Studying daily fluctuations of emotional effort among nurses of intensive care units: the establishment of latent profiles and its relationship with daily secondary traumatic stress and vitality.

Introduction: Nursing professionals working in Intensive Care Units (ICU) face significant challenges that can result in secondary traumatic stress (STS). These challenges stem from witnessing patients' suffering and managing difficult tasks (i.e. communication with patients' relatives). Furthermore, these professionals encounter emotional demands, such as emotional effort, which is the dissonance between the emotion felt and the emotion that should be expressed to meet work expectations. Consequently, we aimed to investigate whether different profiles exist concerning nurses' levels of emotional effort over a five-day period and whether these profiles are related to daily STS and vitality. Methods: The sample comprised 44 nursing professionals from ICUs in Spanish hospitals. They were assessed daily, using a package of questionnaires twice per day for five working days: a) immediately after their shift and b) at a later time after working. Results: The findings revealed three distinct profiles based on emotional effort levels: high (Profile 1), moderate (Profile 2), and low (Profile 3). These profiles were found to be negative predictors for both daily shattered assumptions and symptomatology. Discussion: This study underscores the importance of assessing daily emotional demands in an ICU setting. Such assessments are crucial for establishing preventive measures to help nursing professionals manage lower-level emotional demands.

Passionate healthcare workers in demanding intensive care units: its relationship with daily exhaustion, secondary traumatic stress, empathy, and self-compassion.

This study focuses on Intensive Care Units (ICU) and aims to test whether daily job demands are related to daily emotional exhaustion and secondary traumatic stress (STS) after work through the experience of passion at work and whether personal resources in ICU, such as empathy and self-compassion, moderate these relationships. A diary study was designed to assess day-level job demands, passion, empathy, self-compassion at work; and day-level emotional exhaustion and STS after work. The sample was 97 healthcare workers from ICU from different Spanish hospitals being selected by the snowball technique. This sample was assessed 5 days x two moments per day through a diary questionnaire. The multilevel analysis showed a negative mediational effect of harmonious passion between daily job demands and both emotional exhaustion and STS. Also, in predicting emotional exhaustion, a moderator effect of empathy on harmonious passion was found, as well as a moderator effect of self-compassion on obsessive passion. In predicting STS, a direct positive effect was found in empathy. Our findings highlight the vocational work of these healthcare workers, considering job demands as challenging and enhancing their harmonious passion to overcome the drawbacks. Moreover, empathy revealed to have a negative effect whereas self-compassion the contrary. Thus, increase the awareness on these personal resources and how to train them could be considered as valuable preventative measures.

Long-term effectiveness of a mindfulness based intervention (MBI) program for stuttering: a case study / La eficacia a largo plazo de un programa de intervención basada en la atención plena (MBI) para la tartamudez: un estudio de caso

A mindfulness-based intervention (MBI) to address emotional factors that may negatively impact the fluency of the subjects was implemented. A MBI consisting of 5 weekly 2-h sessions was designed and applied to two stuttering cases. The goals were to lower stuttering and to reduce anxiety through the acquisition of mindfulness skills. Participants were asked to video-record a speaking task and to fill out anxiety and mindfulness skills self-reports pre and post-intervention. Both participants diminished stuttering error rates from severe (participant 1) and moderate (participant 2) to mild. Participant 2, who showed high pre-treatment anxiety, showed a significant reduction. A year-follow-up revealed that therapeutic gains in anxiety, mindfulness skills, and stuttering were successfully maintained in both participants. This is the first study focused on emotional aspects of stuttering showing long-term improvements through a MBI. MBI programs could serve as a promising complement for stuttering treatments. (AU)

Se utilizó una intervención basada en mindfulness (MBI) para abordar los factores emocionales que pueden afectar negativamente a la fluidez de los sujetos a través de un estudio de caso. Se diseñó un MBI que constaba de 5 sesiones semanales de 2 horas y se aplicó a dos casos de tartamudez. Los objetivos eran dismunuir la tartamudez y reducir los síntomas de ansiedad mediante la adquisición de habilidades de atención plena. Se pidió a los participantes que grabaran en video una tarea oral y que cumplimentaran los autoinformes de ansiedad y de habilidades de atención plena antes y después de la intervención. En ambos participantes disminuyó el índice de errores de tartamudeo de grave (participante 1) y moderado (participante 2) a leve. El participante 2, que mostró una elevada ansiedad previa al tratamiento, mostró una reducción significativa. Al año de seguimiento los beneficios terapéuticos en ansiedad, habilidades de atención plena y tartamudeo se mantuvieron con éxito en ambos participantes. Se trata del primer estudio centrado en los aspectos emocionales de la tartamudez que muestra mejoras a largo plazo a través de un MBI. Por lo tanto, los programas MBI podrían servir como complemento prometedor a los tratamientos de tartamudez. (AU)

The Role of Healthcare Professionals' Passion in Predicting Secondary Traumatic Stress and Posttraumatic Growth in the Face of COVID-19: A Longitudinal Approach.

COVID-19 has increased the likelihood of healthcare professionals suffering from Secondary Traumatic Stress (STS). However, the difficulty of this crisis may lead these professionals to display personal resources, such as harmonious passion, that could be involved in posttraumatic growth. The goal of this study is to examine the STS and posttraumatic growth among healthcare professionals and the demands and resources related to COVID-19. A longitudinal study was carried out in April 2020 (T1) and December 2020 (T2). The participants were 172 health professionals from different health institutions and they reported their workload, fear of contagion, lack of staff and personal protection equipment (PPE), harmonious passion, STS and posttraumatic growth. The results revealed that workload and fear of contagion in T2 were positive predictors for STS, whereas harmonious passion was a negative predictor. Fear of contagion of both times seemed to positively predict posttraumatic growth, as well as harmonious passion. One moderation effect was found concerning the lack of staff/PPE, as posttraumatic growth was higher when the workload was high, especially in those with a high lack of staff/PPE. All in all, these findings pointed out the need for preventative measures to protect these professionals from long-term negative consequences.

The Job Demands and Resources Related to COVID-19 in Predicting Emotional Exhaustion and Secondary Traumatic Stress Among Health Professionals in Spain.

The current COVID-19 crisis may have an impact on the mental health of professionals working on the frontline, especially healthcare workers due to the increase of occupational psychosocial risks, such as emotional exhaustion and secondary traumatic stress (STS). This study explored job demands and resources during the COVID-19 crisis in predicting emotional exhaustion and STS among health professionals. The present study is a descriptive and correlational cross-sectional design, conducted in different hospitals and health centers in Spain. The sample consisted of 221 health professionals with direct involvement in treating COVID-19. An online survey was created and distributed nationwide from March 20 to April 15 which assessed: sociodemographic and occupational data, fear of contagion, contact with death/suffering, lack of material and human protection resources (MHRP), challenge, emotional exhaustion, and STS. Descriptive findings show high levels of workload, contact with death/suffering, lack of MHPR and challenge, and are moderately high for fear of contagion, emotional exhaustion, and STS. We found an indirect significant effect of lack of MHPR on predicting (1) emotional exhaustion through the workload and (2) on STS through fear of contagion, contact with death/suffering, and workload. To conclude, this study examines the immediate consequences of the crisis on health professionals' well-being in Spain, emphasizing the job demands related to COVID-19 that health professionals are facing, and the resources available in these health contexts. These findings may boost follow-up of this crisis among health professionals to prevent them from long-term consequences.

Pilot study of a brief psychological intervention for reducing emotional exhaustion and secondary traumatic stress among physicians of intensive care units in Mexico / Estudio piloto de una intervención psicológica breve para reducir el agotamiento emocional y el estrés traumático secundario en personal médico de las unidades de cuidados intensivos en México

Abstract Introduction Physicians of Intensive Care Units (ICU) have a potential risk to develop negative outcomes such as emotional exhaustion and secondary traumatic stress (STS). Specifically, job demands in these units (i.e., work stressors and emotional effort) may positively predict these outcomes, whereas personal resources such as harmonious passion and self-compassion may diminish them. Objetive To design a specific intervention for physicians in ICU and provide preliminary evidence of its effectiveness. Method A brief intervention of five weekly sessions (two hour-sessions) was carried out with four physicians in ICU in a hospital in Mexico. Other four physicians were selected as a control group. The intervention was aimed at reducing emotional exhaustion and STS by increasing harmonious passion and self-compassion, and diminishing the emotional effort. Results The intervention group showed a significant reduction in: a) work stressors (2/4 physicians; RCI = .21); emotional effort (1/4 physicians; (RCI = .60); emotional exhaustion (2/4 physicians; RCI = .34); and STS (3/4 physicians; RCI = .26). One physician experienced a significant increase in harmonious passion (RCI = 1.00), but the intervention seems to maintain high levels of this and self-compassion in comparison with the control group. The control group showed a worse result in its outcomes. Discussion and conclusion Despite the limitations, this study provides preliminary evidence for effectively reducing emotional exhaustion and STS. Our findings highlight the individual analysis of the effective tools per physician and address interventions focused on harmonious passion and self-compassion. This study calls for future research concerning intervention proposals in ICU with follow-up measures to diminish the negative consequences in the long-term.

Resumen Introducción Los médicos de las unidades de Cuidados Intensivos (UCI) presentan un riesgo de desarrollar agotamiento emocional y estrés traumático secundario (ETS). Las demandas laborales en estas unidades (estresores laborales y esfuerzo emocional) pueden predecir positivamente estos resultados, mientras que los recursos personales como la pasión armoniosa y la autocompasión pueden disminuirlos. Objetivo Diseñar una intervención específica para médicos de UCI y proporcionar evidencia preliminar de su efectividad. Método Se realizó una intervención de cinco sesiones semanales (de dos horas de duración cada una) con cuatro médicos de una UCI en un hospital de México. Otros cuatro médicos fueron seleccionados como grupo control. El objetivo fue reducir el agotamiento emocional y el ETS mediante el aumento la pasión armoniosa y la autocompasión; y la disminución del esfuerzo emocional. Resultados En el grupo de intervención se halló una disminución significativa en: a) estresores laborales (2/4 médicos; RCI = .21); esfuerzo emocional (1/4 médicos; RCI = .60); agotamiento emocional (2/4 médicos; RCI = .34); y ETS (3/4 médicos; RCI = .26). Un médico experimentó un aumento significativo en la pasión armoniosa (RCI = 1.00), en tanto que el resto mantuvo altos niveles de ésta y autocompasión en comparación con el grupo control. Discusión y conclusión A pesar de las limitaciones, este estudio proporciona evidencia preliminar para reducir el agotamiento emocional y el ETS. Nuestros hallazgos destacan el análisis individual de las herramientas efectivas y destaca las intervenciones centradas en la pasión armoniosa y la autocompasión. Nuestro estudio recalca la importancia de desarrollar investigaciones futuras sobre intervenciones en UCI con medidas de seguimiento que puedan disminuir las consecuencias negativas a largo plazo.

The Moderator Role of Passion for Work in the Association between Work Stressors and Secondary Traumatic Stress: A Cross-Level Diary Study among Health Professionals of Intensive Care Units.

BACKGROUND: Secondary traumatic stress (STS), a construct formed by compassion fatigue, shattered assumptions, and symptomatology, has been scarcely studied in intensive care units (ICU). In these units, healthcare workers encounter daily work stressors which impact on their health and well-being. Also, previous literature revealed a passion for caring among these workers, finding two types: harmonious passion, which may protect them against negative outcomes, and obsessive passion, which may boost negative consequences. We aim to study whether both types of passion could moderate the relationships between daily work stressors and STS. METHODS: In all, 265 assessments were collected at ICUs from different hospitals in Spain through a diary approach (53 health workers × 5 days at two time points per day). RESULTS: First, daily work stressors were positive predictors of symptomatology; secondly, dispositional harmonious passion was a negative predictor of both compassion fatigue and shattered assumptions, also presenting a buffering effect between daily work stressors and daily shattered assumptions. Finally, dispositional obsessive passion showed positive relationships with both shattered assumptions and symptomatology, also presenting a boosting effect between daily work stressors and daily symptomatology. CONCLUSIONS: This study allows us to deepen our understanding of STS in ICUs and to boost preventive proposals. Practical implications are discussed.