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Posttraumatic stress disorder (PTSD) is a pervasive issue within military populations, with approximately 29â¯% of post-9/11 service members experience PTSD at some point in their lifetime. One potentially important factor in PTSD development and treatment response is dysregulation of the stress response system stemming from exposure to multiple traumas and sustained operational stress associated with military training and deployment. In particular, the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, cortisol, is of particular interest to researchers examining physiological stress response in the context of mental health. Research exploring cortisol has been ongoing for decades, both to further understand its pathways and mechanisms, and to develop potential novel PTSD treatments. This paper provides a narrative review of some of the published literature examining cortisol's role in PTSD as a potential factor in development, maintenance, and treatment augmentation, with emphasis on military populations. The results of this review highlight the importance of exploring alterations to the stress response system, and cortisol in particular, for the evaluation and treatment of PTSD in the military, the need for more comprehensive work towards understanding development of these alterations through military training and service, and its impact on long-term PTSD outcomes.
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BACKGROUND: To prevent the infection from spreading, patients who were dying from COVID-19 were treated in isolation with restricted family access, which differed from existing end-of-life care procedures. This was a significant change that affected the care provided by nurses. OBJECTIVES: This study explored nurses' end-of-life care experiences in a limited family visitation setting during the COVID-19 pandemic. METHODS: A descriptive qualitative study was conducted. Data were collected through individual, in-depth, semistructured interviews with ten critical care nurses who provided end-of-life care to patients with COVID-19 in South Korea. The data were analysed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used to assess the study's rigour. FINDINGS: Three themes were identified: 'Witnessing patients' and families' heartbreak over separation', 'The gaps between the ideals and realities of end-of-life care', and 'Efforts to provide patients with a comfortable final journey'. Nurses realise the importance of their central role in supporting interactions between patients and families during end-of-life care. CONCLUSIONS: Family participation, facilitated by nurses' interest and efforts as mediators connecting patients and families, is essential for achieving high-quality care for inpatients facing end of life. This study is significant as it emphasises that the direction of end-of-life care should be family centric, even in a pandemic situation with limited family participation. To improve interaction between patients and families, creating an environment based on family participation that builds trust and strengthens communication is essential. Additionally, hospital support, such as professional education and counselling, should be provided to strengthen nurses' end-of-life care competency.
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Introduction: Nurses, who care for patients with various traumas, may also experience post-traumatic stress disorder due to indirect or direct exposure to traumatic situations. This study examined the effectiveness of an Internet-based trauma recovery intervention for Korean nurses. Methods: This randomized controlled trial was conducted with 112 nurses aged 23-40 years who were randomly assigned to the intervention (n = 56) or control group (n = 56) from May 7 to December 20, 2020. Nurses in the intervention group attended eight sessions, and the same intervention was administered to the control group. Repeated measures were collected at pre-test, post-test 1 (immediately after the intervention), and post-test 2 (4 weeks after the intervention). A total of 102 nurses (intervention group: n = 49; control group: n = 53) were completed because 10 nurses dropped out before the first session. Data were analyzed using the χ2 test, Fisher's exact test, t-test, Mann-Whitney U test, and repeated measures ANOVA (intention-to-treat and per protocol). Results: There were significant changes in functional health, resilience, post-traumatic stress, depressive symptoms, state anxiety, and trait anxiety over time and in the group-by-time interactions (intention-to-treat and per protocol). There was a significant difference in social support in the group-by-time interactions, but there were no significant changes between the two groups or over time (intention-to-treat and per protocol). Conclusion: The Internet-based trauma recovery nursing intervention is effective in clinical and community settings for nurses who cannot participate in fixed-schedule programs due to shift work. This study's findings are relevant for implementing Internet-based trauma recovery programs for nurses and the general population, including survivors and relatives of patients who suffered from COVID-19. This program will also be very useful for people in other high-stress situations. Nurse leaders should consider different populations and situations when offering effective coping strategies suitable for changing environments.
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BACKGROUND: Prenatal ultrasounds form an important part of routine maternity care in Australia and indeed internationally. The COVID-19 pandemic necessitated rapid changes in society and healthcare to curb transmission, with evidence demonstrating detrimental impacts on childbearing women associated with these restrictions. However, experiences with pandemic restrictions for prenatal ultrasounds in relation to distress, patient expectations, and satisfaction are largely unknown. This study aimed to explore the experiences of pregnant women attending prenatal ultrasound during the pandemic in Australia. METHODS: A cross-sectional online survey of people in Australia who had undergone at least one prenatal ultrasound during the period of maternity care restrictions was performed. The survey included validated tools for assessing post-traumatic stress, satisfaction, and expectations with maternity care. RESULTS: A total of 1280 responses were obtained. Almost 37% of respondents returned a PCL-C score consistent with probable post-traumatic stress disorder. Unexpected ultrasound findings or a high PCL-C score were more likely to have higher expectations and lower levels of satisfaction with their maternity care experience. Having an ultrasound for pregnancy loss, fetal abnormality, and/or a prior post-traumatic stress disorder diagnosis were the strongest factors correlating with a high PCL-C score. DISCUSSION: The prevalence of post-traumatic stress symptoms in the study population is concerning and elucidates the distress experienced in association with prenatal ultrasounds during pandemic restrictions in Australia. Maternity services should acknowledge the high levels of service consumers with post-trauma symptoms and consider trauma-responsive maternity care adaptations in response to adverse perinatal outcomes for those afflicted with post-trauma and distress-related symptoms.
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BACKGROUND: Past research has suggested a cross-sectional association between COVID-19-related discrimination and PTSD symptom severity. However, no cohort study has examined the longitudinal association that better supports causal interpretation. Also, even if such an association genuinely exists, the specific pathway remains unclear. METHODS: We conducted a two-year follow-up study, obtaining data from healthcare workers in a hospital setting. We first evaluated how COVID-19-related discrimination in 2021 was associated with subsequent PTSD symptom severity in 2023. Thereafter, we conducted causal mediation analysis to examine how this association was mediated by psychological distress in 2022, accounting for exposure-mediator interaction. Missing data were handled using random forest imputation. RESULTS: A total of 660 hospital staff were included. The fully adjusted model showed greater PTSD symptom severity in individuals who experienced any COVID-19-related discrimination compared with those without such experiences (ß, 0.44; 95% CI, 0.04-0.90). Regarding each type of discrimination, perceived discrimination was associated with greater PTSD symptom severity (ß, 0.52; 95% CI, 0.08-0.96), whereas verbal discrimination did not reach statistical significance. Psychological distress mediated 28.1%-38.8% of the observed associations. CONCLUSIONS: COVID-19-related discrimination is associated with subsequent PTSD symptom severity in healthcare workers. Psychological distress may serve as an important mediator, underscoring the potential need for interventions targeting this factor.
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COVID-19 , Personnel de santé , Détresse psychologique , Troubles de stress post-traumatique , Humains , COVID-19/psychologie , COVID-19/épidémiologie , Troubles de stress post-traumatique/psychologie , Troubles de stress post-traumatique/épidémiologie , Mâle , Femelle , Adulte , Études de suivi , Personnel de santé/psychologie , Personnel de santé/statistiques et données numériques , Adulte d'âge moyen , Indice de gravité de la maladie , Études transversalesRÉSUMÉ
Humans must identify others as enemies or allies to develop, protect, maintain, and refine their sense of self. This is a part of their normal psychological development. These phenomena operate on individual and large group levels and are pronounced under threat. In peril, they help create psychological boundaries between conflicting parties and bonds between allies. These boundaries and bonds are invested with strong emotions. The narcissism of minor differences concept is involved in identifying and delineating enemies at times of perceived danger. This article introduces the concept of the narcissism of minor resemblances. This concept is discussed from the psychodynamic perspective and illustrated with examples of socio-political developments from modern history. The narcissism of minor resemblances concept may help us understand the underlying dynamics of bonding with allies and identifying with others when undergoing threat and hardship. This concept connects the public arena of political action with individual psychological development. Awareness of this phenomenon can help mitigate the negative aspects of rigid enemy-ally distinctions and promote cooperation and peace. It may also help individuals impacted by psychological trauma to make meaning of psychological and societal processes experienced and contribute to their healing.
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Introduction: It has been suggested that the COVID-19 pandemic was a potentially traumatic occurrence that may have induced generalized anxiety and discomfort, particularly in susceptible populations like individuals with mental illnesses. The therapeutic approach known as eye movement desensitization and reprocessing (EMDR) has been shown to be successful in helping patients process traumatic events and restore wellbeing. Nevertheless, little is known about the precise processes through which EMDR fosters symptom recovery. Methods: In order to disentangle these issues, we conducted a randomized controlled trial (ClinicalTrials.gov Identifier NCT06110702) with 107 participants who were selected from university hospitals as a sample of investigation. Random assignments were applied to the participants in order to assign them to the experimental and control groups. The experimental group, but not the control group, underwent an 8-week EMDR intervention. Body perception, disgust, and emotions of guilt and shame, as well as mental contamination and posttraumatic and obsessive-compulsive symptoms, were investigated before and after the EMDR intervention. Results: The EMDR intervention was able to improve all of the variables investigated. Path analysis showed that body perception was able to predict both disgust and emotions of guilt and shame. Disgust was able to predict both mental contamination and obsessive-compulsive symptoms, while guilt and shame were able to predict post-traumatic symptoms. Conclusions: EMDR is an effective therapy for the treatment of post-traumatic and obsessive symptoms that acts through the promotion of improvement of the emotions of guilt/shame and disgust, respectively. Implications for clinical practice are examined. Clinical trial registration: https://www.clinicaltrials.gov, identifier NCT06110702.
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In pediatric primary care, incorporation of existing practice tools into screening for adverse childhood experiences (ACEs) may reduce screening barriers, promoting timely intervention on negative health impacts from childhood trauma. One such screening tool is the Bright Futures Previsit Questionnaire (PVQ). To evaluate the extent to which the PVQ may be used to screen for ACEs, this research aimed to map items related to ACEs from adolescent PVQs against adverse events historically identified as conventional and expanded ACEs. The adolescent PVQs mapped effectively to nine ACEs: adverse neighborhood experiences, bullying, emotional neglect, friend or family substance misuse, household safety, intimate partner violence, interpersonal violence, physical neglect, and sexual abuse. Universal ACE screening can be conducted using adolescent PVQs; however, issues remain regarding the reliability and validity of using the PVQs to identify ACEs, and some ACEs are not effectively assessed using adolescent PVQs.
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Rêves , Prazosine , Humains , Rêves/effets des médicaments et des substances chimiques , Rêves/psychologie , Mâle , Singapour , Adulte , Femelle , Prazosine/usage thérapeutique , Adulte d'âge moyen , Antagonistes des récepteurs alpha-1 adrénergiques/usage thérapeutique , Troubles de stress post-traumatique/traitement médicamenteux , Troubles de stress post-traumatique/psychologie , Jeune adulteRÉSUMÉ
Functional neurological disorder is a condition in which a person experiences physical symptoms that cannot be fully explained by a medical condition. In Pakistan, domestic violence as well as emotional, physical and sexual abuse in children are prevalent. Despite legal and social support for victims, stigmatisation regarding seeking psychological help complicates the challenge. Some of the research culminated that patients with neurological disorder reported high level of sexual abuse and trauma. The symptomatology of functional neurological disorder is being ignored in Asian countries due to indigenous factors like poverty, lack of information on reporting abuse, poor law-enforcement and victim blaming. Functional neurological disorder can be manifested in various ways in the human body, such as blindness, paralysis, dystonia, swallowing difficulties, difficulty walking, motor symptoms affecting limbs, voice production, problems in sensory functions, problems in cognitive function, psychogenic non-epileptic seizures and even dementia, whereas differential diagnosis is established after screening for organicity. The common risk factors of functional neurological disorder may include psychosocial stressors, family history of functional neurological disorder, and significant life changes. It is critical to understand the disorder in reference to predisposing risk factors, cultural context, comorbidities and gender specification to diagnose and treat functional neurological disorder in time so that better intervention protocols could be devised to treat it efficiently.
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Trouble de conversion , Humains , Pakistan/épidémiologie , Enfant , Trouble de conversion/psychologie , Maladies du système nerveux/psychologie , Maltraitance des enfants/psychologie , Facteurs de risqueRÉSUMÉ
BACKGROUND: The relationship between suicidality and resilience is underexplored among the general population. This study aimed to explore the relationship between lifetime, one-year, and one-month prevalence of suicidality (ideation, plan, attempt) and resilience in the general population. METHODS: Data on suicidality, resilience, prevalence of major mental disorders, and other key psychological factors were collected from the National Mental Health Survey of Korea 2021. Interviewees comprised 5511 South Koreans aged 18-79 years. The contribution of resilience to suicidality was evaluated using Rao-Scot logistic regression, adjusting for possible confounders such as mental disorder prevalence and demographic and psychological characteristics. RESULTS: Significantly lower resilience levels were noted among participants who reported lifetime, one-year, and one-month suicidal ideation, plan, or attempts. High resilience levels predicted no suicidal ideation, plans, and attempts in the lifetime, and no suicidal ideation and plans in the one-year and one-month time frames. LIMITATIONS: First, this study's cross-sectional design has limitations for ascertaining a causal relationship between resilience and suicidality. Second, because the number of participants who had attempted suicide in the past year and reported suicidal thoughts/attempts in the past month was small, there were limitations in the analysis of suicidality in these time frames. Third, it was difficult to rule out the mediating effects of personality and temperament on the relationship between resilience and suicidality. CONCLUSIONS: High resilience levels predicted lower lifetime and current suicidal ideation and suicidal planning in the general population. This study shows that psychological resilience is an important factor in evaluating an individual's current suicidality.
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Enquêtes de santé , Résilience psychologique , Idéation suicidaire , Tentative de suicide , Humains , Adulte , République de Corée/épidémiologie , Adulte d'âge moyen , Mâle , Femelle , Études transversales , Adolescent , Sujet âgé , Tentative de suicide/statistiques et données numériques , Tentative de suicide/psychologie , Jeune adulte , Prévalence , Troubles mentaux/épidémiologie , Troubles mentaux/psychologie , Santé mentale , Suicide/statistiques et données numériques , Suicide/psychologieRÉSUMÉ
Despite the growing incidence of burn injuries globally and the advancements in physical recovery, the psychological aspect of burn trauma recovery remains inadequately addressed. This review aims to consolidate existing literature posttraumatic stress disorder (PTSD) and depression in adult burn survivors, recognizing the need for a holistic approach to burn recovery that encompasses both physical and mental health. The comprehensive analysis of 156 studies revealed significant variations in methodological approaches, leading to challenges in creating standardized protocols for mental health assessment in burn care. Key findings include the identification of a wide range of psychological assessment tools and a substantial research gap in low and middle-income countries, where the majority of burn injuries occur. Only 7.0% of the studies assessed interventions for PTSD or depression, indicating a lack of focus on treatment modalities. The studies identified demographic factors, patient history, psychosocial factors, burn injury characteristics, and treatment course as risk factors for PTSD and depression post-burn injury. The review highlights the need for early screening, intervention, and attention to subjective experiences related to burn injury, as these are strong predictors of long-term psychological distress. It also emphasizes the complexity of addressing psychological distress in burn survivors and the need for more standardized practices in assessing PTSD and depression specific to this population.
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OBJECTIVE: Previous studies investigated the varying prevalence of post-epileptic seizure posttraumatic stress disorder (PS-PTSD). The current study aimed first to compare the profiles of patients with and without PS-PTSD and, second, to study the interaction between other past traumatic experiences, subjective ictal anxiety, psychiatric comorbidities, and PS-PTSD in people with epilepsy (PWE). METHODS: We conducted an observational study, investigating past traumatic experiences and PS-PTSD through standardized scales (CTQ-28, LEC-5 and PCL-5). We used semi-structured interviews and validated psychometric scales (NDDIE for depression and GAD-7 for anxiety) to collect data on general psychiatric comorbidities. We also assessed epilepsy specific psychiatric symptoms (interictal and peri-ictal). We performed a mediation analysis through PROCESS for SPSS to evaluate the effect of history of past trauma and subjective ictal anxiety on PS-PTSD through interictal depression and anxiety symptoms. RESULTS: We enrolled 135 PWE, including 35 patients with PS-PTSD (29.5 %). Patients with PS-PTSD had significantly higher depression (12.87 vs 10; p = 0.005) and anxiety (7.74 vs 5.01; p = 0.027) scores and higher prevalence of peri-ictal psychiatric symptoms, compared to patients without PS-PTSD. The relationship between other past traumatic experiences and PS-PTSD was totally mediated by interictal depression and anxiety. We found a significant indirect effect of interictal anxiety symptoms on the path between subjective ictal anxiety and PS-PTSD. SIGNIFICANCE: Our results showed that patients with PS-PTSD have a more severe psychopathological profile (more peri ictal and inter ictal depressive and anxiety symptoms). Both inter ictal and subjective ictal anxiety appear to have a significant role in PS-PTSD.
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Anxiété , Crises épileptiques , Troubles de stress post-traumatique , Humains , Mâle , Femelle , Troubles de stress post-traumatique/psychologie , Troubles de stress post-traumatique/épidémiologie , Adulte , Adulte d'âge moyen , Crises épileptiques/psychologie , Crises épileptiques/complications , Anxiété/étiologie , Anxiété/psychologie , Anxiété/épidémiologie , Dépression/étiologie , Dépression/psychologie , Analyse de médiation , Épilepsie/psychologie , Épilepsie/complications , Épilepsie/épidémiologie , Échelles d'évaluation en psychiatrie , Jeune adulte , ComorbiditéRÉSUMÉ
BACKGROUND: Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. METHOD: This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. RESULTS: Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). CONCLUSIONS: Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS.
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BACKGROUND: Healthcare workers (HCW; e.g., nurses, social workers) work in stressful conditions, a situation that has been further exacerbated by the COVID-19 pandemic. A review of the supportive role of Psychological first aid (PFA) suggested that it can protect HCW from psychological distress. Despite the growing interest of PFA among public health organizations, there is a dearth of literature on its potential impact for the psychological well-being of HCW and its implementation within organizations. OBJECTIVE: This study aimed to evaluate whether PFA met the psychological needs of HCW in Montreal, Quebec. METHODS: A sample of 15 HCW who received PFA by a peer within their organization were recruited to participate in semi-structured interviews. Qualitative research using thematic analysis was conducted. RESULTS: Five themes were identified: 1) PFA satisfied participants' psychosocial needs; 2) PFA provided by peers allowed participants to feel understood and supported; 3) High availability and multiple modalities facilitated PFA access; 4) Occupational and organizational cultures hindered PFA access; and 5) Recommendations to promote the use of the PFA service. CONCLUSION: Results describe four psychosocial needs met by the PFA intervention: to have resources/strategies, to be validated, to obtain a better understanding of the psychological reactions they were experiencing, and to be guided and supported in their difficulties at work. Overall, these findings illustrate how PFA goes beyond the reduction of distress symptoms in the aftermath of a potentially traumatic event. The relevance to further the assessment of PFA's positive effects on psychological adaptation and/or recovery is also highlighted.
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This school program evaluation aims to highlight the mental health needs of students in special education with behavioral and emotional challenges and describe the implementation of a resilience curriculum with this population. We evaluated district mental health data from a convenience sample of 814 students in grades 5-12 special education to identify risk for mental health symptoms, violence exposure, and substance use. School social workers provided feedback on the implementation of the resilience curriculum to inform program evaluation. Students reported significant risk for traumatic stress, anxiety, and depressive symptoms, and high rates of violence exposure and substance use. School social workers described adaptations to the resilience curriculum and gave recommendations for future implementation. Students receiving special education services for behavioral and emotional challenges had high mental health need, including high rates of violence exposure, and may benefit from a trauma-informed school-based resilience curriculum adapted for their needs.
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Programme d'études , Enseignement spécialisé , Résilience psychologique , Humains , Mâle , Femelle , Adolescent , Enfant , Étudiants/psychologie , Évaluation de programmeRÉSUMÉ
OBJECTIVE: It is widely acknowledged that emotional states can influence skin conditions, yet limited research has delved into the impact of stress on skin cancer development. This retrospective study sought to expand the perspective on skin cancer risk factors by investigating the complex relationship between stressful life events and the incidence of skin cancer. METHODS: The sample included 268 individuals followed-up in a dermatological clinic, in three groups: Patients who had previously been diagnosed with cutaneous melanoma and are currently in remission (32%), those who had been diagnosed with non-melanoma skin cancer (30%), and a control group who are at risk for skin cancer (38%). Participants filled in questionnaires regarding childhood and adulthood life events, and loss and gain of resources following their subjectively most stressful event in adulthood. Multinomial logistic regression was used to examine the associations of life events with skin cancer occurrence, and mediating and moderating effects of resource loss/gain. RESULTS: Adverse childhood experiences were associated with melanoma occurrence, with the melanoma group reporting significantly more such experiences compared to the control group (p < 0.001). Resource loss from subjectively significant stressful life events in adulthood partially mediated the association between adverse childhood experiences and melanoma incidence. CONCLUSIONS: The findings suggest that there may be intricate connections between stress, life events, adaptation to change, and skin cancer, which future research may further unravel. This study underscores the need for a more comprehensive approach to stress management, coping strategies development, and skin cancer prevention in healthcare settings.
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Événements de vie , Mélanome , Tumeurs cutanées , Stress psychologique , Humains , Femelle , Mâle , Tumeurs cutanées/épidémiologie , Tumeurs cutanées/psychologie , Adulte d'âge moyen , Stress psychologique/épidémiologie , Stress psychologique/psychologie , Mélanome/épidémiologie , Mélanome/psychologie , Études rétrospectives , Adulte , Sujet âgé , Enquêtes et questionnaires , Incidence , Facteurs de risque , Adaptation psychologique , Expériences défavorables de l'enfance/statistiques et données numériquesRÉSUMÉ
BACKGROUND: The International Trauma Questionnaire (ITQ) is used to measure posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) symptoms, and the Posttraumatic Cognitions Inventory-9 (PTCI-9) is used to measure posttraumatic cognitions. Both tools have been translated for use in Brazil. However, the psychometric properties of the Brazilian versions were not investigated, and no study has verified the invariance of these tools for many traumatic event types. OBJECTIVE: This study examined the validity, reliability, and measurement invariance of the Brazilian versions of the ITQ and the PTCI-9 for trauma type, gender, race, age group, education level, and geographical region. METHODS: A total of 2,111 people (67.74% women) participated in an online survey. The scale models were tested via confirmatory factor analyses and measurement invariance through multigroup analyses. Pearson's correlation analyses were used to examine the relationships between PTSD, CPTSD, posttraumatic cognitions, and depressive symptoms. RESULTS: Except for the affective dysregulation factor, the reliabilities of the ITQ and PTCI-9 dimensions were adequate. Models with six correlated dimensions for the ITQ and three correlated dimensions for the PTCI-9 showed adequate fit to the data. The ITQ and PTCI-9 exhibited scalar invariance for gender, race, age group, education level, and geographical region. The ITQ also demonstrated full invariance for trauma type. The factors of both instruments were related to each other and to depressive symptoms, with higher effect sizes for posttraumatic cognitions and complex posttraumatic stress disorder symptoms. CONCLUSION: We recommend using the Brazilian versions of the ITQ and PTCI-9, which are crucial tools for assessing and treating trauma-related disorders.
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AIM: To facilitate an understanding of the risk for psychological trauma in labour and delivery nurses. DESIGN: Concept analysis. METHODS: The Walker and Avant method of concept analysis was applied to 56 articles. The characteristics, antecedents, and consequences of psychological trauma in labour and delivery nurses were identified. DATA SOURCES: Peer-reviewed articles in English from CINAHL, PubMed and Google Scholar were reviewed on July 2023. RESULTS: The characteristics of psychological trauma in labour and delivery nurses are overwhelming distress, intrusive symptoms, avoidance and numbing behaviours, hypervigilance or hyperarousal, emotional dysregulation, cognitive distortions, and interpersonal challenges. The antecedents are exposure to one or more of the following nurse-specific traumas: natural or person-made disasters, historical role limitations, second victim situations, secondary trauma, system-mediated or over-medicalized care, insufficient resources, or workplace incivility. The consequences are disruptions in mental health, diminished physical health, alterations in relationships, and variable work performance. CONCLUSION: Labour and delivery nurses experience unique causes of psychological trauma due to their practice environment and patient population. The consequences of labour and delivery nurses' psychological trauma extend beyond individual health and impact the quality of patient care and organizational capacity. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Furthermore, research is needed to inform education, support and policy measures to mitigate harm effectively. WHAT PROBLEM DID THE STUDY ADDRESS?: Nurse-specific trauma theory has not been applied to the unique labour and delivery environment with a high incidence of patient trauma. WHAT WERE THE MAIN FINDINGS?: Multiple causes of trauma in the perinatal context have created a pervasive yet largely preventable issue. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This research will impact labour and delivery nurses, their leadership, and their patients. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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BACKGROUND: Student nurses often do not receive adequate preparation, support, and debriefing related to witnessing or experiencing critical events in the clinical setting. PURPOSE: The purpose of this analysis was to describe the experiences of student nurses who have witnessed critical events in the clinical setting, the support and preparation they received, and staff and faculty actions they perceived as facilitating or hindering their processing of the event. METHODS: This is a sub-analysis of a Straussian Grounded Theory qualitative study. RESULTS: Staff and faculty actions that helped and hindered the processing of the critical event were identified at four time points: pre-event, during the critical event, immediately post-event, and in the days and weeks following. CONCLUSIONS: Students exposed to critical events during their clinical rotations can experience psychological trauma. If unresolved, this can result in new nurses entering the profession already in distress. Preparation and support for witnessing critical patient events should start at the beginning of nursing school. During critical patient events, students need faculty or staff to be actively present to explain the event and support the student throughout the event. Immediate debrief and follow-up is recommended and should continue weeks or months after the event.