Second Victim Experience among OBGYN Trainees: What Is Their Desired Form of Support?

OBJECTIVES: Physician trainees in obstetrics and gynecology (OBGYN) experience unexpected outcomes similar to those of supervising physicians. A relative lack of experience and perspective may make them more vulnerable to second victim experience (SVE), however. The objectives of our study were to contrast the prevalence of SVE between supervising physicians and trainees and to identify their preferred methods of support. METHODS: In 2019, the Second Victim Experience and Support Tool, a validated survey with supplemental questions, was administered to healthcare workers caring for OBGYN patients at a large academic center in the midwestern United States. RESULTS: The survey was sent to 571 healthcare workers working in OBGYN. A total of 205 healthcare workers completed the survey, including 18 (43.9% of 41) supervising physicians and 12 (48.0% of 25) resident/fellow physicians. The mean scores for the Second Victim Experience and Support Tool dimensions and outcomes were similar between the two groups. Seven (58.3%) trainees reported feeling like a second victim after an adverse patient safety event at some point in their work experience compared with 10 (55.6%) of the supervising physicians. Five (41.7%) trainees identified as a second victim in the previous 12 months compared with 3 (16.7%) supervising physicians (P = 0.21). The most common form of desired support for both groups was conversations with their peers. CONCLUSIONS: Trainees and supervising physicians are both at risk of SVE after an unexpected medical event and prefer conversations with peers as a desired form of support. Because trainees commonly encounter SVEs early in their careers, program directors should consider implementing a program for peer support after an unexpected event.

Factor structure of the professional quality of life scale among direct support professionals: factorial validity and scale reliability.

BACKGROUND: Direct support professionals (DSPs) support people with intellectual and developmental disabilities in activities of daily living. DSPs may experience both contentment and struggles with their work. As agencies grapple with their recruitment and retention, understanding DSPs' holistic work experience is important. The Professional Quality of Life (ProQOL) scale assesses multiple domains of work experiences (i.e. compassion satisfaction, burnout and secondary traumatic stress). Despite extensive use across helping professions, the ProQOL is largely absent from DSP research. METHOD: This study examined the factor structure of the ProQOL with DSPs. Using secondary data from 495 DSPs, confirmatory factor analysis was conducted to determine if the original three-factor structure holds for this population. RESULTS: We confirmed the factorial validity of the ProQOL with the three-factor solution. In the validation process, some modifications were suggested to the model, which also improved the scale reliability. CONCLUSIONS: The current study provides initial evidence of the factorial validity of the ProQOL when used with DSPs, as well as recommendations for subsequent improvements and future research.

Secondary Traumatic Stress and Related Factors in Australian Social Workers and Psychologists.

Secondary traumatic stress (STS) is an indirect form of trauma affecting the psychological well-being of mental health workers. This study examined STS and related factors of empathetic behavior and trauma caseload among a purposive sample of 190 social workers and psychologists. Participants completed an online questionnaire comprising demographics, the Secondary Traumatic Stress Scale, and the Empathy Scale for Social Workers. A moderated moderation model was used to evaluate the hypothesized relationship between the amount of trauma in clinician caseload and STS, as moderated by empathy and personal trauma history. Approximately 30 percent of participants met the criteria for a diagnosis of STS. Results indicated that although caseload trauma was not an independent predictor of STS, there was a significant interaction between caseload trauma and personal trauma history on STS. Similarly, empathy alone was not directly related to changes in STS, yet the trauma in caseload effect on STS was moderated by empathy, and that relationship was moderated by personal trauma history. This overall effect was shown to significantly predict STS. The current study highlights the importance of developing evidence-based risk strategies for mental health workers working in the area of trauma and at risk of developing symptoms of STS.

Construct Validity of the Professional Quality of Life (ProQoL) Scale in a Sample of Child Protection Workers.

The Professional Quality of Life (ProQOL) scale is one of the most widely used measures of compassion satisfaction and fatigue despite there being little publicly available evidence to support its validity. This study, conducted among a sample of 310 child protection workers, assessed the construct validity of this measure using confirmatory factor analysis (CFA) and bifactor modeling. The CFA failed to confirm the adequacy of the three-factor structure proposed by Stamm (2010). In response, a bifactor model postulating a factor structure with a general factor in addition to independent factors (compassion satisfaction, job burnout, and secondary traumatic stress) was proposed, highlighting the unidimensionality of the ProQOL while allowing for each subscale to be used separately. Moreover, this bifactor model of the ProQOL was moderately correlated with the Posttraumatic Disorder Checklist, r = -.427, p < .001, and strongly correlated with scales of well-being at work, r = .694, p < .001, and psychological distress at work, r = -.666, p < .001, thus supporting the ProQOL's convergent validity. No associations were found between the ProQOL and the Life Event Checklist, which supports the ProQOL's discriminant validity. Overall, the results indicated that compassion satisfaction and compassion fatigue represent higher and lower levels of the same construct rather than two different constructs. Researchers and clinicians could therefore compute a single score to rate professionals' individual levels of professional quality of life.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Validez de Constructo del instrumento de medición de Calidad de Vida Profesional (ProQoL) en una muestra de trabajadores de protección infantil ESCALA DE CALIDAD DE VIDA PROFESIONAL: VALIDEZ DE CONSTRUCTO La escala de Calidad de Vida Profesional (ProQoL en su sigla en inglés) es una de las medidas más ampliamente usadas de compasión satisfacción y fatiga por compasión, a pesar de que hay escasa evidencia disponible públicamente que soporte su validez. Este estudio, realizado en una muestra de 310 trabajadores de protección infantil, evaluó la validez de constructo de esta medición usando análisis confirmatorio de factores (CFA, por su sigla en inglés) y modelado bifactor. El CFA no confirmó la idoneidad de la estructura de tres factores propuesta por Stamm (2010). En respuesta, se propone un modelo bifactor que postula una estructura factorial con un factor general junto a factores independientes (compasión satisfacción, agotamiento laboral y estrés traumático secundario), destacando la unidimensionalidad de la ProQoL mientras permite el uso por separado de cada subescala. Más aún, este modelo bifactor de la ProQoL estuvo moderadamente correlacionado con la Lista de Chequeo de Trastorno Postraumático, r = -.427, p < .001, y fuertemente correlacionado con escalas de bienestar en el trabajo, r = .694, p <.001, y malestar psicológico en el trabajo, r = -.666, p <.001, apoyando por tanto la validez convergente de la ProQoL. No se encontraron asociaciones entre la ProQoL y la Lista de Chequeo de Eventos Vitales, lo cual apoya la validez discriminante de la ProQoL. En suma, los resultados indicaron que la compasión satisfacción y la fatiga por compasión representan niveles más altos y más bajos del mismo constructo más que dos constructos diferentes. Los investigadores y los clínicos podrían por lo tanto calcular un único puntaje para calificar los niveles individuales de calidad de vida profesional de los profesionales.

Compassion fatigue among nurses working in a long-term care facility: The Israeli experience.

Nurses working in a long-term care facility could be at risk of developing compassion fatigue due to the nature of their work. In this descriptive, cross-sectional survey, we explored the level of compassion fatigue among nurses working in a long-term care facility, as well as the associated sociodemographic and occupational factors. In total, 103 nurses employed in various departments of a long-term care facility in central Israel completed the Hebrew version of the Professional Quality of Life Scale R-IV. Nurses scored moderate-high on the compassion fatigue (mean = 3.6, standard deviation = .5), burnout (mean = 3.5, standard deviation = .5), and compassion satisfaction (mean = 3.8, standard deviation = .5) scales. Older nurses scored lower on compassion fatigue, while nurses with higher qualifications scored higher on compassion satisfaction. In this study, we implicate that it is necessary to raise awareness about compassion fatigue, both in nursing education and training and in long-term care organizations. It is necessary to improve understanding of this phenomenon in order to help nurses acquire appropriate coping skills to address this critical issue.

Combating compassion fatigue.

Nurses are especially susceptible to compassion fatigue. This article offers strategies to help nurses recognize the signs of compassion fatigue, take steps to combat it, and support their coworkers.

Veterans are not the only ones suffering from posttraumatic stress symptoms: what do we know about dependents' secondary traumatic stress?

PURPOSE: Previous research has mainly focused on veterans' mental health problems, especially on posttraumatic stress disorder (PTSD). Less is known about the impact that the veteran's experienced potentially traumatic events (PTEs) might have on their significant others. Therefore, we reviewed the scientific literature to find out what is known about the prevalence of secondary traumatic stress (STS) in significant others of veterans. METHODS: We systematically searched Pubmed, PsycINFO, Embase, Cochrane Library and PILOTS for relevant articles. This search resulted in 3100 records from which we included 48 articles. RESULTS: Two studies that reported on parental PTSD did not find evidence that parents were affected by their offspring's experience. Nine studies that reported on PTSD in mainly adult children of veterans found only scant evidence that children were affected by their parent's experienced PTE. Twenty-seven studies investigated PTSD symptoms in partners of veterans. Here results varied largely between studies with PTSD rates between 0 and 51 %. CONCLUSIONS: Overall, we found the strongest evidence of STS in partners of help-seeking veterans with PTSD. The lack of clarity provided by the currently available evidence suggests a pressing need for further work to examine this subject in more detail.

Secondary Traumatic Stress in NICU Nurses: A Mixed-Methods Study.

BACKGROUND: Secondary traumatic stress is an occupational hazard for healthcare providers who care for patients who have been traumatized. This type of stress has been reported in various specialties of nursing, but no study to date had specifically focused on neonatal intensive care unit (NICU) nurses. PURPOSE: (1) To determine the prevalence and severity of secondary traumatic stress in NICU nurses and (2) to explore those quantitative findings in more depth through nurses' qualitative descriptions of their traumatic experiences caring for critically ill infants in the NICU. METHODS: Members of NANN were sent e-mails with a link to the electronic survey. In this mixed-methods study, a convergent parallel design was used. Neonatal nurses completed the Secondary Traumatic Stress Scale (STSS) and then described their traumatic experiences caring for critically ill infants in the NICU. SPSS version 24 and content analysis were used to analyze the quantitative and qualitative data, respectively. RESULTS: In this sample of 175 NICU nurses, 49% of the nurses' scores on the STSS indicated moderate to severe secondary traumatic stress. Analysis of the qualitative data revealed 5 themes that described NICU nurses' traumatic experiences caring for critically ill infants. IMPLICATIONS FOR PRACTICE: NICU nurses need to know the signs of secondary traumatic stress that they may experience caring for their critically ill infants. Avenues for dealing with the stress should be provided. IMPLICATIONS FOR RESEARCH: Future research with a higher response rate to increase the external validity of the findings to the population of neonatal nurses is needed.

Secondary traumatic stress in emergency medicine clinicians.

Previously called Secondary Traumatic Stress (STS), secondary exposure to trauma is now considered a valid DSM-5 Criterion A stressor for posttraumatic stress disorder (PTSD). Previous studies have found high rates of STS in clinicians who treat traumatically injured patients. However, little research has examined STS among Emergency Medicine (EM) physicians and advanced practice providers (APPs). The current study enrolled EM providers (N = 118) working in one of 10 hospitals to examine risk factors, protective factors, and the prevalence of STS in this understudied population. Most of the participants were physicians (72.9%), Caucasian (85.6%), and male (70.3%) with mean age of 39.7 (SD = 8.9). Overall, 12.7% of the sample screened positive for STS with clinical levels of intrusion, arousal, and avoidance symptom clusters, and 33.9% had at least one symptom cluster at clinical levels. Low resilience and a history of personal trauma were positively associated with positive STS screens and STS severity scores. Borderline significance suggested that female gender and spending ≥10% of one's time with trauma patients could be additional risk factors. Findings suggest that resilience-building interventions may be beneficial.

Fatigue: Has It Affected Your Compassion?

Compassion fatigue is a concept used to describe how various stressors affect individuals who work in health care and other caregiving professions. The results of compassion fatigue may include decreased work productivity, poor quality of care, safety concerns, job dissatisfaction, and job turnover. The NICU professionals are at an increased risk for experiencing compassion fatigue because of the nature of working with critically ill infants, their families, and the additional stress of the workplace. The purpose of this article is for the NICU professional to understand compassion fatigue, identify the risk factors, recognize the signs and symptoms, and offer strategies to implement within the NICU environment.

Development of guidelines for family and non-professional helpers on assisting an older person who is developing cognitive impairment or has dementia: a Delphi expert consensus study.

BACKGROUND: Assisting a person with dementia can lead to significant carer burden and possible negative outcomes for the person. Using the Delphi method, this study developed expert consensus guidelines for how family and non-professional carers should assist a person who is developing cognitive impairment, or has dementia or delirium. METHODS: A systematic search of websites, books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions needed for assisting a person who is developing cognitive impairment, or has dementia or delirium. These items were rated over three rounds by two international expert panels comprising professionals specialising in research or treatment of dementia, and dementia carer advocates. RESULTS: A total of 65 participants (43 in the professional panel and 22 in the carer advocate panel) completed all three survey rounds. Of the 656 survey items that were rated, a total of 389 items were endorsed by at least 80 % of each panel. The endorsed items formed the basis of a guidelines document that explains what family and non-professional carers need to know and do when assisting a person who is developing cognitive impairment, or has dementia or delirium. CONCLUSIONS: The two groups of experts were able to reach substantial consensus on how to assist a person who is developing cognitive impairment, or has dementia or delirium.

Compassion Fatigue in Pediatric Nurses.

Compassion fatigue in nursing has been shown to impact the quality of patient care and employee satisfaction and engagement. The aims of this study were to determine the prevalence and severity of compassion fatigue among pediatric nurses and variations in prevalence based on respondent demographics using a cross-sectional survey design. Nurses under 40 years of age, with 6-10 years of experience and/or working in a medical-surgical unit had significantly lower compassion satisfaction and higher levels of burnout. Secondary traumatic stress from caring for children with severe illness or injury or end of life was a key contributor to compassion fatigue.

Psychiatric caregiver stress: clinical implications of compassion fatigue.

The capacity to work productively is a key component of health and emotional well-being. People who work in health care can be exposed to the fatigue of care. Compassion fatigue has been described as an occupational hazard specific to clinical work related severe emotional distress. In our study, we have evaluated compassion fatigue in a mental health group (47 psychiatric staff) and its relationship with inpatients (237 inpatients) affected by some psychiatric disorders. At baseline, the more significant data indicate a high percentage of Job Burnout and Compassion Fatigue in psychiatric nurses (respectively, 39.28%, 28.57%). Significant Compassion Fatigue percentage is present also in psychologist group (36.36%). Finally, in psychiatrists, the exposure to patients increased vicarious trauma (28.57%), but not job burnout. After a year of participation in Balint Groups, the psychiatric staff presented an overall reduction in total mean score in any administered scale (CBI: p<0.0000045; sCFs: (Vicarious Trauma: p<0.0288; Job Burnout: p<0.000001)). Thus, compassion fatigue causes concern among mental health professionals, and Balint Groups may represent a therapeutic strategy to help health professionals to face difficulties in challenging work environments.

A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in maternal-fetal medicine physicians in the United States.

BACKGROUND: Compassion fatigue is secondary traumatic distress experienced by providers from ongoing contact with patients who are suffering. Compassion satisfaction is emotional fulfillment from caring for others. Burnout is distress related to dissonance between job demands and available resources. Although burnout is well-studied, compassion satisfaction and compassion fatigue are neglected components of physician well-being. Because of recurrent exposure to adverse outcomes, maternal-fetal medicine providers may be at particular risk for compassion fatigue. OBJECTIVE: This study aimed to better characterize both clinical and nonclinical drivers of work-related distress vs satisfaction. STUDY DESIGN: The modified Compassion Fatigue and Satisfaction Self-Test and a questionnaire of professional and personal characteristics were distributed electronically to maternal-fetal medicine providers nationally. Multivariable regression models were constructed for compassion fatigue, burnout, and compassion satisfaction as a function of potential predictors. RESULTS: The survey response rate was 24% (n=366), primarily consisting of White physicians working in academic medical centers. Significant predictors of lower burnout scores included employment at 1 institution for >20 years, discussing work-related distress with friends, and having one's most recent involvement in decision-making for a periviable fetus >6 months ago; distress because of coworkers and personal factors predicted higher scores. Female sex, self-report of significant emotional depletion, use of mental health services, and having other maternal-fetal medicine physicians as part of the care team for a fetus with severe anomalies were significant predictors of higher compassion fatigue scores, whereas White race and having social work as part of the care team for a maternal mortality predicted lower scores. Personal spiritual practice was a significant predictor of higher compassion satisfaction score, whereas employment at current institution for <5 years predicted lower scores. CONCLUSION: Compassion fatigue, compassion satisfaction, and burnout are associated with several modifiable risk factors, such as practice type, having a multidisciplinary team, and emotional support outside of the workplace; these are potential targets for intervention.

Diagnostic and Translational Utility of the Secondary Traumatic Stress Clinical Algorithm (STS-CA).

Current tools available to assess secondary traumatic stress (STS) do not account for whether the symptoms are functionally related to indirect trauma, determine functional impairment caused by the STS symptoms, and/or consider the duration of the disturbance. This prevents delineation of various expressions of traumatic stress related to indirect trauma that may constitute the phenomenon of STS. The STS Clinical Algorithm (STS-CA) was developed to make these distinctions, so that interventions can be tailored to need. This study investigates the following: (1) the diagnostic concordance between the STS-CA findings and scores on the Secondary Traumatic Stress Scale (STSS); (2) reasons for diagnostic discrepancies between the STS-CA and the STSS assessments. Three trained interviewers used the STS-CA to guide the determination of clinical outcome (N = 181) in a diverse group of helping professionals. There was 100% agreement between the CAPS and the STS-CA, and fair agreement (κ =.426, p = .000) between the STS-CA and the STSS. The STS-CA demonstrated more sensitivity in classifying positive cases, and specificity in delineating those with atypical cluster presentations or little to no functional impairment that prohibited a post-traumatic stress disorder diagnosis than the STSS. Effective treatment of STS requires proper identification and the delivery of protocols that are tailored to the unique ways that STS manifests. This study provides some insights into the utility of the STS-CA in guiding this process and creates STS categories to organize and classify intervention strategies.

Work-related well-being of personal care attendants employed in the aged care sector: Prevalence and predictors of compassion fatigue.

OBJECTIVE: This study examined the factors contributing to compassion fatigue (CF) for personal care attendants (PCAs) working in the Australian aged care sector. METHODS: Social media was the main recruitment mode. An anonymous online self-report survey collected demographic information and measures of CF from 169 PCAs, aged between 18 and 66 years. RESULTS: High levels of CF were reported by 53.3% of respondents. Compassion fatigue was higher in PCAs working in residential aged care than those in community care. Predictors of CF were psychological distress, not having time to care for clients, and poor work psychosocial safety climate. Psychological distress explained 47.9% of the variance in the regression model. CONCLUSIONS: Many PCAs working in the Australian aged care sector report experiencing CF, which is highly associated with psychological distress. Interventions to reduce psychological stress for PCAs in aged care are urgently needed to ensure quality care and safety for residents.

Prevalence and factors of compassion fatigue among nurse in China: A protocol for systematic review and meta-analysis.

BACKGROUND: Compassion fatigue is defined as a detrimental consequence of experiencing work-related stress among nurses, which can affect the job performance and harm emotional and physical health. The high risk of compassion fatigue among nurses may be even more severe in China. Although several studies have explored the prevalence and factors of compassion fatigue among Chinese nurses, most data derived merely from the specialty units of the hospital or limited samples, and there is a large heterogeneity among studies. Thus, it is indispensable to systematically summarize the risk factors and prevalence of compassion fatigue among clinical nurse in China. METHODS: Two reviewers will independently conduct comprehensively searches in 9 electronic databases including PubMed, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Web of science, MEDLINE, China National Knowledge Infrastructure (CNKI), WanFang and Chinese Biological Medical Database (CBM) with no search date restriction. Cross-sectional and prospective cohort studies that described the prevalence and factors of Chinese nurses compassion fatigue will be eligible for inclusion. The risk of bias and methodological quality of individual study will be assessed using an adapted quality assessment tool from the Agency for Healthcare Research and Quality (AHRQ). Stata 16.0 software will be used for meta-analysis. RESULTS: The primary outcome will be the prevalence of 3 dimension of compassion fatigue in Chinese nurses. The secondary outcomes will be comparisons of compassion fatigue scores among Chinese nurse of different education background, marital status, employment forms and professional titles. CONCLUSION: This overview will contribute to reveal the prevalence and influencing factors in compassion fatigue among Chinese nurses and provide a scientific evidence for the prediction and prevention in compassion fatigue. REGISTRATION NUMBER: The registration DOI is 10.17605/OSF.IO/V34X6.