[The Structural Analysis of Variables Related to Posttraumatic Growth among Psychiatric Nurses]

Effects of compassion satisfaction and compassion fatigue on posttraumatic growth of psychiatric nurses: A cross-sectional study

AIMS

This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses.

BACKGROUND

Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear.

METHODS

A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale-Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T-test and one-way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research.

RESULTS

Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth.

CONCLUSIONS

Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth.

Mediating mechanism of posttraumatic growth as buffers of burnout and PTSD among nurses during the COVID-19 pandemic

Objective

The study aims to investigate factors that prevent burnout (BO) and symptoms of posttraumatic stress disorder (PTSD) while facilitating posttraumatic growth (PTG) among nurses combating the coronavirus disease 2019 (COVID-19) pandemic, with the purpose of validating the mediating effects of PTG.

Methods

A total of 247 nurses who provided patient care during the COVID-19 pandemic were enrolled, and a questionnaire was used to measure BO, PTSD, and PTG, data on deliberate rumination, emotional expression, adaptive cognitive emotion regulation (CER), maladaptive CER, and social support. The mediation path models for the effects of the predictors on BO and PS through the mediation of PTG were analyzed using the R Lavaan package.

Results

The results showed that deliberate rumination, emotional expression, and adaptive CER significantly increased PTG, while PTG significantly reduced BO and PTSD symptoms (PSs). However, maladaptive CER did not have a significant effect on PTG and only had significant direct effects on BO and PS. Bootstrapping confirmed that PTG significantly mediated the effects of all predictors. It partially mediated the effects of deliberate rumination and adaptive CER and completely mediated the effects of emotional expression.

Conclusion

Based on the results, it has been supported that deliberate rumination, emotional expression, and adaptive CER should be addressed as important variables in psychological interventions addressing nurses' adversities during the pandemic. These variables can prevent BO and PS by facilitating PTG.

Promotion factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai: a qualitative study

BACKGROUND

Since March 2022, Shanghai, China, has experienced a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The pandemic has severely constrained the local healthcare system. After treating critically ill COVID-19 patients, emergency nurses may experience some positive changes due to new insights or gains in their work, even if they have had traumatic experiences. This study aimed to explore the promoting factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai. We hoped to provide a new perspective and theoretical basis for intervening in and promoting the psychological rehabilitation of medical staff after traumatic circumstances.

METHODS

This study employed a qualitative design based on the phenomenological approach. 18 participants from the emergency department of a third-level class-A hospital in Shanghai who participated in treating COVID-19 patients were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. The seven-step Colaizzi process was used for data analysis.

RESULTS

The investigation uncovered two themes and six subthemes. Internal factors contained self-affirmation, deliberate rumination, and cognitive restructuring, which constituted attitudes and behaviours that participants could subjectively determine. External factors included social support, transformational leadership, and role modelling, which constituted factors influenced by others or the environment.

CONCLUSIONS

The promoting factors of PTG of emergency nurses originated from different sources such as individuals, organizations, and society. In addition to good psychological adjustment of the individual, society, hospitals, and nursing managers should focus on establishing supportive PTG strategies. The ultimate purpose is to improve the retention rate and career growth of nurses.

Relationship between rumination and post-traumatic growth in mobile cabin hospital nurses: The mediating role of psychological resilience

Psychological resilience helps individuals to actively respond to various emergencies, but its mediating role between the rumination and post-traumatic growth (PTG) of nurses remains unknown. Our study aimed to explore the extent to which psychological resilience mediates the association between rumination and PTG among nurses working in mobile cabin hospitals. This cross-sectional survey was conducted on 449 medical team members working in mobile cabin hospitals to support the prevention and control of coronavirus disease 2019 in Shanghai, China in 2022. Pearson correlation analysis was applied to assess the correlation between rumination, psychological resilience, and PTG. Structural equation models were used to examine the mediating role of psychological resilience between rumination and PTG. Our study results showed that deliberate rumination directly promoted psychological resilience and PTG and had positive effects on PTG through the mediating effect of psychological resilience. Invasive rumination had no direct effect on PTG. However, it had a negative effect on PTG through the mediating effect of psychological resilience. Together the results of this study indicate that the mediating effect of psychological resilience was significant in the association of rumination and PTG among mobile cabin hospital nurses, with a higher individual psychological resilience level helping nurses to achieve PTG. Therefore, targeted interventions should be implemented to improve nurses' psychological resilience and guide their rapid growth.

[A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19]

PURPOSE

This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi's Posttraumatic Growth model and a literature review.

METHODS

The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Disclosure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0.

RESULTS

The modified model showed appropriate goodness of fit (χ² = 369.90, χ²/degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%.

CONCLUSION

This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.

Post-Traumatic Growth of Nurses in COVID-19 Designated Hospitals in Korea

BACKGROUND

This descriptive survey aimed to identify the factors affecting the post-traumatic growth (PTG) of nurses in COVID-19 designated hospitals on the basis of a PTG model.

METHODS

A survey of 250 nurses working at three COVID-19 hospitals in Seoul, South Korea, was conducted from May to July 2021. The collected data were analyzed using the IBM SPSS 25 (IBM Inc., Armonk, NY, USA).

RESULTS

The participants in this study were mostly women (92.7%), and the average age and career duration were 32.08 and 7.88 years, respectively. The factors that significantly influenced the participants' PTG were identified as marriage, religion, self-disclosure, deliberate rumination, meaning in life, and resilience.

CONCLUSIONS

As new infectious diseases emerge, it is necessary to develop a program that can encourage self-disclosure and deliberate rumination, help nurses discover and pursue meaning in life, and enhance their ability to overcome trauma and promote PTG.

Post-traumatic growth experience of first-line emergency nurses infected with COVID-19 during the epidemic period-A qualitative study in Shanghai, China

Background

In March 2022, Shanghai, China, was hit by a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The medical staff was greatly infected during this period, which posed a traumatic event for them. Meanwhile, they also experience post-traumatic growth under introspection and positive change. However, the psychological coping and growth after infection with COVID-19 among medical staff have rarely been investigated.

Objectives

To explore the process and influencing factors of post-traumatic growth among emergency nurses infected with coronavirus disease (COVID-19) so as to provide a new perspective and theoretical basis for psychological rehabilitation or intervention for medical staff who experienced traumatic events.

Methods

The study used a qualitative design based on the phenomenological approach. A purposive sampling method was used to explore the subjective feelings and post-traumatic growth among 13 first-line emergency nurses infected with COVID-19 in Shanghai, China. Semi-structured face-to-face interviews were conducted in June 2022. A Seven-step Colaizzi process was used for data analysis.

Results

Themes were described and extracted from the experience and insights at different stages during the fight against the virus. Three main themes, i.e., stress period, adjustment period, and growth period, as well as several sub-themes, were identified.

Conclusion

First-line emergency nurses infected with COVID-19 are a sensitive group that should be given more attention. Investigating how they achieve psychological adjustment and growth in the case of severe trauma can provide valuable references for nursing management and education in the future. Society, hospital and nursing managers should pay more attention to the PTG of nurses and establish supportive PTG strategies, which will benefit the retention rate and career development of nurses.

Factors influencing posttraumatic growth among nurses caring for COVID-19 patients: A path analysis

AIMS

Based on Calhoun and Tedeschi's posttraumatic growth model, this study aimed to establish a path model of posttraumatic growth among nurses who provided care for coronavirus disease 2019 (COVID-19) patients and to examine the associations between the relevant variables.

BACKGROUND

There are increasingly many studies examining the psychological health status of nurses caring for patients on the front lines of COVID-19. However, research results showing the effects of various variables affecting nurses' posttraumatic growth through positive psychological transformation are insufficient.

METHODS

This cross-sectional study was based on a sample of 229 nurses who cared for COVID-19 patients for more than 1 month in South Korea from April to May 2021.

RESULTS

The fitness of the modified path model (χ² =1.380, p=.502, GFI=0.99, CFI=1.00, NFI=0.99, RMSEA=0.00, and TLI=1.01) was higher than that of the hypothesis path model (χ² =124.133, p<.001, GFI=0.85, CFI=0.66, NFI=0.65, RMSEA=0.36, and TLI=0.15). Deliberate rumination had directly influenced posttraumatic growth and post-traumatic stress disorder and social support had a direct and indirect effect on posttraumatic growth. Self disclosure indirectly influenced posttraumatic growth through deliberate rumination but was not significant.

CONCLUSIONS

In order to improve posttraumatic growth of nurses caring for COVID-19 patients, it is necessary to provide and support opportunities for self disclosure.

IMPLICATION FOR NURSING MANAGEMENT

The results of this study can help institutions and nurse managers comprehensively understand the factors affecting posttraumatic growth of nurses caring for COVID-19 patients in the front lines and determine basic strategies based on the importance of these factors.

Predictors of posttraumatic growth of intensive care unit nurses in Korea

AIM

Nurses working in intensive care units are repeatedly exposed to trauma (e.g., verbal or physical abuse by confused patients, and unexpected death). However, after experiencing traumatic events, not all intensive care unit nurses develop psychopathological issues, including posttraumatic stress disorder. Therefore, this study aims to examine the level of posttraumatic growth and psychosocial factors such as posttraumatic stress symptoms, deliberate rumination, wisdom, and self-compassion to predict posttraumatic growth in Korean intensive care unit nurses.

METHODS

A total of 156 intensive care unit nurses participated in this cross-sectional survey. Posttraumatic growth, posttraumatic stress symptoms, deliberate rumination, wisdom, and self-compassion were measured using validated self-report scales, and data were analyzed by descriptive statistics.

RESULT

Posttraumatic growth was found to be comparatively low in intensive care unit nurses, while multiple regression showed that positive self-compassion was the most significant predictor for posttraumatic growth, followed by wisdom, age, and deliberate rumination. All together four variables explained 30% of the variance in posttraumatic growth.

CONCLUSION

Findings from this study suggest that intensive care unit nurses' posttraumatic growth may be enhanced by increasing positive self-compassion, wisdom, and deliberate rumination. Therefore, a paradigm shift focusing on possible positive pathways, such as development of mental health programs to improve posttraumatic growth for intensive care unit nurses is required rather than focusing on management of posttraumatic stress disorder. The results of this study could provide theoretical guidance to seek more effective and integrated intervention strategies for intensive care unit nurses.

Association of Nursing Work Environment, Relationship with the Head Nurse, and Resilience with Post-Traumatic Growth in Emergency Department Nurses

Emergency department nurses are confronted with unpredictable diseases and disasters and work-related traumatic stress events. This study aimed to examine the relationship between nursing work environment, relationship with the head nurse, resilience, and posttraumatic growth among emergency department nurses. Data were collected from December 2018 to February 2019 through a self-administered survey questionnaire. Participants comprised 127 nurses working in the emergency department. The collected data were analyzed using t-test, analysis of variance with Scheffé’s test, Pearson’s correlations, and hierarchical multiple regression. The mean posttraumatic growth score of emergency department nurses was 2.59 ± 0.64 out of a possible 5.00. The posttraumatic growth showed a statistically significant difference according to age in the emergency department nurse. Resilience was the most significant variable controlling other variables, accounting for 29% of the variability. The findings support that intervention programs should be developed to encourage a positive relationship with the head nurse and enhance resilience in emergency department nurses.