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Tang LK, Yobas P, Wong DNX, Pikkarainen M, Zhang R, Ho D, He HG. Personal and work-related factors associated with post-traumatic growth in nurses: A mixed studies systematic review. J Nurs Scholarsh 2024. [PMID: 38703352 DOI: 10.1111/jnu.12973] [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: 08/08/2023] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Nurses, assuming a wide range of clinical and patient care responsibilities in a healthcare team, are highly susceptible to direct and indirect exposure to traumatic experiences. However, literature has shown that nurses with certain traits developed a new sense of personal strength in the face of adversity, known as post-traumatic growth (PTG). This review aimed to synthesize the best available evidence to evaluate personal and work-related factors associated with PTG among nurses. DESIGN Mixed studies systematic review. METHODS Studies examining factors influencing PTG on certified nurses from all healthcare facilities were included. Published and unpublished studies were identified by searching 12 databases from their inception until 4th February 2023. Two reviewers independently screened, appraised, piloted a data collection form, and extracted relevant data. Meta-summary, meta-synthesis, meta-analysis, as well as subgroup and sensitivity analyses were performed. Integration of results followed result-based convergent design. RESULTS A total of 98 studies with 29,706 nurses from 18 countries were included. These included 49 quantitative, 42 qualitative, and seven mixed-methods studies. Forty-six influencing factors were meta-analyzed, whereas nine facilitating factors were meta-summarized. A PTG conceptual map was created. Four constructs emerged from the integration synthesis: (a) personal system, (b) work-related system, (c) event-related factors, and (d) cognitive transformation. CONCLUSION The review findings highlighted areas healthcare organizations could do to facilitate PTG in nurses. Practical implications include developing intervention programs based on PTG facilitators. Further research should examine the trend of PTG and its dynamic response to different nursing factors. CLINICAL RELEVANCE Research on trauma-focused therapies targeting nurses' mental health is lacking. Therefore, findings from this review could inform healthcare organizations on the PTG phenomenon and developing support measures for nurses through healthcare policies and clinical practice.
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Affiliation(s)
- Lian Kwang Tang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
- Raffles Hospital, Singapore, Singapore
| | - Piyanee Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Dionne Ning Xuan Wong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
- Singapore General Hospital, Singapore, Singapore
| | - Minna Pikkarainen
- Oslomet, Oslo Metropolitan University, Oslo, Norway
- University of Oulu, Oulu, Finland
| | - Renwen Zhang
- Department of Communications and New Media, National University of Singapore, Singapore, Singapore
| | - Dean Ho
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health (N.1), National University of Singapore, Singapore, Singapore
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
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Nowicki GJ, Schneider-Matyka D, Godlewska I, Tytuła A, Kotus M, Walec M, Grochans E, Ślusarska B. The relationship between the strength of religious faith and spirituality in relation to post-traumatic growth among nurses caring for COVID-19 patients in eastern Poland: a cross-sectional study. Front Psychiatry 2024; 14:1331033. [PMID: 38260777 PMCID: PMC10800582 DOI: 10.3389/fpsyt.2023.1331033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The COVID-19 pandemic had forced intensive care unit (ICU) nurses to adapt to extreme conditions in a short period of time. This resulted in them experiencing extremely stressful situations. The aim of this study was to assess the relationship between post-traumatic growth (PTG) and religiosity and spirituality (R/S) among nurses caring for COVID-19 patients in intensive care during the pandemic. Materials and methods 120 nurses working in Lublin, eastern Poland, participated in the cross-sectional study. The questionnaire was made up of three standardised tools: The Post-Traumatic Growth Inventory, The Santa Clara Strength of Religious Faith Questionnaire, The Spiritual Attitude and Involvement List. Results In terms of spirituality, the study group of nurses achieved the highest score in the Connectedness with Nature subscale (4.37 ± 1.07), while the strength of religious beliefs had a positive correlation with post-traumatic growth only in the Spiritual changes subscale (r = 0.422, p < 0.001). The following dimensions of spirituality were significantly correlated with post-traumatic growth in the multi-factor model that included religiosity and spirituality: Transcendent experiences, Spiritual activities, Meaningfulness, Acceptance, and Trust. We saw that increase in the assessment of the Transcendent experiences, Meaningfulness and Trust subscales significantly mirrors increase in post-traumatic growth, while increase in the assessment of the Spiritual activities and Acceptance subscales significantly mirrors decrease in post-traumatic growth. The above variables explained up to 44% of the dependent variable. Conclusion Both religiosity and spirituality were significantly associated with post-traumatic growth in the group of ICU nurses, but spirituality appears to have played a larger role. Our findings support the value and significance of the development of spiritual and religious identity as a means of enhancing positive psychological changes in the face of traumatic events.
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Affiliation(s)
- Grzegorz Józef Nowicki
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Daria Schneider-Matyka
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Iwona Godlewska
- Second Department of Anaesthesia and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Andrzej Tytuła
- Head Chamber of Nurses and Midwives, Warszawa, Poland
- Faculty of Human Sciences, University of Economics and Innovation, Lublin, Poland
| | - Marzena Kotus
- Department of Anaesthesiological and Intensive Care Nursing, Medical University of Lublin, Lublin, Poland
| | - Monika Walec
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Bovero A, Balzani S, Tormen G, Malandrone F, Carletto S. Factors Associated with Post-Traumatic Growth during the COVID-19 Pandemic: A Systematic Review. J Clin Med 2023; 13:95. [PMID: 38202102 PMCID: PMC10779553 DOI: 10.3390/jcm13010095] [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: 11/21/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
The COVID-19 pandemic was an unprecedented event that further stimulated the debate on the concept of trauma. To increase knowledge about the traumatic potential of the pandemic, the main objective of this study was to identify, through a systematic literature review, the main factors associated with the adaptive outcome of post-traumatic growth caused by COVID-19. Studies were selected from the PsychInfo, Embase, and PubMed databases, and 29 articles were included at the end of the screening process. The identified factors are of different natures, including personal variables such as personality traits, coping, and cognitive strategies used to face adversity, and interpersonal variables, one of the most important of which is the level of social support. In addition, several results confirmed a relationship between post-traumatic growth and post-traumatic stress symptoms, as well as indices related to psychological well-being. Finally, the results are discussed by comparing them with those already present in the literature, as well as with some of the main explanatory models of post-traumatic growth. In this regard, some of the factors identified, such as maladaptive coping, avoidance symptoms, optimism, and low-stress tolerance, suggest the possibility that the process of post-traumatic growth may also be characterized by an illusory dimension.
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Affiliation(s)
- Andrea Bovero
- Clinical Psychology Unit, University Hospital “Città della Salute e della Scienza di Torino”, 10123 Torino, Italy; (A.B.); (S.B.); (G.T.); (S.C.)
| | - Sarah Balzani
- Clinical Psychology Unit, University Hospital “Città della Salute e della Scienza di Torino”, 10123 Torino, Italy; (A.B.); (S.B.); (G.T.); (S.C.)
| | - Gabriela Tormen
- Clinical Psychology Unit, University Hospital “Città della Salute e della Scienza di Torino”, 10123 Torino, Italy; (A.B.); (S.B.); (G.T.); (S.C.)
| | - Francesca Malandrone
- Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy
| | - Sara Carletto
- Clinical Psychology Unit, University Hospital “Città della Salute e della Scienza di Torino”, 10123 Torino, Italy; (A.B.); (S.B.); (G.T.); (S.C.)
- Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy
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Tjasink M, Keiller E, Stephens M, Carr CE, Priebe S. Art therapy-based interventions to address burnout and psychosocial distress in healthcare workers-a systematic review. BMC Health Serv Res 2023; 23:1059. [PMID: 37794353 PMCID: PMC10552408 DOI: 10.1186/s12913-023-09958-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 08/23/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Burnout and psychosocial distress are serious and growing issues for healthcare workers (HCWs) and healthcare systems across the globe. Exacerbated by changes in healthcare delivery during and following the Covid-19 pandemic, these issues negatively affect HCW wellbeing, clinical outcomes and patient safety. Art Therapy has demonstrated promise as a suitable but under researched intervention, warranting further investigation. This systematic review aims to ascertain what art therapy-based interventions used to address burnout and / or psychosocial distress in HCWs have been reported in the health and social care literature and how these have been evaluated. METHODS Six databases (PubMed, PsycINFO, MEDLINE, EMBASE, CINAHL, ProQuest Central), Google Scholar and three clinical trial registries (CENTRAL, ICTRP and ClinicalTrials.gov) were searched for studies using art therapy-based methods to engage with burnout risk or psychosocial distress in HCWs. Following screening for eligibility study characteristics and outcomes were extracted by two reviewers independently. Studies were evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Outcomes were grouped for analysis. Quantitative and qualitative results were synthesised and integrated using narrative synthesis. RESULTS Twenty-seven studies, drawn from thirteen countries, spanning five continents were selected for inclusion. Fifty percent were published in the last five years, indicating growing global research in the field. Fourteen studies used quantitative research methods and thirteen used qualitative methods. A total of 1580 participants took part in the studies, with nurses most broadly represented (59%). Interventions were mostly delivered in groups (95%) and by an art therapist (70%). Heterogeneity and insufficient randomised controlled trials precluded the possibility of meta-analysis. However, a review of available data showed evidence of medium to large effects for emotional exhaustion (burnout), work-related stress and common mental health issues. A content analysis of qualitative data of perceived effect complemented quantitative findings. CONCLUSION Global research into the use of art therapy-based methods to address burnout and psychosocial distress in HCWs is growing. Whilst further high-quality evidence such as randomised controlled trials would be beneficial, findings suggest that art therapy-based methods should be strongly considered as an acceptable and effective treatment for symptoms of emotional exhaustion (burnout) and psychosocial distress in HCWs.
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Zeng Z, Wang H, Zhou Y, Lu Z, Ci R, Lin Y, Zeng X, Huang L. The prevalence and factors associated with posttraumatic growth after 3-years outbreak of COVID-19 among resident physicians in China: a cross-sectional study. Front Psychiatry 2023; 14:1228259. [PMID: 37753265 PMCID: PMC10518389 DOI: 10.3389/fpsyt.2023.1228259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction The Coronavirus disease 2019 (COVID-19) pandemic is a global traumatic event that has profoundly struck individuals' mental health. However, this might potentially promote positive transformation such as posttraumatic growth (PTG). Studies have indicated that the COVID-19 pandemic negatively affected the well-being of resident physicians, but little is known about PTG among this vulnerable population in China. Therefore, this study investigated the prevalence and associated factors of PTG among Chinese resident physicians after 3-years outbreak of COVID-19. Methods An online survey was conducted from 9 March to 20 March in 2023. PTG was assessed using the 10-item Posttraumatic Growth Inventory-Short Form (PTGI-SF). Scores ≥30 implied moderate-to-high PTG. We also collected possible associated factors for PTG, including socio-demographic and psychological variables. Data was analyzed by applying descriptive statistics, univariable and multivariable logistic regression models. Results In total, 2267 Chinese resident physicians provided validated data. 38.7% of them reported moderate-to-high PTG. In the multivariable logistic regression models, age (odds ratio, OR = 1.039; 95% confidence interval, 95%CI = 1.008-1.070), female (OR = 1.383, 95%CI = 1.151-1.662), satisfied or neutral with annual income (OR = 2.078, 95%CI = 1.524-2.832; OR = 1.416, 95%CI = 1.157-1.732), sufficient support at work (OR = 1.432, 95%CI = 1.171-1.751) and resilience (OR = 1.171, 95%CI = 1.096-1.252) were significantly positively associated with moderate-to-high PTG. On the contrary, burnout (OR = 0.653, 95%CI = 0.525-0.812), depression symptoms (OR = 0.700, 95%CI = 0.552-0.889), and stress (OR = 0.757, 95%CI = 0.604-0.949) were significantly negatively associated with moderate-to-high PTG. Discussion Overall, resident physicians in China experienced relatively high prevalence of PTG that could be associated with several psychosocial factors. Findings may provide evidence to develop interventions for resident physicians to systematically and constructively process traumatic events related to the pandemic and foster their PTG.
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Affiliation(s)
- Zixuan Zeng
- Department of Psychiatry, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huan Wang
- Clinical Research Center, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yaxing Zhou
- Department of Medical Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhanghong Lu
- Teaching Office, Renmin Hospital of Wuhan University, Wuhan, China
| | - Renyangcuo Ci
- Department of Medical Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yezhe Lin
- Clinical Research Center for Mental Disorders, Chinese-German Institute of Mental Health, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoping Zeng
- Department of Medical Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lei Huang
- Department of Psychiatry, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Medical Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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