiple regression analysis, emotion-focused coping and self-distraction had predictive roles. Conclusion The participants used different coping strategies to cope with the stress of unsuccessful CPR. The most common coping mechanisms used by the participants were problem-focused, emotion-focused, and support-focused coping. Pre-hospital emergency officials can assist pre-hospital emergency technicians in coping with occupational stress, including the stress of unsuccessful CPR, through organizing educational courses, teaching effective coping strategies, and offering support programs.
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Affiliation(s)
- Meysam Babakhani
- MSc Student of Emergency Nursing, Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Maryam Aghabarary
- Ph.D. in Nursing Research, Assistant Professor, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Roohangiz Norouzinia
- Ph.D. in Health in Emergencies and Disasters, Assistant Professor, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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2
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Salameh B, Abdallah J, Alkubati SA, ALBashtawy M. Alarm fatigue and perceived stress among critical care nurses in the intensive care units: Palestinian perspectives. BMC Nurs 2024; 23:261. [PMID: 38654236 PMCID: PMC11036661 DOI: 10.1186/s12912-024-01897-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE The frequency of alarms generated by monitors and other electro-medical devices is undeniably valuable but can simultaneously escalate the workload for healthcare professionals, potentially subjecting intensive care unit nurses to alarm fatigue. The aim of this study is to investigate alarm fatigue and stress levels among critical care nursing personnel. Additionally, the study aims to assess predictors for both alarm fatigue and perceived stress. METHODOLOGY A descriptive cross-sectional study recruited 187 Intensive Care Unit (ICU) nurses from hospitals located in the northern and central regions of the West Bank, Palestine. Data were gathered through online surveys due to logistic concerns using the Alarm Fatigue Scale and the Perceived Stress Scale. The research was conducted between November 2023 and January 2024. RESULTS The mean overall alarm fatigue score was 23.36 (SD = 5.57) out of 44. The study showed that 62.6% of the participating ICU nurses experience average to high degree of alarm fatigue, while 69.5% experience average to high levels of perceived stress. A significant positive Pearson correlation was found between stress and alarm fatigue (0.40, P < 0.01). Important predictors of alarm fatigue include perceived stress, nurse-to-patient ratio, gender, and years of experience, while important predictors of perceived stress include alarm fatigue, type of working shift and hospital unit. CONCLUSION Alarm fatigue can compromise the timely intervention required to prevent adverse outcomes by causing delayed responses or missed critical alarm, which can have major ramifications for patient safety. Addressing stress is crucial for mitigating alarm fatigue and fostering a supportive work environment to ensure optimal patient care. Consequently, exploring strategies to alleviate the negative impacts of alarm fatigue on critical care nurses' stress merits further investigation in future research studies.
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Affiliation(s)
- Basma Salameh
- Faculty of Nursing, Arab American University, Jenin, Palestine.
| | - Jihad Abdallah
- Department of Animal Production, An-Najah National University,Nablus, Jenin, Palestine
| | - Sameer A Alkubati
- Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida, Yemen
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail, Saudi Arabia
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3
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Zaghini F, Fiorini J, Moons P, Sili A. Cardiovascular nurses and organizational well-being: a systematic review. Eur J Cardiovasc Nurs 2024; 23:213-220. [PMID: 37561990 DOI: 10.1093/eurjcn/zvad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/12/2023]
Abstract
AIMS This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it. METHODS AND RESULTS The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive. CONCLUSION Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes. REGISTRATION PROSPERO: CRD42022355669.
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Affiliation(s)
- Francesco Zaghini
- Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Jacopo Fiorini
- Department of Nursing Professions, University Hospital of Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35 PB 7001, 3000 Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Klipfontein Rd, Rondebosch, 7700 Cape Town, South Africa
| | - Alessandro Sili
- Department of Nursing Professions, University Hospital of Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
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4
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Abdelbaky AM, Eldelpshany MS. Intensive Care Unit (ICU)-Related Post-traumatic Stress Disorder: A Literature Review. Cureus 2024; 16:e57049. [PMID: 38681363 PMCID: PMC11046361 DOI: 10.7759/cureus.57049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
An intensive care unit (ICU) is a challenging environment characterized by frequent incidences of stressors and traumatic situations. Therefore, both patients and caregivers are at high risk of developing psychological disorders such as post-traumatic stress disorder (PTSD), anxiety, and depression. ICU-related PTSD is a significant concern that remains under-recognized. This literature review examines the current state of knowledge regarding ICU-related PTSD, including its prevalence, risk factors, clinical manifestations, and potential interventions. Key findings suggest that a considerable proportion of ICU survivors develop PTSD symptoms, which can significantly impact their quality of life and recovery. The most common predictors investigated for PTSD in ICU survivors are age, gender, pre-illness psychopathy, length of stay in the ICU, delirium, and sedative agents. The treatment and prevention strategies of ICU-related PTSD include psychological therapies and pharmacological and non-pharmacological treatments. Psychological interventions, including cognitive-behavioral therapy and pharmacotherapy, have shown promise in mitigating PTSD symptoms in ICU survivors. However, further research is needed to better understand the mechanisms underlying ICU-related PTSD and to develop targeted interventions to prevent and manage this debilitating condition.
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5
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Delgado-Corcoran C, Wawrzynski SE, Mansfield K, Fuchs E, Yeates C, Flaherty BF, Harousseau M, Cook L, Epps JV. Grieving Children' Death in an Intensive Care Unit: Implementation of a Standardized Process. J Palliat Med 2024; 27:236-240. [PMID: 37878371 PMCID: PMC10825263 DOI: 10.1089/jpm.2023.0134] [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] [Accepted: 09/15/2023] [Indexed: 10/26/2023] Open
Abstract
Background: The grief that accompanies witnessing the death of a child puts health care professionals at risk of secondary trauma, burnout, and turnover when left unaddressed. Objective: Support staff well-being and promote resiliency. Methods: Descriptive implementation of a structured, peer-to-peer bereavement support program for intensive care unit (ICU) staff at a tertiary children's hospital. Results: Thirty-five virtual sessions were held over the period of one year.Through these sessions, participants shared perspectives and normalized reactions, and explored potential coping strategies. Post-session feedback surveys demonstrated the negative impact of a death on the personal or work life of ICU staff. Additionally, nearly all reported some level of burnout. Conclusions: The sessions were feasible and positively impacted staff coping and well-being. Barriers and facilitators to session attendance, as well as suggestions for improvement, were also explored. Implications for practice and future research are discussed. No clinical trial registration is applicable.
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Affiliation(s)
- Claudia Delgado-Corcoran
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
- Division of Pediatric Palliative Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Sarah E. Wawrzynski
- Center for HealthCare Delivery Science, Nemours Children's Hospital, Wilmington, Delaware, USA
| | - Kelly Mansfield
- College of Nursing, Division of Acute and Chronic Care, University of Utah, Salt Lake City, Utah, USA
| | - Erin Fuchs
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Chelsea Yeates
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Brian F. Flaherty
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Mark Harousseau
- Division of Pediatric Palliative Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Lawrence Cook
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Jake Van Epps
- Department of Educational Psychology, University of Utah, Salt Lake City, Utah, USA
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6
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Koželj A, Strauss M, Poštuvan V, Strauss Koželj A, Strnad M. Perception of Personal Participation of the Nurses in Resuscitation Procedures: A Qualitative Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:196. [PMID: 38399484 PMCID: PMC10890641 DOI: 10.3390/medicina60020196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/18/2023] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Resuscitation is one of the most stressful tasks in emergency medicine. The participation of nurses in this procedure can have specific effects on them. In this research, we wanted to find out what these effects are. Materials and Methods: A qualitative approach by conducting semi-structured interviews was used, and a thematic data analysis of the recorded interviews was carried out. The collected data were transcribed verbatim, with no corrections to the audio recordings. The computer program ATLAS.ti 22 was used for the qualitative data analysis. Results: Eleven male registered nurses were interviewed, with an average of 18.5 years of experience working in a prehospital environment (max. 32/min. 9). A total of 404 min of recordings were analyzed, and 789 codes were found, which were combined into 36 patterns and 11 themes. As the most stressful situations, the interviewees pointed out the resuscitation of a child, familiar persons, conflicts with the environment, conflicts within the resuscitation team, nonfunctioning or insufficient equipment, complications during resuscitation, and resuscitating a person only for training. As positive effects, the interviewees cited successful resuscitations or their awareness that, despite an unsuccessful resuscitation, they did everything they could. Conclusions: Participation in these interventions has a specific positive or negative impact on the performers. The interviewees shared the opinion that they can cope effectively with the adverse or stressful effects of resuscitation. Yet, despite everything, they allow the possibility of subconscious influences of this intervention on themselves.
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Affiliation(s)
- Anton Koželj
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia;
| | - Maja Strauss
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia;
| | - Vita Poštuvan
- Slovene Center for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia;
| | | | - Matej Strnad
- Emergency Department, University Clinical Centre Maribor, 2000 Maribor, Slovenia;
- Center for Emergency Medicine, Prehospital Unit, Community Healthcare Center, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
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7
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El-Ashry AM, Elsayed SM, Ghoneam MA, Atta MHR. Compassion fatigue and stress related to cardiopulmonary resuscitation: a study of critical care nurses' experiences. BMC Nurs 2023; 22:482. [PMID: 38110907 PMCID: PMC10726549 DOI: 10.1186/s12912-023-01640-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) is considered one of the most stressful experiences in critical care nursing; it directly and indirectly leads to compassion fatigue and burnout. AIM Determine the levels of and relationship between postcode stress and compassion fatigue. DESIGN AND METHODS A descriptive-correlational study using 300 critical care nurses from five intensive care units in two hospitals was conducted. TOOLS Demographic and work-related data, the Postcode Stress Scale, and the Professional Quality of Life Scale: Compassion Fatigue subscale. RESULTS Nurses had moderate to high postcode stress and compassion fatigue (67.98 ± 16.39 and 65.40±14.34, respectively). Moreover, there was a significant positive correlation between postcode stress, burnout (r=0.350, p=<0.001), secondary traumatic stress (r=0.518, p=<0.001), and subsequently, compassion fatigue (r=0.449, p=<0.001). In addition, higher levels of postcode stress were associated with higher levels of compassion fatigue with its subscales: burnout and secondary traumatic stress, with a coefficient of determination for compassion fatigue (0.199), burnout subscale (0.121), and secondary traumatic stress (0.266). CONCLUSION Critical care nurses involved in resuscitation experiences are susceptible to postcode stress, burnout, secondary traumatic stress, and compassion fatigue. There is a significant relationship between these factors, with higher levels of postcode stress contributing to higher levels of compassion fatigue and its subscales: burnout and secondary traumatic stress. These results highlight the importance of addressing and managing the psychological well-being of nurses in resuscitation settings to mitigate the adverse effects of stress and promote their overall resilience and well-being.
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Affiliation(s)
- Ayman Mohamed El-Ashry
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
| | - Shimmaa Mohamed Elsayed
- Critical Care and Emergency Nursing Department, Faculty of Nursing, Damanhour University, Damanhour, Egypt
| | - Mohamed Adel Ghoneam
- Critical Care and Emergency Nursing Department, Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt
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8
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Chan PS, Greif R, Anderson T, Atiq H, Bittencourt Couto T, Considine J, De Caen AR, Djärv T, Doll A, Douma MJ, Edelson DP, Xu F, Finn JC, Firestone G, Girotra S, Lauridsen KG, Kah-Lai Leong C, Lim SH, Morley PT, Morrison LJ, Moskowitz A, Mullasari Sankardas A, Mustafa Mohamed MT, Myburgh MC, Nadkarni VM, Neumar RW, Nolan JP, Odakha JA, Olasveengen TM, Orosz J, Perkins GD, Previdi JK, Vaillancourt C, Montgomery WH, Sasson C, Nallamothu BK. Ten Steps Toward Improving In-Hospital Cardiac Arrest Quality of Care and Outcomes. Resuscitation 2023; 193:109996. [PMID: 37942937 PMCID: PMC10769812 DOI: 10.1016/j.resuscitation.2023.109996] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Affiliation(s)
- Paul S Chan
- Mid-America Heart Institute, Kansas City, MO, United States.
| | - Robert Greif
- Department of Anesthesiology and Pain Medicine, University of Bern, Switzerland
| | - Theresa Anderson
- Department of Internal Medicine, University of Michigan Medical, Ann Arbor, United States
| | - Huba Atiq
- Centre of Excellence for Trauma and Emergencies, Aga Khan University Hospital, Pakistan
| | | | | | - Allan R De Caen
- Division of Pediatric Critical Care, Stollery Children's Hospital, Edmonton, Canada
| | - Therese Djärv
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ann Doll
- Global Resuscitation Alliance, Seattle, WA, United States
| | - Matthew J Douma
- Department of Critical Care Medicine, University of Alberta, Canada
| | - Dana P Edelson
- Department of Medicine, University of Chicago Medicine, IL, United States
| | - Feng Xu
- Department of Emergency Medicine, Qilu Hospital of Shandong University, China
| | - Judith C Finn
- School of Nursing, Curtin University, Perth, Australia
| | - Grace Firestone
- Department of Family Medicine, University of California Los Angeles Health, Santa Monica, United States
| | - Saket Girotra
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, United States
| | | | | | - Swee Han Lim
- Department of Emergency Medicine, Singapore General Hospital, Singapore
| | - Peter T Morley
- Department of Intensive Care, The University of Melbourne, Australia
| | - Laurie J Morrison
- Division of Emergency Medicine, University of Toronto, Ontario, Canada
| | - Ari Moskowitz
- Department of Medicine, Montefiore Medical Center, The Bronx, NY, United States
| | | | | | | | - Vinay M Nadkarni
- Department of Anesthesiology and Critical Care, Childrens Hospital of Philadelphia, PA, United States
| | - Robert W Neumar
- Department of Emergency Medicine, University of Michigan, Ann Arbor, United States
| | | | | | - Theresa M Olasveengen
- Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Judit Orosz
- Department of Medicine, The Alfred, Melbourne, Australia
| | | | | | | | | | | | - Brahmajee K Nallamothu
- Department of Internal Medicine, University of Michigan Medical, Ann Arbor, United States
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9
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Nallamothu BK, Greif R, Anderson T, Atiq H, Couto TB, Considine J, De Caen AR, Djärv T, Doll A, Douma MJ, Edelson DP, Xu F, Finn JC, Firestone G, Girotra S, Lauridsen KG, Leong CKL, Lim SH, Morley PT, Morrison LJ, Moskowitz A, Mullasari Sankardas A, Mohamed MTM, Myburgh MC, Nadkarni VM, Neumar RW, Nolan JP, Athieno Odakha J, Olasveengen TM, Orosz J, Perkins GD, Previdi JK, Vaillancourt C, Montgomery WH, Sasson C, Chan PS. Ten Steps Toward Improving In-Hospital Cardiac Arrest Quality of Care and Outcomes. Circ Cardiovasc Qual Outcomes 2023; 16:e010491. [PMID: 37947100 PMCID: PMC10659256 DOI: 10.1161/circoutcomes.123.010491] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
| | - Robert Greif
- Department of Anesthesiology and Pain Medicine, University of Bern, Switzerland (R.G.)
| | - Theresa Anderson
- Department of Internal Medicine, University of Michigan Medical, Ann Arbor (B.K.N., T.A.)
| | - Huba Atiq
- Centre of Excellence for Trauma and Emergencies, Aga Khan University Hospital, Pakistan (H.A.)
| | | | | | - Allan R. De Caen
- Division of Pediatric Critical Care, Stollery Children’s Hospital, Edmonton, Canada (A.R.D.C.)
| | - Therese Djärv
- Department of Medicine, Karolinska Institute, Stockholm, Sweden (T.D.)
| | - Ann Doll
- Global Resuscitation Alliance, Seattle, WA (A.D.)
| | - Matthew J. Douma
- Department of Critical Care Medicine, University of Alberta, Canada (M.J.D.)
| | - Dana P. Edelson
- Department of Medicine, University of Chicago Medicine, IL (D.P.E.)
| | - Feng Xu
- Department of Emergency Medicine, Qilu Hospital of Shandong University, China (F.X.)
| | - Judith C. Finn
- School of Nursing, Curtin University, Perth, Australia (J.F.)
| | - Grace Firestone
- Department of Family Medicine, University of California Los Angeles Health, Santa Monica (G.F.)
| | - Saket Girotra
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas (S.G.)
| | | | - Carrie Kah-Lai Leong
- Department of Emergency Medicine, Singapore General Hospital (C.K.-L.L., S.H.L.)
| | - Swee Han Lim
- Department of Emergency Medicine, Singapore General Hospital (C.K.-L.L., S.H.L.)
| | - Peter T. Morley
- Department of Intensive Care, The University of Melbourne, Australia (P.T.M.)
| | - Laurie J. Morrison
- Division of Emergency Medicine, University of Toronto, Ontario, Canada (L.J.M.)
| | - Ari Moskowitz
- Department of Medicine, Montefiore Medical Center, The Bronx, NY (A.M.)
| | | | | | | | - Vinay M. Nadkarni
- Department of Anesthesiology and Critical Care, Childrens Hospital of Philadelphia, PA (V.N.)
| | - Robert W. Neumar
- Department of Emergency Medicine, University of Michigan, Ann Arbor (R.W.N.)
| | - Jerry P. Nolan
- University of Warwick, Coventry, United Kingdom (J.P.N., G.D.P.)
| | | | - Theresa M. Olasveengen
- Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway (T.M.O.)
| | - Judit Orosz
- Department of Medicine, The Alfred, Melbourne, Australia (J.O.)
| | - Gavin D. Perkins
- University of Warwick, Coventry, United Kingdom (J.P.N., G.D.P.)
| | | | | | | | | | - Paul S. Chan
- Mid-America Heart Institute, Kansas City, MO (P.S.C.)
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10
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Hao Y, Zhu W, Wu H, Guo Y, Mu W, Li D, Ren X, Fan L. Experience of cardiopulmonary resuscitation by healthcare professionals in emergency departments: A descriptive phenomenological study. Int Emerg Nurs 2023; 70:101336. [PMID: 37657134 DOI: 10.1016/j.ienj.2023.101336] [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: 12/12/2022] [Revised: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Emergency department healthcare professionals have the most contact with patients in cardiac arrest, and their physical and mental state has a significant impact on the quality of cardiopulmonary resuscitation and patient outcomes. However, there is limited research discussing the experience of resuscitation by emergency department healthcare professionals. AIM To explore the experiences of emergency department healthcare professionals in performing cardiopulmonary resuscitation. METHODS A descriptive phenomenological study. The study used purposive sampling and selected 9 nurses and 6 physicians from the emergency departments of four general hospitals of different levels in western China between May 2022 and October 2022. Semi-structured interview guides and face-to-face interviews were used to collect information. Colaizzi analysis was used to analyze the data. RESULTS The study identified 3 themes and 11 sub-themes. These themes and sub-themes include 1) emotional experience (A sense of achievement, A sense of powerlessness and trauma, Stress, Empathy, Psychological resilience strengthens), 2) cognitive growth (Understanding CPR rationally, Increasing concern for personal and family health, Mastering self-relaxation methods), and 3) the desire for continued development (Seeking professional development, Hoping for professional psychological assistance, Strengthening team support). CONCLUSIONS The experience of performing cardiopulmonary resuscitation by healthcare professionals in emergency departments is dynamic, with changes in mood and cognitive growth. Managers in hospitals should pay attention to their experiences and need at different stages of career development and actively carry out targeted cognitive guidance, skills training, and psychological support to help them achieve professional development and physical and mental health. At the same time, to promote the development of CPR for all, it is recommended that the authorities actively improve the public infrastructure for first aid and related policy protection.
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Affiliation(s)
- Yaru Hao
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Wei Zhu
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Hui Wu
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Yue Guo
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Wenjing Mu
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Dan Li
- Cardiac Care Unit, The First Hospital of Lanzhou University, Lanzhou, China.
| | - Xuanlin Ren
- General Surgery II, The First Hospital of Lanzhou University, Lanzhou, China.
| | - Luo Fan
- School of Nursing, Lanzhou University, Lanzhou, China; Nursing Administration Department, The First Hospital of Lanzhou University, Lanzhou, China.
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11
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Bloomer MJ, Ranse K, Adams L, Brooks L, Coventry A. "Time and life is fragile": An integrative review of nurses' experiences after patient death in adult critical care. Aust Crit Care 2023; 36:872-888. [PMID: 36371292 DOI: 10.1016/j.aucc.2022.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Providing bereavement support and care to families is an aspect of critical care nursing practice that can be rewarding, yet emotionally and psychologically challenging. Whilst significant research has focused on end-of-life care in critical care, less is known about nurses' experiences after patient death. AIM The aim of this study was to synthesise research evidence on the experience of registered nurses after patient death in adult critical care. DESIGN A structured integrative review of the empirical literature was undertaken. A combination of keywords, synonyms, and Medical Subject Headings were used across the Cumulative Index Nursing and Allied Health Literature (CINAHL) Complete, Ovid Medline, PsycInfo, Embase, and Emcare databases. Records were independently assessed against inclusion and exclusion criteria. A process of forward and backward chaining was used to identify additional papers. All papers were assessed for quality. Narrative synthesis was used to analyse and present the findings. RESULTS From the 4643 records eligible for screening, 36 papers reporting 35 studies were included in this review, representing the voices of 1687 nurses from more than 20 countries. Narrative synthesis revealed three themes: (i) postmortem care, which encompassed demonstrating respect and dignity for the deceased, preparation of the deceased, and the concurrent death rituals performed by nurses; (ii) critical care nurses' support of bereaved families, including families of potential organ donors and the system pressures that impeded family support; and (iii) nurses' emotional response to patient death including coping mechanisms. CONCLUSIONS Whilst a focus on the provision of high-quality end-of-life care should always remain a priority in critical care nursing, recognising the importance of after-death care for the patient, family and self is equally important. Acknowledging their experience, access to formal education and experiential learning and formal and informal supports to aid self-care are imperative.
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Affiliation(s)
- Melissa J Bloomer
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia; Intensive Care Unit, Princess Alexandra Hospital, Metro South Health, Queensland Health, Queensland, Australia.
| | - Kristen Ranse
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia
| | - Leah Adams
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; Intensive Care Unit, Latrobe Regional Hospital, Victoria, Australia
| | - Laura Brooks
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Deakin University, Victoria, Australia
| | - Alysia Coventry
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; St Vincent's Health Network Sydney, St Vincent's Hospital, Melbourne and Australian Catholic University, Australia
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12
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Deltour V, Poujol AL, Laurent A. Post-traumatic stress disorder among ICU healthcare professionals before and after the Covid-19 health crisis: a narrative review. Ann Intensive Care 2023; 13:66. [PMID: 37477706 PMCID: PMC10361923 DOI: 10.1186/s13613-023-01145-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The ICU (intensive care unit) involves potentially traumatic work for the professionals who work there. This narrative review seeks to identify the prevalence of post-traumatic stress disorder (PTSD) among ICU professionals; how PTSD has been assessed; the risk factors associated with PTSD; and the psychological support proposed. METHODS Three databases and editorial portals were used to identify full-text articles published in English between 2009 and 2022 using the PRISMA method. RESULTS Among the 914 articles obtained, 19 studies met our inclusion criteria. These were undertaken primarily during the Covid-19 period (n = 12) and focused on nurses and assistant nurses (n = 10); nurses and physicians (n = 8); or physicians only (n = 1). The presence of mild to severe PTSD among professionals ranged from 3.3 to 24% before the pandemic, to 16-73.3% after the pandemic. PTSD in ICU professionals seems specific with particularly intense intrusion symptoms. ICU professionals are confronted risk factors for PTSD: confrontation with death, unpredictability and uncertainty of care, and insecurity related to the crisis COVID-19. The studies show that improved communication, feeling protected and supported within the service, and having sufficient human and material resources seem to protect healthcare professionals from PTSD. However, they also reveal that ICU professionals find it difficult to ask for help. CONCLUSION ICU professionals are particularly at risk of developing PTSD, especially since the Covid-19 health crisis. There seems to be an urgent need to develop prevention and support policies for professionals.
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Affiliation(s)
- Victoire Deltour
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Anne-Laure Poujol
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Alexandra Laurent
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France.
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France.
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Varner-Perez SE, Mathis KA, Banks SK, Burke ES, Slaven JE, Morse GJ, Whitaker MK, Cottingham AH, Ahmed RA. A descriptive study of the multidisciplinary healthcare experiences of inpatient resuscitation events. Resusc Plus 2023; 13:100349. [PMID: 36654725 PMCID: PMC9841215 DOI: 10.1016/j.resplu.2022.100349] [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: 09/29/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023] Open
Abstract
Background In-hospital resuscitation events have complex and enduring effects on clinicians, with implications for job satisfaction, performance, and burnout. Ethically ambiguous cases are associated with increased moral distress. We aim to quantitatively describe the multidisciplinary resuscitation experience. Methods Multidisciplinary in-hospital healthcare professionals at an adult academic health center in the Midwestern United States completed surveys one and six weeks after a resuscitation event. Surveys included demographic data, task load (NASA-TLX), overall and moral distress, anxiety, depression, and spiritual peace. Spearman's rank correlation was computed to assess task load and distress. Results During the 5-month study period, the study included 12 resuscitation events across six inpatient units. Of 82 in-hospital healthcare professionals eligible for recruitment, 44 (53.7%) completed the one-week post-resuscitation event survey. Of those, 37 (84.1%) completed the six-week survey. Highest median task load burden at one week was seen for temporal demand, effort, and mental demand. Median moral distress scores were low, while "at peace" median scores tended to be high. There were no significant non-zero changes in task load or distress scores from weeks 1-6. Mental demand (r = 0.545, p < 0.001), physical demand (r = 0.464, p = 0.005), performance (r = -0.539, p < 0.001), and frustration (r = 0.545, p < 0.001) significantly correlated with overall distress. Performance (r = -0.371, p = 0.028) and frustration (r = 0.480, p = 0.004) also significantly correlated with moral distress. Conclusions In-hospital healthcare professionals' experiences of resuscitation events are varied and complex. Aspects of task load burden including mental and physical demand, performance, and frustration contribute to overall and moral distress, deserving greater attention in clinical contexts.
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Affiliation(s)
- Shelley E. Varner-Perez
- Indiana University (IU) Health, Indianapolis, IN, USA,IU Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA,Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, IN, USA,Corresponding author at: Indiana University Health Methodist Hospital, Spiritual Care & Chaplaincy, 1812 N Capitol, Wile Hall W230, Indianapolis, IN 46202, USA.
| | | | | | - Emily S. Burke
- IU Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - James E. Slaven
- IU Department of Biostatistics and Health Data Science, IU School of Medicine, Indianapolis, IN, USA
| | | | | | - Ann H. Cottingham
- IU School of Medicine, Indianapolis, IN, USA,IU Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - Rami A. Ahmed
- IU Department of Emergency Medicine, Division of Medical Simulation, IU School of Medicine, Indianapolis, IN, USA
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14
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Jiang C, Chen W, Tao L, Wang J, Cheng K, Zhang Y, Qi Z, Zheng X. Game-matching background music has an add-on effect for reducing emotionality of traumatic memories during reconsolidation intervention. Front Psychiatry 2023; 14:1090290. [PMID: 36873205 PMCID: PMC9974640 DOI: 10.3389/fpsyt.2023.1090290] [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: 11/05/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION Hospital is a stressful place of employment, and a high proportion of healthcare workers, especially the ICU (Intensive Care Unit) nurses were found to be at risk of PTSD. Previous studies showed that taxing working memory through visuospatial tasks during the reconsolidation process of aversive memories can reduce the number of intrusions afterwards. However, the finds could not be replicated by some researches, indicating there may be some boundary conditions that are subtle and complex. METHODS We performed a randomized controlled trial (ChiCTR2200055921; URL: www.chictr.org.cn). In our study, a series of ICU nurses or probationers who performed a cardiopulmonary resuscitation (CPR) were enrolled and instructed to play a visuospatial music tapping game ("Ceaseless Music Note", CMN; Beijing Muyuan Technology Co., Ltd., Beijing, China) at the fourth day after CPR. The numbers of intrusions each day were recorded from the first to the seventh days (24 h×6 day), and the vividness and emotionality of CPR memories were rated at the 4th and 7th days. These parameters were compared between different groups (game with background sound; game with sound off; sound only; none). RESULTS The game-matching background music can have an add-on effect for single tapping game with no sound in reducing the emotionality of previous aversive memories. DISCUSSION We proposed that flow experience (the subjective experience of effortless attention, reduced self-awareness, and enjoyment, and may be induced by optimal skill-demands compatibility in challenging tasks) as a key boundary condition for successful reconsolidation intervention. CLINICAL TRIAL REGISTRATION www.chictr.org.cn, identifier: ChiCTR2200055921.
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Affiliation(s)
- Che Jiang
- School of Psychology, South China Normal University, Guangzhou, China.,Department of Neurosurgery, General Hospital of Southern Theatre Command, Guangzhou, China
| | - Wei Chen
- School of Psychology, South China Normal University, Guangzhou, China
| | - Ling Tao
- Computer Engineering Technical College, Guangdong Polytechnic of Science and Technology, Guangzhou, China
| | - Jiajia Wang
- Department of Neurosurgery, General Hospital of Southern Theatre Command, Guangzhou, China
| | - Kuihong Cheng
- Department of Neurosurgery, General Hospital of Southern Theatre Command, Guangzhou, China
| | - Yibo Zhang
- Department of Neurosurgery, General Hospital of Southern Theatre Command, Guangzhou, China
| | - Zijuan Qi
- Department of Neurology, General Hospital of Southern Theatre Command, Guangzhou, China
| | - Xifu Zheng
- School of Psychology, South China Normal University, Guangzhou, China
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15
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Silverplats J, Strömsöe A, Äng B, Södersved Källestedt ML. Attitudes towards cardiopulmonary resuscitation situations and associations with potential influencing factors—A survey among in-hospital healthcare professionals. PLoS One 2022; 17:e0271686. [PMID: 35839233 PMCID: PMC9286263 DOI: 10.1371/journal.pone.0271686] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/05/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Attitudes towards cardiopulmonary resuscitation (CPR) among in-hospital healthcare professionals (HCPs) are poorly understood. The aim of this study was to evaluate attitudes towards CPR situations among in-hospital HCPs and assess associations with potential influencing factors. Materials and methods A questionnaire was distributed to 3,085 HCPs in 2009 and 2,970 HCPs in 2015–2016. The associations of influencing factors were analyzed using binary logistic regression. Results In the event of a possible cardiac arrest situation, 61% of the HCPs would feel confident in their CPR knowledge, 86% would know what to do, and 60% would be able to take command if necessary. In the latest real-life CPR situation, 30% had been worried about making mistakes or causing complications, 57% had been stressed, and 27% had been anxious. A short time since the latest real-life CPR performance and a high number of previous real-life CPR performances were associated with lower odds of worrying about making mistakes/causing complications, lower odds of feeling stressed or anxious, and higher odds of feeling calm. Regardless of previous real-life CPR experience, there were differences in attitudes between groups of professions, where physicians showed increased odds of worrying about making mistakes/causing complications and nurses showed increased odds of stress. Working on a non-monitored ward meant increased odds of stress and worrying about making mistakes/causing complications. Twelve months or more having passed since the latest CPR training course was associated with increased odds of anxiety. Conclusions Despite HCPs’ generally positive attitudes towards performing CPR in the event of a possible cardiac arrest situation, feelings of stress and anxiety were common in real-life CPR situations. Regular CPR training among all HCPs is a key factor to maintain competence and reduce anxiety. The possible effects of attitudes on performing CPR need to be studied further.
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Affiliation(s)
- Jennie Silverplats
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Anaesthesiology and Intensive Care, Region Dalarna, Mora Hospital, Mora, Sweden
- * E-mail:
| | - Anneli Strömsöe
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- Department of Prehospital Care, Region Dalarna, Falun, Sweden
| | - Björn Äng
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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16
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Baldor DJ, Smyrnios NA, Faris K, Guilarte-Walker Y, Celik U, Torres U. A Controlled Study in CPR-Survival in Propensity Score Matched Full-Code and Do-Not-Resuscitate ICU Patients. J Intensive Care Med 2022; 37:1363-1369. [PMID: 35815880 DOI: 10.1177/08850666221114052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiopulmonary Resuscitation (CPR) causes significant injuries and increased cost among transiently resuscitated patients that do not survive their hospitalizations. Descriptive studies show zero and near-zero percent survival for CPR recipients with high Apache II scores. Despite these factors, no controlled studies exist in CPR to guide patient selection for CPR candidacy. Our objective was therefore to perform a controlled study in CPR to inform recommendations for CPR candidacy. We hypothesize that the protective effects of CPR decrease as illness severity increases, and that Full-Code status provides no survival benefit over Do-Not-Resuscitate (DNR) status for patients with the highest predicted mortality by Apache IV score. METHODS We performed propensity-score matched survival analyzes between Full-Code and DNR patients after stratifying by predicted mortality quartiles using Apache IV scores. Primary outcomes were mortality hazard ratios. Secondary outcomes were Median Survival Differences, ICU LOS, and tracheostomy rates. RESULTS Among 17,710 propensity-score matched ICU encounters, DNR status was associated with greater mortality in the first through third predicted mortality quartiles. There was no difference in survival outcomes in the fourth quartile (HR 0.99, p = .96). There was a stepwise decrease in the mortality hazard ratio for DNR patients as quartiles increased. CONCLUSION Full-Code status provides no survival benefit over DNR status in individuals with greater than 75% predicted mortality by Apache IV score. There is a stepwise decrease in survival benefit for Full-Code patients as predicted mortality increases. We propose that it is reasonable to consider a very high predicted mortality by Apache IV score a contraindication to CPR given the lack of survival benefit seen in these patients. Larger studies with similar methods should be performed to reinforce or refute these findings.
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Affiliation(s)
- Daniel J Baldor
- Department of General Surgery, The University of Massachusetts Chan School of Medicine, Worcester, MA, USA
| | - Nicholas A Smyrnios
- Division of Pulmonary, Allergy, and Critical Care Medicine, The University of Massachusetts Chan School of Medicine, Worcester, MA, USA
| | - Khaldoun Faris
- Division of Anesthesiology Critical Care Medicine, The University of Massachusetts Chan School of Medicine, Worcester, MA, USA
| | - Yurima Guilarte-Walker
- Department of Population and Quantitative Health Sciences, The University of Massachusetts Chan School of Medicine, Worcester, MA, USA
| | - Ugur Celik
- Center for Clinical and Translational Science, Research Informatics Core, The University of Massachusetts Chan School of Medicine, Worcester, MA, USA
| | - Ulises Torres
- George Washington University School of Medicine, Washington, DC, USA
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17
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Schuster M, Berbert L, Meyer S, Dwyer PA. The Impact of Psychological Capital and Workplace Social Support on Pediatric Oncology Nurses' Post Traumatic Stress Disorder (PTSD) Symptomology. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:231-242. [PMID: 35791851 DOI: 10.1177/27527530211073737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction: Work-related post traumatic stress disorder (PTSD) can develop in nurses. Pediatric oncology nursing is a potentially high-risk subspecialty for PTSD secondary to the nature of the work. This study aimed to describe the prevalence of PTSD symptomology and explore relationships between nurse psychological capital, workplace social supports, and PTSD symptomology in pediatric oncology nurses. Methods: The study utilized a cross-sectional correlational survey design. Pediatric oncology nurses working in direct patient care in the United States completed a demographics questionnaire, Psychological Capital Questionnaire (PCQ), Coworker Support Scale, Supervisor Support Scale, and the Post traumatic Checklist for Diagnostic and Statistical Manual of Mental Disorders (PCL-5). Descriptive and inferential statistics, including logistic regression models, were used to analyze data. A cutoff score of ≥31 on the PCL-5 was used to determine the prevalence of PTSD symptomology. Results: The sample included 424 nurses. The prevalence of PTSD symptomology was 13.4%. Work setting (inpatient), decreased coworker and leadership social support, and psychological capital were independently associated with PTSD symptomology. After controlling for covariates, only psychological capital was associated with PTSD symptomology. For a 1 unit decrease in PCQ score, pediatric oncology nurses were 4.25 times more likely to have PTSD symptomology. Discussion: PTSD prevalence rates in pediatric oncology nurses are aligned with rates found in other nursing specialties. Nurse psychological capital may play a protective role against PTSD symptomology. Implications for Future Research: Findings support PTSD as a serious workplace concern for nurses. Workplace programs that foster nurses' psychological capabilities should be considered to protect against the development of PTSD symptomology.
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Affiliation(s)
- Michelle Schuster
- Inpatient Hematology/Oncology Unit, 1862Boston Children's Hospital, Boston, MA, USA
| | - Laura Berbert
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, 1862Boston Children's Hospital, Boston, MA, USA
| | - Shannon Meyer
- Cardiovascular and Critical Care, 1862Boston Children's Hospital, Boston, MA, USA
| | - Patricia A Dwyer
- Satellite Clinical Operations, 1862Boston Children's Hospital, Boston, MA, USA
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18
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Benuto LT, Yang Y, Bennett N, Lancaster C. Distress Tolerance and Emotion Regulation as Potential Mediators Between Secondary Traumatic Stress and Maladaptive Coping. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11557-NP11581. [PMID: 33076751 DOI: 10.1177/0886260520967136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The extant literature has illustrated that protective service workers experience negative repercussions associated with their job (including the development of secondary traumatic stress; STS) and may utilize maladaptive coping mechanisms. Developing an improved understanding of factors that might explain the relationship between STS and the utilization of maladaptive coping mechanisms is warranted. This study sought to examine emotion regulation and distress tolerance as potential mediators between STS and the utilization of maladaptive coping mechanisms. Participants were 152 elder protective service workers and 105 child protective service workers who completed an online survey of self-report measures of emotion regulation, distress tolerance, STS, and coping behaviors. A parallel multiple mediator model was analyzed using structural equation modeling (SEM) to examine the hypothesis that distress tolerance and emotion regulation would mediate the relationship between STS and the utilization of maladaptive coping. Our hypothesis was partially supported as the effect of STS on maladaptive coping was mediated by emotion regulation but not by distress tolerance. The results from this study have both prevention and intervention implications. From a prevention perspective, efforts could be directed at teaching emotion regulation skills to those at risk for developing STS as a mechanism for decreasing the probability of denial, substance use, behavioral disengagement, and self-blame that may occur as a consequence of STS. From an intervention perspective, some of the negative sequelae of exposure to STS may be averted by teaching EPS and CPS workers who present with STS symptoms, emotion regulation skills.
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19
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Exploring the Feelings of Nurses during Resuscitation—A Cross-Sectional Study. Healthcare (Basel) 2021; 10:healthcare10010005. [PMID: 35052169 PMCID: PMC8774964 DOI: 10.3390/healthcare10010005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022] Open
Abstract
Cardiopulmonary resuscitation (CPR) is one of the most stressful situations in emergency medicine. Nurses involved in performing basic and advanced resuscitation procedures are therefore exposed to a certain amount of stress. The purpose of this study was to determine the stressors and the level of stress experienced by nurses during resuscitation. A cross-sectional quantitative study was done. The sample consisted of 457 nurses who worked in emergency units. First demographic data were collected, followed by a questionnaire regarding the effect of different situations that occur during and after resuscitation on nurses including Post-Code Stress Scale questionnaire. The most disturbing situations for respondents were resuscitation of young person (MV = 3.7, SD = 1.4), when they fail to establish an intravenous pathway (MV = 3.5, SD = 1.4), chaotic situation during resuscitation (MV = 3.4, SD = 1.4) and making decision about termination of resuscitation (MV = 3.1, SD = 1.5). Research has shown that nurses are exposed to a certain amount of stress during resuscitation, but most of them manage to compensate for stress effectively.
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20
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Blomquist M, Lasiter S. Nurses’ coping strategies during and after an adult in‐hospital resuscitation attempt: A scoping study. J Clin Nurs 2021; 31:2437-2449. [DOI: 10.1111/jocn.16128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/20/2021] [Accepted: 10/29/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Blomquist
- School of Nursing and Health Studies University of Missouri, Kansas City Kansas City Missouri USA
| | - Sue Lasiter
- School of Nursing and Health Studies University of Missouri, Kansas City Kansas City Missouri USA
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21
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Liyanage S, Addison S, Ham E, Hilton NZ. Workplace interventions to prevent or reduce post-traumatic stress disorder and symptoms among hospital nurses: A scoping review. J Clin Nurs 2021; 31:1477-1487. [PMID: 34636115 DOI: 10.1111/jocn.16076] [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] [Received: 05/08/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to identify literature on evaluated workplace interventions to prevent or reduce the prevalence or impact of work-related post-traumatic stress disorder (PTSD) and PTSD symptoms among hospital nurses. A second objective was to summarise and compare the characteristics and effectiveness of these interventions. BACKGROUND A substantial proportion of nurses report PTSD symptoms. Previous reviews have synthesised interventions to address PTSD in military and other high-risk populations, but similar work focusing on nurses has yet to be conducted. METHODS We conducted a scoping review with the question: What interventions have been studied to prevent or treat PTSD symptoms or PTSD among nurses working in hospitals? We followed the PRISMA Scoping Review Checklist using an unregistered protocol. We searched in twelve academic and grey literature databases (e.g. MedLine, CINAHL) with no language restrictions. We included publications reporting on interventions which were evaluated for measurable impacts on PTSD and PTSD symptoms among nursing staff working in inpatient settings from 1980 to 2019, and charted study characteristics in a spreadsheet. RESULTS From 7746 results, 63 studies moved to full-text screening, and six studies met inclusion criteria. Methodologies included three randomised controlled studies, one quasi-experimental study, one pre-post feasibility study and one descriptive correlational study. Four studies reported a significant reduction in PTSD scores in intervention groups compared with baseline or comparison, when using debriefing, guided imagery or mindfulness-based exercises. CONCLUSIONS This review identified six studies evaluating hospital-based interventions to reduce PTSD and PTSD symptoms among hospital nurses, with some positive effects reported, contributing to a preliminary evidence base on reducing workplace trauma. Larger studies can compare nurse subpopulations, and system-level interventions should expand the focus from individuals to organisations. RELEVANCE TO CLINICAL PRACTICE This review can inform nursing and hospital leaders developing evidence-based interventions for PTSD among nurses.
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Affiliation(s)
- Sugee Liyanage
- Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | - Sonja Addison
- Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | - Elke Ham
- Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | - N Zoe Hilton
- Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
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22
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Wang CP, Hung FM, Ling MS, Chiu HY, Hu S. Factors associated with critical care nurses' acute stress disorder after patient death. Aust Crit Care 2021; 35:402-407. [PMID: 34419340 DOI: 10.1016/j.aucc.2021.06.007] [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: 09/01/2020] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In intensive care units, patient death can have a negative psychological influence on the patient's nurse. However, how the frequency of events and factors contributed to acute stress among nurses remains unknown. OBJECTIVE The objective of this study was to explore the prevalence of and the factors affecting acute stress disorder among intensive care unit nurses after their patient death. METHODS Nurses from five adult intensive care units whose patient had died during the nurses' working shift were recruited from July 2018 to April 2019. Bryant's Acute Stress Disorder Scale, the Beck Anxiety Inventory, and the Beck Depression Inventory-II were used to measure acute stress, depression, and anxiety. Descriptive statistics, chi-square tests, independent sample t-tests, and stepwise logistic regression were used for data analysis. RESULTS In total, 119 nurses were enrolled. Nearly one in three nurses (29.4%) had suffered from acute stress disorder after their patient had died. Nurses experienced a higher risk of acute stress disorder when their patients underwent cardiopulmonary resuscitation before death (odds ratio [OR] = 13.75, 95% confidence interval [CI]: 2.59-72.95), when their patients died unexpectedly (OR = 4.88, 95% CI: 1.16-20.56), and when they experienced verbal abuse from the patient family at the patient death (OR = 4.61, 95% CI: 1.18-18.05) compared with their counterparts. CONCLUSION Intensive care unit nurses often experience acute stress disorder after their patient death. The nurses of patients who underwent cardiopulmonary resuscitation before death and/or who died unexpectedly and/or nurses who were subjected to verbal abuse by the patient's family were at higher risk of acute stress disorder. A comprehensive program aimed at improving the knowledge, skills, and resilience of nurses is needed.
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Affiliation(s)
- Chao-Ping Wang
- Department of Nursing, Far Eastern Memorial Hospital, Taipei, Taiwan.
| | - Fang-Ming Hung
- Surgical Intensive Care Unit, Department Surgical Intensive Care Unit, Far Eastern Memorial Hospital, Taipei, Taiwan.
| | - Mao-Sheng Ling
- Surgical Intensive Care Unit, Department Surgical Intensive Care Unit, Far Eastern Memorial Hospital, Taipei, Taiwan.
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Sophia Hu
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Abdul Rahman H, Bani Issa W, Naing L. Psychometric properties of brief-COPE inventory among nurses. BMC Nurs 2021; 20:73. [PMID: 33952254 PMCID: PMC8099710 DOI: 10.1186/s12912-021-00592-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/22/2021] [Indexed: 12/02/2022] Open
Abstract
Objective Brief-COPE inventory is widely used to assess coping; however, validation evidence is absent and previous results were inconsistent. This study aimed to validate psychometric properties of this inventory to ensure culturally appropriate usage. Methods Preliminary validation study on 423 female nurses from the United Arab Emirates. Confirmatory factor analysis (CFA) with maximum likelihood estimation was computed to test four different previous models. Exploratory factor analysis (EFA) protocol was used to determine underlying domain structure of Brief-COPE in this population. Results The four previous models on CFA had inadequate fit indexes. Two-factor (22-items) second-order model that explained 37.0% of the total variance with Cronbach’s alpha at 0.81 and 0.88, respectively, was suggested. Conclusion This validation of Brief-COPE is timely considering nurses enduring different types of stressors. In addition, cultural diversity needs to be considered in coping research. Re-assessment of this exploratory structure is necessary to ensure accurate measurement of coping strategies.
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Affiliation(s)
- Hanif Abdul Rahman
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Tungku Link Road, Gadong, BE1410, Brunei.
| | - Wegdan Bani Issa
- Research Institute for Medical and Health Sciences, Health Promotion Research Group, University of Sharjah, Sharjah, United Arab Emirates.,College of Health Sciences, Nursing Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Lin Naing
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Tungku Link Road, Gadong, BE1410, Brunei
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Where to Look for a Remedy? Burnout Syndrome and its Associations with Coping and Job Satisfaction in Critical Care Nurses-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084390. [PMID: 33924271 PMCID: PMC8074906 DOI: 10.3390/ijerph18084390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Burnout is a psychological, work-related syndrome associated with long-term exposure to emotional and interpersonal stressors in the workplace. Burnout syndrome in nurses is often caused by an imbalance between work requirements and preparation and fitness for work, a lack of control, insufficient performance recognition and a prolonged exposure to stress. AIM The aims of this study were to explore the associations between levels of burnout syndrome, coping mechanisms and job satisfaction in critical care nurses in multivariate modelling process. A specific aim was also to explore whether coping and job satisfaction in critical care nurses are gender related. METHODS A cross-sectional multicentre study was conducted in a convenience sample of 620 critical care nurses from five university hospitals in Croatia in 2017. The data were collected using the Maslach Burnout Inventory and the Ways of Coping and Job Satisfaction Scale together with the nurses' demographic profiles and were analysed using a multivariable model. RESULTS The results showed no significant association between gender, coping mechanisms and job satisfaction. However, significant negative associations between burnout and job satisfaction (OR = 0.01, 95%CI = 0.00-0.02, p < 0.001) and positive association between burnout and passive coping (OR = 9.93, 95%CI = 4.01-24.61, p < 0.001) were found. CONCLUSION The association between job satisfaction and burnout in nurses urges hospital management teams to consider actions focused on job satisfaction, probably modifications of the work environment. Given that passive coping may increase the incidence of burnout, it is recommendable for active coping to be implemented in nurses' training programmes as an essential element of capacity building aimed at reducing the incidence of burnout in nurses.
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Faronbi JO, Adebiyi AT, Idowu AO, Faronbi GO, Irinoye OO. Predictors of depressive symptoms and effective coping strategies among open and distance learning nursing students. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Sanchez C, Grzenda A, Varias A, Widge AS, Carpenter LL, McDonald WM, Nemeroff CB, Kalin NH, Martin G, Tohen M, Filippou-Frye M, Ramsey D, Linos E, Mangurian C, Rodriguez CI. Social media recruitment for mental health research: A systematic review. Compr Psychiatry 2020; 103:152197. [PMID: 32992073 PMCID: PMC7704547 DOI: 10.1016/j.comppsych.2020.152197] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/14/2020] [Accepted: 08/06/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Social media holds exciting promise for advancing mental health research recruitment, however, the extent and efficacy to which these platforms are currently in use are underexplored. OBJECTIVE A systematic review was conducted to characterize the current use and efficacy of social media in recruiting participants for mental health research. METHOD A literature review was performed using MEDLINE, EMBASE, and PsychINFO. Only non-duplicative manuscripts written in the English language and published between 1/1/2004-3/31/2019 were selected for further screening. Data extracted included study type and design, participant inclusion criteria, social media platform, advertising strategy, final recruited sample size, recruitment location, year, monetary incentives, comparison to other recruitment methods if performed, and final cost per participant. RESULTS A total of 176 unique studies that used social media for mental health research recruitment were reviewed. The majority of studies were cross-sectional (62.5%) in design and recruited adults. Facebook was overwhelmingly the recruitment platform of choice (92.6%), with the use of paid advertisements being the predominant strategy (60.8%). Of the reviewed studies, substance abuse (43.8%) and mood disorders (15.3%) were the primary subjects of investigation. In 68.3% of studies, social media recruitment performed as well as or better than traditional recruitment methods in the number and cost of final enrolled participants. The majority of studies used Facebook for recruitment at a median cost per final recruited study participant of $19.47. In 55.6% of the studies, social media recruitment was the more cost-effective recruitment method when compared to traditional methods (e.g., referrals, mailing). CONCLUSION Social media appears to be an effective and economical recruitment tool for mental health research. The platform raises methodological and privacy concerns not covered in current research regulations that warrant additional consideration.
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Affiliation(s)
- Catherine Sanchez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Adrienne Grzenda
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Andrea Varias
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Alik S Widge
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | - Linda L Carpenter
- Department of Psychiatry and Human Behavior, Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - William M McDonald
- Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta, GA, USA
| | - Charles B Nemeroff
- Department of Psychiatry, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Glenn Martin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Maria Filippou-Frye
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Drew Ramsey
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Eleni Linos
- Department of Dermatology, Stanford University, Stanford, CA, USA
| | - Christina Mangurian
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA; UCSF Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
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Laupland KB, Coyer F. Physician and Nurse Research in Multidisciplinary Intensive Care Units. Am J Crit Care 2020; 29:450-457. [PMID: 33130861 DOI: 10.4037/ajcc2020136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Although clinical care is multidisciplinary, intensive care unit research commonly focuses on single-discipline themes. We sought to characterize intensive care unit research conducted by physicians and nurses. METHODS One hundred randomly selected reports of clinical studies published in critical care medical and nursing journals were reviewed. RESULTS Of the 100 articles reviewed, 50 were published in medical journals and 50 were published in nursing journals. Only 1 medical study (2%) used qualitative methods, compared with 9 nursing studies (18%) (P = .02). The distribution of quantitative study designs differed between medical and nursing journals (P < .001), with medical journals having a predominance of cohort studies (29 articles [58%]). Compared with medical journal articles, nursing journal articles had significantly fewer authors (median [interquartile range], 5 [3-6] vs 8 [6-10]; P < .001) and study participants (94 [51-237] vs 375 [86-4183]; P < .001) and a significantly lower proportion of male study participants (55% [26%-65%] vs 60% [51%-65%]; P = .02). Studies published in medical journals were much more likely than those published in nursing journals to exclusively involve patients as participants (47 [94%] vs 25 [50%]; P < .001). Coauthorship between physicians and nurses was evident in 14 articles (14%), with infrequent inclusion of authors from other health care disciplines. CONCLUSIONS Physician research and nurse research differ in several important aspects and tend to occur within silos. Increased interprofessional collaboration is possible and worthwhile.
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Affiliation(s)
- Kevin B. Laupland
- Kevin B. Laupland is an intensivist, Intensive Care Services, at Royal Brisbane and Women’s Hospital, and a professor at the School of Clinical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Fiona Coyer
- Fiona Coyer is a professor of nursing with a joint appointment in Intensive Care Services at Royal Brisbane and Women’s Hospital and the School of Nursing, Queensland University of Technology (QUT)
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Dimunová L, Bérešová A, Raková J, Rónyová I, Fertaľová T. The relationship between self-esteem of nurses and their choice of strategies to cope with workload burden. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Milstein R, Schreyoegg J. The relationship between nurse staffing levels and nursing-sensitive outcomes in hospitals: Assessing heterogeneity among unit and outcome types. Health Policy 2020; 124:1056-1063. [PMID: 32839013 DOI: 10.1016/j.healthpol.2020.07.013] [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: 07/21/2019] [Revised: 06/15/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To identify which unit types are most sensitive to nurse staffing levels. DATA SOURCES/STUDY SETTING Collection of secondary data took place from March to July 2016. For our study, we analyzed administrative hospital claims data and self-reported structural data from hospitals in Germany. We used 26,502,579 admissions nested in 13,089 units in 3,680 hospitals from 2012 to 2014. STUDY DESIGN We used regression analysis to examine the relationship between 11 established nursing-sensitive outcomes (NSOs) and nurse-to-patient ratios on a unit level. Nurse-to-patient ratios were our key explanatory variable. We conducted separate OLS regressions for each NSO in each unit type using linear and non-linear terms. DATA COLLECTION/EXTRACTION METHODS We linked hospital claims data with self-reported structural data from hospitals from 2012 to 2014. PRINCIPAL FINDINGS We identified 15 unit types with at least one significant NSO. The effect of potential understaffing on NSOs depends on the unit type. CONCLUSIONS Our study indicates that the relationship between nurse staffing levels and NSOs varies greatly depending on the unit type concerning both significance and magnitude. Future research might consider performing analyses on unit level instead of hospital level.
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Affiliation(s)
- Ricarda Milstein
- Universität Hamburg, Germany; Hamburg Center for Health Economics, Germany.
| | - Jonas Schreyoegg
- Universität Hamburg, Germany; Hamburg Center for Health Economics, Germany
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Li L, Yao C, Zhang Y, Chen G. Trait Forgiveness Moderated the Relationship Between Work Stress and Psychological Distress Among Final-Year Nursing Students: A Pilot Study. Front Psychol 2020; 11:1674. [PMID: 32742266 PMCID: PMC7364438 DOI: 10.3389/fpsyg.2020.01674] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 06/19/2020] [Indexed: 12/24/2022] Open
Abstract
This study was to explore the potential moderating effect of trait forgiveness and its facets on the relationship between perceived work stress and psychological distress among Chinese nursing students in clinical practice. A total of 182 Chinese nursing students who had been receiving final-year clinical training completed self-report measures of nursing work stress, trait forgiveness and psychological distress. Correlation analysis and hierarchical multiple regressions were mainly applied for data analysis. Results showed that trait forgiveness was negatively associated with psychological distress, even after controlling for the effects of perceived work stress and demographic/workplace related variables. Further analyses indicated that the ability to forgiveness of situations was particularly crucial in reducing the negative effects of perceived work stress on psychological well-being, especially when students perceived higher level of stress. These results demonstrated that alternative interventions targeting on trait forgiveness, especially those programs which can improve one’s ability to acceptance uncontrollable bad circumstances, may be beneficial for the well-being of nursing students in clinical practice.
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Affiliation(s)
- Lingyan Li
- School of Nursing, Nanchang University, Nanchang, China
| | - Caixia Yao
- School of Nursing, Nanchang University, Nanchang, China
| | - Yan Zhang
- Department of Nursing, Jiangxi Health Vocational College, Nanchang, China
| | - Guangyuan Chen
- The Second Clinical Medical College, Nanchang University, Nanchang, China
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Harvey G, Tapp DM. Exploring the meaning of critical incident stress experienced by intensive care unit nurses. Nurs Inq 2020; 27:e12365. [PMID: 32488969 DOI: 10.1111/nin.12365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 11/29/2022]
Abstract
The complexity of registered nurses' work in the intensive care unit places them at risk of experiencing critical incident stress. Gadamer's philosophical hermeneutics (1960/2013) was used to expand the meanings of work-related critical incident stress for registered nurses working with adults in the intensive care unit. Nine intensive care unit registered nurses participated in unstructured interviews. The interpretations emphasized that morally distressing experiences may lead to critical incident stress. Critical incident stress was influenced by the perception of judgment from co-workers and the organizational culture. Nurses in this study attempted to cope with critical incident stress by functioning in 'autopilot', temporarily altering their ability to critically think and to conceal emotions. Participants emphasized the importance of timely crisis interventions tailored to support their needs. This study highlighted that critical incident stress was transformative in how intensive care unit nurses practiced, potentially altering their professional self-identity. Work-related critical incident stress has implications for nurses, the discipline, and the health care system.
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Affiliation(s)
- Giuliana Harvey
- School of Nursing & Midwifery, Mount Royal University, Calgary, AB, Canada
| | - Dianne M Tapp
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.,Faculty of Nursing, University of Calgary, Calgary, AB, Canada
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Schuster M, Dwyer PA. Post‐traumatic stress disorder in nurses: An integrative review. J Clin Nurs 2020; 29:2769-2787. [DOI: 10.1111/jocn.15288] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/03/2020] [Accepted: 03/23/2020] [Indexed: 12/25/2022]
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Slabe D, Oven A. Evaluation of Slovenian Occupational Therapists' Theoretical Knowledge and Stress Levels Connected With Providing Cardiopulmonary Resuscitation. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2020; 57:46958020963683. [PMID: 33124486 PMCID: PMC7607753 DOI: 10.1177/0046958020963683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 08/12/2020] [Accepted: 09/04/2020] [Indexed: 06/11/2023]
Abstract
This was the first study that evaluated cardiopulmonary resuscitation (CPR) knowledge in a sample of occupational therapists and investigated whether the knowledge of CPR parameters affected their perceived stress levels related to providing CPR. A questionnaire, consisting of 4 clusters of questions, was pretested and used in an online survey of Slovenian occupational therapists. The survey was sent to all electronic addresses obtained from the Association of Occupational Therapists of Slovenia and the Faculty of Health Sciences at the University of Ljubljana. It was completed by 201 occupational therapists, which represented about 40% of all Slovenian occupational therapists. Data were analyzed using independent-samples t-test, 1-way ANOVA, and Pearson's correlation coefficient. On average, the participants scored 5.44 points (SD = 2.96) on the CPR knowledge test that had a maximum of 9 points. A weak negative correlation existed between the perceived level of stress and scores on the knowledge test (r = -0.151; P = .05). Scores on the knowledge test were also negatively correlated with age (r = -0.409; P < .001) and work experience (r = -0.388; P < .001) and positively correlated with self-evaluation of knowledge of CPR (r = 0.366; P < .001). The majority of the participants (92.3%) felt that they needed to update their CPR knowledge. There was no statistically significant difference in the CPR knowledge between occupational therapists working in different clinical areas (P = .85). Our sample of occupational therapists was not optimally prepared to apply CPR. Older and more experienced therapists demonstrated less theoretical knowledge and were particularly vulnerable to stress. To improve knowledge and confidence, regular CPR training is recommended for this group of health professionals.
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Affiliation(s)
- Damjan Slabe
- Faculty of Health Sciences, University of Ljubljana, Slovenia
| | - Alenka Oven
- Faculty of Health Sciences, University of Ljubljana, Slovenia
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Spencer SA, Nolan JP, Osborn M, Georgiou A. The presence of psychological trauma symptoms in resuscitation providers and an exploration of debriefing practices. Resuscitation 2019; 142:175-181. [PMID: 31251894 DOI: 10.1016/j.resuscitation.2019.06.280] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/03/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Witnessing traumatic experiences can cause post-traumatic stress disorder (PTSD). The true impact on healthcare staff of attending in-hospital cardiac arrests (IHCAs) has not been studied. This cross-sectional study examined cardiac arrest debriefing practices and the burden of attending IHCAs on nursing and medical staff. METHODS A 33-item questionnaire-survey was sent to 517 doctors (of all grades), nurses and health-care assistants (HCAs) working in the emergency department, the acute medical unit and the intensive care unit of a district general hospital between April and August 2018. There were three sections: demographics; cardiac arrest and debriefing practices; trauma-screening questionnaire (TSQ). RESULTS The response rate was 414/517 (80.1%); 312/414 (75.4%) were involved with IHCAs. Out of 1463 arrests, 258 (17.6%) were debriefed. Twenty-nine of 302 (9.6%) staff screened positively for PTSD. Healthcare assistants and Foundation Year 1 doctors had higher TSQ scores than nurses or more senior doctors (p = 0.02, p = 0.02, respectively). Debriefing was not associated with PTSD risk (p = 0.98). Only 8/67 (11.9%) of resuscitation leaders had prior debriefing training. CONCLUSIONS Nearly 10% of acute care staff screened positively for PTSD as a result of attending an IHCA, with junior staff being most at risk of developing trauma symptoms. Very few debriefs occurred, possibly because of a lack of debrief training amongst cardiac arrest team leaders. More support is required for acute care nursing and medical staff following an IHCA.
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Affiliation(s)
| | - Jerry P Nolan
- Royal United Hospital, Bath, United Kingdom; Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom
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Dinçer M. The Experiences of Health Workers Applying Resuscitation to the Patients in Palliative Care. ANKARA MEDICAL JOURNAL 2019. [DOI: 10.17098/amj.542455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Alharbi H, Alshehry A. Perceived stress and coping strategies among ICU nurses in government tertiary hospitals in Saudi Arabia: a cross-sectional study. Ann Saudi Med 2019; 39:48-55. [PMID: 30712051 PMCID: PMC6464677 DOI: 10.5144/0256-4947.2019.48] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND No study has examined the stress level and coping strategies among critical care nurses in Saudi Arabia. OBJECTIVES Examine perceived stress and coping behaviors among nurses in intensive care units in Saudi Arabia, and the influence of cop.ing mechanisms on stress. DESIGN Descriptive cross-sectional. SETTING Two tertiary training hospitals in Riyadh, Saudi Arabia. SUBJECTS AND METHODS Nurses from cardiac, surgery and pediatric intensive care units responded to an online survey. Perceived Stress Scale-10 (PSS-10) and the Brief COPE Inventory were used as primary research tools. Multivariate methods were used to analyze the data. MAIN OUTCOME MEASURES Stress levels, coping strategies, and associated factors. SAMPLE SIZE 154 nurses. RESULTS The majority of the respondents reported a moderate level of stress in the past month (87.0%). Mean (SD) scores for nurses working in the cardiac ICU indicated significantly higher levels of stress compared to surgical ICU (18.18 [3.88] vs 6.17 [3.21], P=.025). Belief in religion was the most common coping behavior while the use of substances was the lowest (mean scores [SD] 6.70 [ 1.72] vs 2.22 [0.81]). In the multivariate analysis, behavioral disengagement (P=.016) and self-blame (P less than .001) intensified the PSS-10 score, whereas acceptance (P=.048) reduced the PSS-10 score. CONCLUSION The additional knowledge that behavioral disengagement and blaming aggravate stress can serve as the basis in formulating work-related stress reduction strategies among nurses caring for critical patients. LIMITATIONS The use of self-reports, convenience sampling, and selected demographic factors may have limited the scope and generalizability of the findings and induced social desirability bias. CONFLICT OF INTEREST None.
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Affiliation(s)
- Homood Alharbi
- Dr. Homood Alharbi, Nursing College,, King Saud University,, Riyadh 11451, Saudi Arabia, T: +966118063920, , ORCID: http:// orcid.org/0000-0002-6144-513X
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MicroRNA miR-24-3p Reduces Apoptosis and Regulates Keap1-Nrf2 Pathway in Mouse Cardiomyocytes Responding to Ischemia/Reperfusion Injury. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:7042105. [PMID: 30622671 PMCID: PMC6304907 DOI: 10.1155/2018/7042105] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/13/2018] [Accepted: 10/11/2018] [Indexed: 12/18/2022]
Abstract
In recent years, microRNAs (miRNAs) have received increasing attention for their role in ischemia/reperfusion injury (I/RI), and many miRNAs have been demonstrated to play a very important role in cardiac I/RI. The miRNA miR-24-3p is a tumor suppressor that regulates multiple tumors; however, it remains unclear whether the expression level of miR-24-3p is altered in cardiac cells under I/RI. In this study, we used mouse primary cardiomyocytes and the H9C2 cardiomyocyte cell line to perform in vitro stimulated ischemia/reperfusion (SI/R) and then detected miR-24-3p expression level using quantitative real-time PCR (qRT-PCR). We discovered that the expression of miR-24-3p was significantly increased in cardiomyocytes following SI/R, and that the miR-24-3p level was inversely correlated to the ischemia marker HIF-1a. Furthermore, we transfected cardiomyocytes with miR-24-3p mimic or inhibitor to explore the role of miR-24-3p in cardiomyocyte ischemia/reperfusion injury in vitro. We performed flow cytometry to detect the apoptotic rate of H9C2 cardiomyocytes and found that the transfection of miR-24-3p mimic resulted in the decrease of the apoptosis rate of cardiomyocytes after SI/R, whereas the transfection of miR-24-3p inhibitor increased the number of apoptotic cardiomyocytes. These data suggest that the overexpression of miR-24-3p could reduce in vitro myocardial cell apoptosis induced by I/R injury. Finally, we applied the dual luciferase reporter gene system to verify whether miR-24-3p targets the Keap1 gene, and found that the luciferase signal intensity from a vector carrying the Keap1 wild-type reporter gene was significantly reduced after transfection with miR-24-3p mimic. The Keap1 protein level was also reduced following the transfection of miR-24-3p. The results from this study suggest a novel function of miR-24-3p in protecting cardiomyocytes from ischemia/reperfusion injury by the activation of the Nrf2-Keap1 pathway.
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Abstract
OBJECTIVE The aim of this study was to explore the relationship between resilience and coping in frontline nurses working in a healthcare system that has recently undergone a merger. BACKGROUND Hospital mergers are common in the current healthcare environment. Mergers can provide hospital nurses the opportunity to use and develop positive coping strategies to help remain resilient during times of change. METHODS An anonymous-survey, quantitative, exploratory, descriptive study design was used. Data were obtained from an electronic survey that was made available to all nurses working in a 3-hospital system located in the northeast. RESULTS Overall, the results showed that, when nurses reported using positive coping strategies, they report higher levels of resilience. The levels of resilience also varied from campus to campus. The campus that has been through 2 recent mergers reported the highest levels of resilience. CONCLUSION This study suggests that, during times of change in the workplace, if nurses are encouraged to use positive coping strategies, they may have higher levels of resilience. This changing environment provides the clinical nurse specialists/clinical nurse educators the opportunity to foster and support frontline nurses in the use of healthy coping strategies and to help improve and maintain a high level of resilience, which is critical in today's healthcare environment.
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