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.

Freeing the performer's mind: A network analysis of music performance anxiety, negative affect, self-consciousness and mindfulness among music performers.

Music performance anxiety (MPA) is a common damaging phenomenon in musicians' careers. Mindfulness stands as a promising construct to prevent MPA. However, the relationships between mindfulness and MPA are scarcely explored, alongside other relevant attention-based (e.g., self-consciousness) or emotion-based constructs (e.g., negative affect). This study explores the relationships between these constructs. A sample of 151 musicians was assessed to explore the relationships between these constructs. Self-reports of mindfulness, MPA, negative affect, and self-consciousness were applied. We implemented network analysis following a general (second-order) and specific (first-order) framework. Networks showed dispositional mindfulness as negatively associated with negative affect and MPA in both general and facet levels, while mindfulness in past performances was only negatively associated with negative affect. MPA was positively associated with negative affect and self-consciousness. Mindfulness displayed light or no associations with self-consciousness. Therefore, mindfulness seems to be a relevant construct toward MPA. We propose a preliminary model to improve mindfulness research and interventions applied to music performers. We also outline limitations and future directions.

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.

Satisfied as professionals, but also exhausted and worried!!: The role of job demands, resources and emotional experiences of Spanish nursing home workers during the COVID-19 pandemic.

Nursing home workers have been exposed to great physical and mental burdens during the COVID-19 pandemic. Although this has generated high levels of exhaustion, it may also have contributed to feelings of professional satisfaction. The objective of this study was to explore the levels of satisfaction among nursing home workers during the COVID-19 pandemic, as well as the role of job demands, resources and emotional experiences in explaining their levels of satisfaction. This cross-sectional study was conducted in Spain between March and May 2020. Three hundred and thirty-five nursing home workers participated. A quantitative analysis was conducted, as was a content analysis of the responses to an open-ended question about the respondents' perceptions of job demands and resources during the crisis. The results showed that workers had very high levels of satisfaction. Social pressure from work, contact with death and suffering, and emotional exhaustion were negatively associated with satisfaction. Moreover, under conditions of extensive contact with suffering people and great fear of contagion, social support at work was shown to promote professional satisfaction. In conclusion, nursing home workers in Spain experienced high rates of satisfaction during the COVID-19 crisis despite the high job demands, lack of job resources, fear of contagion and exhaustion. The main practical implication of this study is the importance of ensuring optimal working conditions in the nursing home sector in order to guarantee professional satisfaction, prevent burnout, reduce turnover and promote post-crisis resilience.

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.

Daily Work-Family Conflict and Burnout to Explain the Leaving Intentions and Vitality Levels of Healthcare Workers: Interactive Effects Using an Experience-Sampling Method.

There is an intensification of work in global health systems, a phenomenon that could increase work-family conflict, exhaustion, and intentions to leave among healthcare workers. The main objective of this study is to analyze if daily work-family conflict and burnout could explain the daily leaving intentions and vitality of healthcare workers. This is a diary study, which employs an experience-sampling methodology (ESM). A total of 56 physicians, nurses, and nursing aides from intensive care and nephrology units filled out various quantitative scales during 5 working days (56 × 5 = 280 observations). Multilevel hierarchical analysis showed that daily work-family conflict and burnout were significantly associated with higher daily intentions of leaving the profession, and with lower levels of daily vitality. In addition, those workers who experienced more work-family conflict and depersonalization on a daily basis were those who showed more intentions to leave and less daily vitality, showing an interactive effect. The results highlight the importance of examining the psychosocial risks experienced by healthcare workers by employing experience-sampling methodologies, which could help us to deepen our understanding of the proximal antecedents of their intentions to leave and their psychological well-being.

Overwhelmed by Emotional Job Demands in High Vigor Days! Its Detrimental Effects on Daily Recovery from Work among Health-Care Workers.

The objective of this study is twofold: first, to analyze whether the daily level of energy in terms of vigor at work could explain the way in which workers psychologically detach from their work, relax, practice challenging activities, and have the feeling of having control over their leisure time when arriving home. Second, to check if the daily emotional job demands could hinder that relationship, reversing the positive effect of vigor in recovery. For this purpose, a multilevel study with a diary methodology was designed. In total, 94 nurses from various hospital and primary care centers in Madrid and Basque Country (Spain) participated in this study. They completed daily questionnaires twice a day (in the afternoon after work and at night before going to bed) for five consecutive workdays from Monday to Friday (N = 94*5 = 470). The results revealed that on days that vigor at work was high, nurses experienced more psychological detachment, relaxation, feelings of mastery, and time control at home. Moreover, on days that emotional job demands were high, vigor was more negatively related to psychological detachment and time control at home. Additionally, vigor was more positively related to all recovery experiences at home in days that emotional demands were low. Therefore, daily vigor can act as an energy resource that helps the worker to recover. However, this effect can occur in situations in which stressors are not present in high intensity. These results have clear practical implications for both health organizations and workers.

Stressors, Job Resources, Fear of Contagion, and Secondary Traumatic Stress Among Nursing Home Workers in Face of the COVID-19: The Case of Spain.

This study aimed to analyze the psychological consequences of the COVID-19 pandemic on nursing home workers, as well as the influence of certain related stressors and job resources. Two-hundred twenty-eight nursing home workers in Spain participated in this cross-sectional study. High levels of workload, social pressure from work, contact with suffering, and fear of contagion were found. In nursing homes where cases of COVID-19 had been detected, workers experienced higher levels of secondary traumatic stress. Social pressure from work, high doses of exposure to suffering, lack of personnel and personal protective equipment, and minimal supervisor support were significant in explaining traumatic stress. Supervisor and coworker support moderated some of these relationships. The results are discussed in terms of the need to implement urgent psychosocial protection strategies and to provide personal protective equipment (PPE) to help prevent future psychological disorders in this worker population.

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.