A Mixed-Method Study on the Assessment of Factors Influencing Nurses' Provision of Spiritual Care.

The purpose of this study was to explore factors that influence nurses' beliefs about offering spiritual care. STUDY DESIGN: A mixed-method study design, incorporating both quantitative (questionnaire) and qualitative research, was used for this study (focus group discussion). METHODS: The questionnaires were completed by a convenience sample of nurses and their assistants working in two public hospitals. These questionnaires included the Greek versions of the FACIT-Sp-12, SCIPS, NEO-FFI, and the Spiritual Climate Scale, as well as a specially designed questionnaire to gather demographic, socioeconomic, and professional information about the study population (SCS). Three nurses and two nursing assistants who worked in public hospitals and were chosen through purposive sampling made up the sample for the qualitative study. In utilizing inductive content analysis methodology, a qualitative analysis was carried out. RESULTS: Greek nurses frequently offer spiritual care to their patients, primarily existential spiritual care. It was discovered that the spiritual climate, the nurses' positive coherence, and their educational level all exert a favorable effect on total spiritual care. Three categories and seven subcategories were used to describe the participants' prior experiences with spiritual care. CONCLUSIONS: Greek nurses frequently offer spiritual care to their patients, and both internal and external factors influence their attitudes in this regard.

When the "Scytale" of Alcohol Runs in a Family and Alcohol Use Becomes a Transgenerational Issue: Case Report of a Father and Son Attending the Same Therapeutic Program.

Children whose parents are diagnosed with alcohol use problems are exposed to genetic and environmental risk factors and face a greater risk of developing mental health and behavioral problems and a higher risk of alcohol use. In this study, we present the case of a father and his son, both diagnosed with alcohol use disorder, who both attended, 12 years apart, the Inpatient Alcohol Treatment Program of the Alcohol Treatment Unit, in the Psychiatric Hospital of Attica, in Athens. The Alcohol Treatment Unit offers two inpatient treatment programs that have been operating since 1996 and are based on the principles of the Therapeutic Community. It was the first time that both a father and son coming from the same family attended one of these programs. The aim of this study is to extract useful information regarding the dynamics of a family in which alcohol dependence is transferred from generation to generation. Therapists try to decode this transference and interpret attitudes and behaviors under these circumstances.

Compassion Fatigue and Compassion Satisfaction in Pediatric Intensive Care Professionals.

Background: Paediatric ICU doctors and nurses' quality of professional life is influenced by the intense emotions and distress experienced when caring for suffering children and their families. Objective: The aim of this study was to examine the prevalence of compassion satisfaction (CS) and compassion fatigue (CF) in Paediatric Intensive Care Units in Greece. Methods: Out of 147 intensive care professionals in public hospitals in Greece completed the ProQOL-V scale as well as a socio-demographic and professional-life characteristics questionnaire. Results: Almost two thirds of participants reported medium-risk for CF (74.8%) while 23.1% and 76.9% of professionals expressed high or medium potential for CS respectively. More than half of doctors and nurses in paediatric ICUs report being overprotective towards members of the family as a result of their professional life and that their work-life affects their attitude towards life in general. Conclusion: Recognizing factors related to CF may support paediatric intensive care professionals in avoiding the costs of exposure to the trauma and loss experiences of patients and their families. A trauma-informed intensive care culture and continuing trauma-informed education may shield professionals from the erosive effects of lingering emotions which may trigger secondary traumatic stress symptoms and also facilitate adequate reflection on their emotional reactions in the landscape of intensive care.

Containment and therapeutic relationships in acute psychiatric care spaces: the symbolic dimensions of doors.

BACKGROUND: There is an increasing trend of door locking practices in acute psychiatric care. The aim of the present study was to illuminate the symbolic dimensions of doors in Greek mental health nurses' experiences of open and locked working spaces. RESULTS: A sequential mixed-method designexplored the experiences of nurses working in both open and locked psychiatric acute care units. Participants experiences revealed four types of doors related to the quality of recovery-oriented care: (a) the open door, (b) the invisible door, (c) the restraining door, and (d) the revolving door. Open doors and permeable spacesgenerated trust and facilitated the diffusion of tension and the necessary perception of feeling safe in order to be involved in therapeutic engagement. When the locked unit was experienced as a caring environment, the locked doors appeared to be "invisible". The restraining doors symbolized loss of control, social distance and stigma echoing the consequences of restrictingpeople's crucial control over spaceduring the COVID-19 pandemicin relation toviolence within families, groups and communities. The revolving door (service users' abscondence/re-admission) symbolised the rejection of the offered therapeutic environment and was a source of indignation and compassion fatigue in both open and locked spaces attributed to internal structural acute care characteristics (limited staffing levels, support, resources and activities for service users) as well as 'locked doors' in the community (limited or no care continuity and stigma). CONCLUSIONS: The impact of COVID-19 restrictions on people's crucial control of space provides an impetus for erecting barriers masked by the veil of habit and reconsidering the impact of the simple act of leaving the door open/locked to allow both psychiatric acute care unit staff and service users to reach their potential.

Wounded healers during the COVID-19 syndemic: Compassion fatigue and compassion satisfaction among nursing care providers in Greece.

PURPOSE: The aim of this study was to investigate compassion fatigue (CF) and compassion satisfaction (CS) in nursing care providers in COVID-19 units. METHODS: A mixed-method study with 105 nurses. RESULTS: 23% of participants reported high CF risk while 77% expressed high to moderate potential for CS. Adequate preparation/education, clear and accountable leadership, and team sharing of feelings, experiences, and responsibilities during the transition in the COVID-19 unit helped participants to deal with overwhelming anxiety which if unattended could bring about frustration and long-lasting feelings of powerlessness. PRACTICAL IMPLICATIONS: In the face of the present and future pandemics, there is a clear need to prepare healthcare organizations and nursing care providers to cope with the emotional content of public health emergencies while protecting themselves and avoid absorbing unmanageable emotions.

Compassion Fatigue and Compassion Satisfaction Among Addiction Nursing Care Providers in Greece: A Mixed Method Study Design.

ABSTRACT: The risk of compassion fatigue (CF) for professionals who support and care for individuals and families facing the dual burden of addiction and trauma has been recently recognized. The aim of this mixed methods study was to investigate CF/secondary traumatic stress and compassion satisfaction (CS) in addiction nursing care providers. The Professional Quality of Life Scale was distributed to 21 addiction nurses and 29 nurse assistants in the alcohol and drug dependency centers of a psychiatric hospital in Greece. High CF risk was reported in 22% of participants, whereas 46% expressed high-to-moderate potential for CS. Participants described the long transition from compassion frustration or disengagement at the beginning of their career to CS at later stages. Learning to be compassionate entailed finding the right distance, redefining therapeutic role and expectations, and containing feelings and experiences. Being able to experience CS involved getting satisfaction from small changes, personal and professional growth, and self-care. A compassionate organizational culture, clinical supervision, and ongoing education may protect addiction professionals from absorbing or internalizing unmanageable emotions, which may lead to CF and also help them to gain a deeper understanding of their communication and interactions with individuals fighting addiction.

Locked versus open ward environments and restrictive measures in acute psychiatry in Greece: Nursing students' attitudes and experiences.

PURPOSE: To examine student nurses' attitudes and experiences of door policies and restrictive measures in acute psychiatric care. METHODS: A mixed-method study with 274 third-year students. RESULTS: Participants' attitudes towards door locking and other containment measures appeared to be more a matter of custom, practice and tradition at particular units. The therapeutic benefits of open doors was the central organizing element in open units experiences while locked doors appeared to be "invisible" when the locked unit was perceived as a caring environment. PRACTICAL IMPLICATIONS: Exploring student nurses' attitudes towards crucial and debatable aspects of mental health practice contributes in cultivating a critical and analytical attitude towards the service they provide necessary for supporting a recovery mental health model and building a strong professional identity.

Secondary Posttraumatic Stress and Nurses' Emotional Responses to Patient's Trauma.

Alarmingly high percentages of secondary posttraumatic stress have been reported in several nursing domains such as critical care and emergency nursing, oncology, pediatric nursing, mental health nursing, and midwifery. The purpose of this review is to examine and describe nurses' emotional responses in the face of their exposure to patients' trauma. Lack of understanding of the dynamics of trauma may limit nurses' ability to interact in a meaningful and safe way with patients and their families. Spirituality can be a precious compass in the long-term journey of resolving feelings of grief and loss at work and of building a strong professional identity.

Changes in Professionals' Attitudes and Approaches to Parents in the Drug and Alcohol Treatment.

BACKGROUND: Parental involvement with drug and alcohol services remains limited. AIM: to illuminate changes in addiction professionals' subjective attitudes and approaches of parents over time in their career. METHODS: Overall, twenty seven drug and alcohol professionals participated in the study. RESULTS: Themes depicting changes on therapists' attitudes, beliefs and experiences of working with the families of their clients are 'Redefining therapeutic role and expectations', 'Increased understanding and acceptance', 'Finding the right distance in relationships', 'Ability to contain feelings and experiences', 'Being selective in collaborations with professionals', 'Empathy for coworkers and increased collaboration'. Therapists described their interaction with families of their clients in their earlier years of practice as a challenging and often overwhelming experience generating intense anger and frustration which sometimes led to acting outs and tempted them to give up their efforts to build an alliance with family members. Nevertheless, experience, clinical supervision and personal growth contributed in being gradually more capable in managing their emotional reactions, setting limits, having less and more realistic expectations from family members and finally providing the latter with the necessary experience of being understood. CONCLUSIONS: Overall, addiction therapists feel unprepared for meeting the challenging experience of collaborating with families in their earlier years of practice requiring educational support and clinical supervision. Further research is required on addiction professionals-parents alliance and countertransference issues.

Cultivating a Trauma Awareness Culture in the Addictions.

BACKGROUND: Research evidence points to the high prevalence of trauma exposure and post traumatic stress among addicted individuals, their families and the professionals responsible for their treatment. OBJECTIVE: The purpose of this review is to enhance understanding of the continuing effects of trauma and its impact on the lives of people with addiction problems as well as on the professionals who strive to provide support and care for them. METHOD: Review of twenty eight articles on traumatic experiences in individuals and families facing addiction problems as well as on traumatic stress in addiction professionals. Eligibility criteria were: publication in a peer-reviewed journal dating from 1990 to present; articles written in the English language; quantitative or qualitative design aiming to explore the lived experience of trauma and the recovery process from it. RESULTS: It is argued that for service providers to be able to help patients restore purpose and meaning in the recovery process, it is important to be aware of the trauma dynamics implicated in the long history of the addiction problems. Professionals' difficulty to process their emotions may lead to disengagement or overinvolvement and the adoption of maladaptive roles. Strong and unexpected emotional reactions in the professional may be a clue to the presence of masked trauma. CONCLUSION: Ongoing training on trauma dynamics, self-care and clinical supervision may deepen professionals' understanding of the impact of trauma on their work culture and protect them from the risk of secondary traumatic stress.