Predictors of posttraumatic growth of intensive care unit nurses in Korea

Mediating Role of Rumination in Second Victim Experience to Turnover Intention in Psychiatric Nurses

BACKGROUND

Psychiatric nurses often face patient safety incidents that can cause physical and emotional harm, even leading to s econd victim syndrome and staff shortages. Rumination-a common response after nurses suffer a patient safety event-may play a specific role between the second victim experience and turnover intention. Understanding these mechanisms is crucial for supporting psychiatric nurses and retaining psychiatric nursing resources.

OBJECTIVES

The study aimed to explore the associations among second victim experience, rumination, and turnover intention in psychiatric nurses and confirm how second victim experience influences turnover intention through rumination and its subtypes.

METHODS

A descriptive, cross-sectional study was adapted to survey 252 psychiatric nurses who experienced a patient safety incident at three hospitals in China between March and April 2023. We used the Sociodemographic and Patient Safety Incident Characteristics Questionnaire (the Chinese version of the Second Victim Experience and Support Tool), the Event-Related Rumination Inventory, and the Turnover Intention Scale. Path analysis with bootstrapping was employed to accurately analyze and estimate relationships among the study variables.

RESULTS

There was a positive association between second victim experience and turnover intention. In addition, both invasive and deliberate rumination showed significant associations with second victim experience and turnover intention. Notably, our results revealed that invasive and deliberate rumination played partial mediating roles in the relationship between second victim experience and turnover intention in psychiatric nurses.

DISCUSSION

The negative experience and turnover intention of the psychiatric nurse second victims are at a high level. Our results showed that invasive rumination positively mediated the relationship between second victim experience and turnover intention, and deliberate rumination could weaken this effect. This study expands the knowledge of the mechanisms underlying the effect of the second victim experience on turnover intention. Organizations must attach importance to the professional dilemmas of the psychiatric nurses' second victims. Nurse managers can reduce nurses' turnover intention by taking measures to reduce invasive rumination and fostering deliberate meditation to help second victims recover from negative experiences.

The prevalence and factors of posttraumatic growth among nurses based on the PTGI: A systematic review and meta-analysis

BACKGROUND

The urgency and risk of clinical nursing may cause nurses to experience traumatic stress, but it may also lead to posttraumatic growth. However, no study has comprehensively analyzed the prevalence of posttraumatic growth among nurses using a unified outcome measure and a validated assessment tool.

AIM

This study aims to systematically assess the prevalence and factors of posttraumatic growth among nurses based on the Posttraumatic Growth Inventory (PTGI).

METHODS

Ten databases, including The Cochrane Library, PubMed, Web of Science, CINAHL, Springerlink, Embase, Chinese Biomedical (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases, were searched as of December 31, 2022. The prevalence of posttraumatic growth was pooled using Stata 17.0 software. The PRISMA guideline was used to report the systematic review and meta-analysis. PROSPERO registration number: CRD42022365620.

RESULTS

A total of 30 studies were included in this systematic review and meta-analysis, consisting of 14,022 nurses worldwide from four countries. In our study, the pooled mean score of posttraumatic growth among nurses was 66.34 (95% CI: 61.25-71.43). From 2015 to 2022, nurses' posttraumatic growth levels gradually increased. In addition, Turkey nurses have the lowest posttraumatic growth levelnurses who experienced workplace violence have a lower posttraumatic growth level compared with other nurses; while nurses aged over 30 and male have higher posttraumatic growth levels.

CONCLUSIONS

While several studies on the prevalence of posttraumatic growth among nurses have been published, the reported data are quite different. Our systematic review and meta-analysis found that nurses' posttraumatic growth level was "moderate," and nurses' posttraumatic growth may vary based on publication year, country, traumatic event, age, and gender.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Our findings may provide a theoretical basis for hospital administrators and policy makers to scientifically manage human resources, comprehensively evaluate nurses' mental health, and promote nurses' posttraumatic growth in different traumatic events, which is conducive to the formulation and implementation of relevant policy guidelines.

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

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

ABSTRACT

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

AIM

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

METHOD

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

RESULTS

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

DISCUSSION

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

IMPLICATIONS FOR PRACTICE

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

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

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.

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.

Secondary traumatic stress and posttraumatic growth in newly graduated nurses: the mediating role of compassion satisfaction

BACKGROUND

Nurses' secondary traumatic stress, compassion satisfaction and posttraumatic growth are closely related, but for newly graduated nurses, there are few reports to evaluate the specific path between these three. The aim of this study was to investigate examine the mediating role of compassion satisfaction in secondary traumatic stress and posttraumatic growth among newly graduated nurses.

METHODS

From March 2021 to May 2021, a total of 330 newly graduated nurses from five tertiary hospitals in China were enrolled, and asked to complete questionnaires regarding secondary traumatic stress, compassion satisfaction and posttraumatic growth. Descriptive statistics, independent-samples T-test, one-way analysis of variance (ANOVA), Pearson correlation analysis and structural equation model were used in this study. A STROBE checklist was used to report findings.

RESULTS

The scores of secondary traumatic stress, compassion satisfaction and posttraumatic growth of newly graduated nurses were 27.11 ± 4.94 (score range: 10-50), 31.89 ± 6.22 (score range: 10-50) and 56.47 ± 20.41 (score range: 0-100), respectively. Additionally, structural equation modeling showed that compassion satisfaction mediated the relationship between secondary traumatic stress and posttraumatic growth with the partial mediating effect of 0.089.

CONCLUSIONS

Newly graduated nurses may experience moderate secondary traumatic stress, but their posttraumatic growth is at a low level, and compassion satisfaction significantly affects the relationship between the two. Nursing managers should strengthen psychological evaluation, and promote their posttraumatic growth by improving their level of compassion satisfaction.

Factors Associated with Post-Traumatic Growth in Healthcare Professionals: A Systematic Review of the Literature

Post-traumatic growth (PTG) research is flourishing across various disciplines; however, it is only emerging in healthcare. Recently, a flurry of studies assessed PTG among healthcare professionals. However, to date, no systematic review has identified the factors that predict their experiences of PTG among healthcare professionals. The current paper aims to address this gap. Of 126 papers, 27 were selected for this systematic review. The analysis identified a range of demographic, individual (work-related and personal), interpersonal and environmental factors that contributed to healthcare professionals' experiences of PTG. Analysis of findings offers a novel perspective on individual factors by dividing them into personal and work-related factors. Results also highlight a variety of psychological interventions that can be used in healthcare to cultivate PTG. In addition, the gaps in current research, implications for further research, policy and practice that can facilitate the experience of PTG among healthcare professionals are discussed.