Optimistic thinking, satisfaction with life and job and nursing care rationing: Multicentre study in Poland.

AIMS: The aim was to examine whether the level of optimism and job and life satisfaction is a differentiating factor from the level of implicit rationing of nursing care in a sample of Polish registered nurses. BACKGROUND: Satisfaction with life and job is reflected by greater effectiveness of nurses at work and creates a positive work environment, which in turn may modulate the level of implicit rationing of nursing care. METHODS: A cross-sectional multicentre research design was adopted, employing a representative sample of 1,010 registered Polish nurses identified between the beginning of January and the end of June 2019. Four self-report scales were used in this study: Basel Extent of Rationing of Nursing Care, Satisfaction with Life Scale, Satisfaction with Job Scale and Life Orientation Test-Revised. The results were analysed using the k-means method, Student's t test and two-way ANOVA. RESULTS: Optimistic thinking, and satisfaction with job and life exerted a significant effect on the level of implicit rationing of nursing care among Polish nurses. Nurses from the group 'pessimistic' were at higher risk of nursing care rationing than those from the group 'optimistic'. CONCLUSION: Strengthening of the personal competencies, providing support and responding to all identified needs might increase job satisfaction of nurses and hence reduce the risk of nursing care rationing. IMPLICATIONS FOR NURSING MANAGEMENT: Leadership modelling and training in positive thinking might be the methods to support nurses and to prevent nursing care rationing.

The mediating role of job satisfaction in the relationship between social support and the consequences of secondary exposure to trauma among medical providers working with trauma victims.

OBJECTIVES: Medical providers working with trauma survivors are exposed to the negative and positive effects of secondary trauma, both of which are affected by social support and job satisfaction. The aim of this study was to determine the mediating role of job satisfaction in the relationship between social support and the negative and positive effects of secondary exposure to trauma among medical personnel. The negative indicator of such exposure was secondary traumatic stress (STS), while the positive indicator was secondary posttraumatic growth (SPTG). MATERIAL AND METHODS: The analyses included 419 medical providers working with trauma victims (201 paramedics and 218 nurses). Data was collected with the Secondary Traumatic Stress Inventory, Secondary Posttraumatic Growth Inventory, Social Support Scale, Work Satisfaction Scale, and survey. Mediation analyses were applied to assess relationships between variables. RESULTS: The mediation analyses indicated that job satisfaction mediates (mainly partly) the relationship between social support and STS and SPTG. This may indicate that both social support and job satisfaction act as significant predictors of the negative and positive effects of secondary exposure to trauma. CONCLUSIONS: As a friendly and mutually-supportive environment can increase job satisfaction, reducing the risk of secondary traumatic stress and promoting positive posttraumatic changes, it is important to increase social support and job satisfaction among medical providers exposed to secondary trauma. Int J Occup Med Environ Health. 2023;36(4):505-16.

The Relationship between Social Support and Secondary Posttraumatic Growth among Health Care Providers Working with Trauma Victims-The Mediating Role of Cognitive Processing.

BACKGROUND: Individuals, who help trauma victims as part of their professional responsibilities, may experience positive effects of their work, occurring in the form of Secondary Posttraumatic Growth (SPTG). Its determinants include environmental factors such as social support, and individual characteristics, particularly cognitive processing of the trauma. The purpose of this study was to determine the associations between SPTG and social support and cognitive processing of trauma, also considered as a mediator, in a group of medical personnel exposed to secondary trauma. METHODS: The results of 408 participants, paramedics and nurses, were analyzed. Three measurement tools were used: the Secondary Posttraumatic Growth Inventory, the Social Support Scale measuring four sources of support and the Cognitive Trauma Processing Scale to assess five cognitive coping strategies. RESULTS: The results indicated that SPTG was positively related to social support and cognitive coping strategies. Cognitive coping strategies act as a mediator in the relationship between social support and SPTG. CONCLUSIONS: Despite their exposure to secondary traumatization, paramedics and nursing staff experience positive consequences of their work related to helping injured people. In order to promote growth after trauma, it is advisable to encourage medical representatives to use social support and primarily positive coping strategies.

Prevalence and determinants of secondary posttraumatic growth following trauma work among medical personnel: a cross sectional study.

Background: People helping trauma victims as a part of their work may experience positive results, known as Secondary Posttraumatic Growth (SPTG). Aim: The present study aimed to determine the prevalence and determinants of SPTG among medical personnel, considering occupational load, job satisfaction, social support, and cognitive processing of trauma, understood as cognitive coping strategies. Methods: Subjects comprised 419 representatives of the medical profession, including paramedics and nurses. The age of the subjects varied from 19 to 65 (M = 39.60; SD = 11.03). Four standard measurement tools were utilized: the Secondary Posttraumatic Growth Inventory, the Job Satisfaction Scale, the Social Support Scale, which measured four support sources, and the Cognitive Processing of Trauma Scale to assess five cognitive coping strategies. Pearson's correlation coefficients were applied to analyse the connections between the variables. A linear stepwise regression analysis was used to identify the determinants of SPTG. Pearson's correlation coefficients with confidence intervals were applied to analyse the connections between the variables. Results: As many as 40% of participants experienced high levels of growth, with only 27.4% indicating a low level. The obtained results showed positive links between job satisfaction, all social support dimensions (from supervisors, co-workers, family, friends), all cognitive coping strategies (positive cognitive restructuring, downward comparison, resolution/acceptance, denial, regret), and SPTG. No significant connection between workload and SPTG total was discovered. The primary determinant of SPTG in the examined group of medical personnel is the cognitive processing of trauma, chiefly the strategy of positive cognitive restructuring. Conclusions: Paramedics and nurses, despite their exposure to secondary trauma, experience positive posttraumatic consequences of the profession that entails helping the injured parties. It is advisable to encourage the medical personnel to apply positive coping strategies, find satisfaction in their work, and benefit from social support to promote posttraumatic growth.

Antecedentes: Las personas que ayudan a las víctimas del trauma como parte de su trabajo pueden experimentar resultados positivos conocidos como crecimiento postraumático secundario (CPTS).Objetivo: Este estudio busca determinar la prevalencia y los determinantes del CPTS entre personal médico, considerando la carga ocupacional, satisfacción con el trabajo, soporte social y procesamiento cognitivo del trauma, comprendido como las estrategias cognitivas de afrontamiento.Métodos: Los participantes incluían a 419 representantes de grupos de profesionales de la salud, incluyendo a paramédicos y a enfermeros. La edad de los participantes variaba entre los 19 y los 65 años (M=39.69; SD=11.03). Se emplearon cuatro instrumentos de medición estándar: el Inventario del Crecimiento Postraumático Secundario, la Escala de Satisfacción Laboral, la Escala de Soporte Social ­ que medía cuatro dimensiones de soporte ­, y la Escala de Procesamiento Cognitivo del Trauma para evaluar cinco estrategias de afrontamiento cognitivo. Se aplicaron los coeficientes de correlación de Pearson para analizar las conexiones entre las variables. Se empleó un análisis de regresión linear para identificar los determinantes del CPTS.Resultados: Un 40% de los participantes experimentó altos niveles de crecimiento, con solo un 27,4% indicando un nivel bajo. Los resultados obtenidos mostraron relaciones positivas entre la satisfacción laboral, todas las dimensiones del soporte social (de los supervisores, de colegas, de la familia y de los amigos), todas las estrategias de afrontamiento cognitivo (reestructuración cognitiva positiva, comparación social a la baja, resolución/aceptación, negación, arrepentimiento) y el CPTS. No se descubrió alguna conexión entre la carga laboral y el CPTS. El principal determinante del CPTS en el grupo de personal de la salud estudiado fue el procesamiento cognitivo del trauma, la estrategia capital de la reestructuración cognitiva positiva.Conclusiones: Los paramédicos y los enfermeros, a pesar de su exposición al trauma secundario, experimentan consecuencias postraumáticas positivas de la profesión que devienen del ayudar a personas heridas. Es aconsejable animar al personal de la salud a aplicar estrategias de afrontamiento positivas, encontrar satisfacción en su trabajo y que se beneficien del soporte social que promueve el crecimiento postraumático.

Factors Affecting Occupational Burnout Among Nurses Including Job Satisfaction, Life Satisfaction, and Life Orientation: A Cross-Sectional Study.

PURPOSE: Everyday nursing practice under demanding conditions, high mental and physical strain may result in occupational burnout. There is still a need for studies on the comprehensive identification of burnout among nursing staff. This study aimed to evaluate factors affecting occupational burnout among nurses, including job satisfaction, life satisfaction, and dispositional optimism. METHODS: The study involved 625 survey participants with a mean age of 49.47 years and was conducted between January and December 2018. The inclusion criteria were job experience >1 year, current nurse work activity, and written informed consent to participate in the study. The study used standardized research tools such as Maslach Burnout Inventory (MBI), Life Orientation Test-Revised version (LOT-R), Satisfaction with Life Scale (SWLS), and Satisfaction with Job Scale (SWJS). Also, sociodemographic data were collected using a self-developed questionnaire. The STROBE guidelines were followed. RESULTS: Emotional exhaustion (EE) was significantly greater in respondents with medium life satisfaction (SWLS). Also, EE was significantly greater in pessimists and those with a neutral orientation than in optimists (LOT-R). Housing conditions and family-related problems were significant factors differentiating depersonalization (DEP). Reduced personal accomplishment (PA) was more significant in respondents with a bachelor's degree than in those with a master's degree. Also, decreased PA was significantly greater in respondents with low life satisfaction than those with medium life satisfaction. Life satisfaction and life orientation were significant factors differentiating job dissatisfaction among the health-related and psychological variables. CONCLUSION: Burnout was found to be related to individual, interpersonal and organizational feelings. There was an interrelationship between personality traits, where a higher level of occupational burnout was found among nurses with a pessimist attitude. Health programs should be implemented to identify and eliminate burnout through mental health support, improved communication skills, optimized teamwork, and evidence-based interventions.

Prevalence and predictors of secondary traumatic stress symptoms in health care professionals working with trauma victims: A cross-sectional study.

INTRODUCTION: Medical personnel is an occupational group that is especially prone to secondary traumatic stress. The factors conditioning its occurrence include organizational and work-related factors, as well as personal features and traits. The aim of this study was to determine Secondary Traumatic Stress (STS) indicators in a group of medical personnel, considering occupational load, job satisfaction, social support, and cognitive processing of trauma. MATERIAL AND METHODS: Results obtained from 419 medical professionals, paramedics and nurses, were analyzed. The age of study participants ranged from 19 to 65 (M = 39.60, SD = 11.03). A questionnaire developed for this research including questions about occupational indicators as well as four standard evaluation tools: Secondary Traumatic Stress Inventory, Job Satisfaction Scale, Social Support Scale which measures four support sources (supervisors, coworkers, family, friends) and Cognitive Processing of Trauma Scale which allows to evaluate cognitive coping strategies (positive cognitive restructuring, downward comparison, resolution/acceptance, denial, regret) were used in the study. RESULTS: The results showed that the main predictor of STS symptoms in the studied group of medical personnel is job satisfaction. Two cognitive strategies also turned out to be predictors of STS, that is regret (positive relation) and resolution/acceptance (negative relation). The contribution of other analyzed variables, i.e., denial, workload and social support to explaining the dependent variable is rather small. CONCLUSIONS: Paramedics and nurses are at the high risk of indirect traumatic exposure and thus may be more prone to secondary traumatic stress symptoms development. It is important to include the medical personnel in the actions aiming at prevention and reduction of STS symptoms.

Rationing of Nursing Care and Professional Burnout Among Nurses Working in Cardiovascular Settings.

Introduction: Nursing needs close interpersonal contact with the patient and emotional involvement, therefore can contribute to professional burnout and rationing of nursing care. Aim: Assessing the relationship between the rationing of nursing care and professional burnout in nursing staff. Materials and Methods: The study included a group of 219 nurses working in cardiovascular facilities. This was a cross-sectional study designed to investigate the relationship between factors of the care rationing and professional burnout. The survey data was collected with standardised and research instruments such as the revised Basel Extent of Rationing of Nursing Care questionnaire (BERNCA-R) and the Maslach Burnout Inventory (MBI). Results: The total mean BERNCA-R score was 1.38 (SD = 0.62), while the total MBI score amounted to 38.14 (SD = 22.93). The specific components of professional burnout yielded the values: emotional exhaustion (M = 44.8), job dissatisfaction (M = 40.66), and depersonalisation (M = 28.95). Multiple linear regression showed that independent predictors of BERNCA-R score were emotional exhaustion, depersonalisation, job dissatisfaction, and multi-jobs activity (p < 0.001). Conclusion: The level of rationing of nursing care in cardiovascular facilities increases along with emotional exhaustion, depersonalisation and job dissatisfaction, and multi-jobs activity.

The Role of Satisfaction With Job and Cognitive Trauma Processing in the Occurrence of Secondary Traumatic Stress Symptoms in Medical Providers Working With Trauma Victims.

Introduction: As an occupational group, medical providers working with victims of trauma are prone to negative consequences of their work, particularly secondary traumatic stress (STS) symptoms. Various factors affect susceptibility to STS, including work-related and organizational determinants, as well as individual differences. The aim of the study was to establish the mediating role of cognitive trauma processing in the relationship between job satisfaction and STS symptoms among medical providers. Procedure and Participants: Results were obtained from 419 healthcare providers working with victims of trauma (218 nurses and 201 paramedics). Three questionnaires, namely the Secondary Traumatic Stress Inventory, Work Satisfaction Scale, and Cognitive Trauma Processing Scale, were used in the study, as well as a survey developed for this research. Correlational and mediation analyses were applied to assess relations between variables. Results: The results showed significant links between STS symptoms and both job satisfaction and cognitive processing of trauma. Three cognitive coping strategies play the intermediary role in the relationship between job satisfaction and symptoms of secondary traumatic stress. However, this role varies depending on preferred strategies. Conclusion: Nurses and paramedics are significantly exposed to the occurrence of STS. Thus, it is important to engage health care providers in activities aimed at preventing and reducing symptoms of STS.

Difficulties Perceived by ICU Nurses Providing End-of-Life Care: A Qualitative Study.

BACKGROUND: With advances in medicine and technology, intensive care units (ICUs) have the capacity to treat patients who would have previously not been expected to survive and would therefore not have been managed in ICUs. When an individual is not expected to survive, doctors and nurses face the modern ethical dilemma of death associated with withdrawal of life-supporting strategies. The aim of this study was to identify difficulties perceived by ICU nurses providing end-of-life care (EOLC) in Poland. METHODS: The qualitative study was designed to investigate the difficulties, and the related barriers, to EOLC provided in ICUs in Poland. We conducted individual telephone interviews with ICU nurses from across Poland. RESULTS: The main issues raised during the interviews included (1) barriers attributable to the hospital, (2) barriers related to the patient's family, and (3) barriers related to the ICU personnel providing direct EOLC. The interviewed nurses considered the lack of support from managers to be the main barrier. We found that ICU nurses in Poland dealt with end-of-life aspects that were emotionally and psychologically taxing. In addition, they lacked specialized training in this area, especially with regard to family care and care provision. CONCLUSIONS: A pressing need exists to improve facilities and make equipment ensuring a desirable standard of care more available. Specialized palliative care training programs should be incorporated into compulsory nursing curricula for ICU nurses.

The relationship between frailty syndrome and quality of life in older patients following acute coronary syndrome.

Purpose: Elderly patients with ST-segment-elevation myocardial infarction (STEMI) have a high risk of mortality, which is particularly high in the first 30 days. Quality of life (QoL) and risk-benefit assessments are of pivotal importance in the elderly. The objective of this study is to assess the relationship between frailty syndrome (FS) and QoL in patients following acute coronary syndrome (ACS) non-ST elevation myocardial infarction (NSTEMI). Patients and Methods: The study involved 100 patients (61 men, 39 women, the average age: M ± SD =66.12±10.92 years). The study used standardized research tools: a questionnaire to assess QoL (World Health Organization Quality of Life Scale Brief version), and a questionnaire to assess FS (Tilburg Frailty Indicator). Results: FS occurred in 80% of patients after ACS. FS has a negative impact on the QoL of patients with ACS. The most important domain of FS in the studied group was the psychological: M ± SD=2.2±0.75 points. The greater FS in the physical domain, the lower the QoL in all areas. The greater FS in the social domain, the lower the QoL in psychological and social fields. Self-evaluation of patient QoL was M ± SD=3.68±0.71 points. Self-assessment of health was M ± SD=2.59±0.98 points. Conclusion: Patients with a coexisting FS have a poorer QoL in the physical, psychological, social, and environmental fields. For a multidisciplinary team, these findings can help make the therapeutic decision for frail patients who have poor QoL. Frailty among elderly patients with ACS can be considered as a determinant of high risk of adverse outcomes.