Prevalence and associated factors of secondary traumatic stress in emergency nurses: a systematic review and meta-analysis.

Background: Nurses in emergency departments are at a high risk of experiencing secondary traumatic stress because of their frequent exposure to trauma patients and high-stress environments.Objective: This systematic review and meta-analysis aimed to determine the overall prevalence of secondary traumatic stress among emergency nurses and to identify the contributing factors.Method: We conducted a systematic search for cross-sectional studies in databases such as PubMed, Web of Science, Embase, CINAHL, Wanfang Database, and China National Knowledge Internet up to October 21, 2023. The Joanna Briggs Institute's appraisal checklists for prevalence and analytical cross-sectional studies were used for quality assessment. Heterogeneity among studies was assessed using Cochrane's Q test and the I2 statistic. A random effects model was applied to estimate the pooled prevalence of secondary traumatic stress, and subgroup analyses were performed to explore sources of heterogeneity. Descriptive analysis summarized the associated factors.Results: Out of 345 articles retrieved, 14 met the inclusion criteria, with 11 reporting secondary traumatic stress prevalence. The pooled prevalence of secondary traumatic stress among emergency nurses was 65% (95% CI: 58%-73%). Subgroup analyses indicated the highest prevalence in Asia (74%, 95% CI: 72%-77%), followed by North America (59%, 95% CI: 49%-72%) and Europe (53%, 95% CI: 29%-95%). Nine studies identified associated factors, including personal, work-related, and social factors. In the subgroup of divided by recruitment period, emergency department nurses in the COVID-19 outbreak period had a higher prevalence of secondary traumatic stress (70%, 95% CI: 62%-78%).Conclusions: Secondary traumatic stress prevalence is notably high among emergency department nurses, with significant regional variations and period differences. The factors affecting secondary traumatic stress also varied across studies. Future research should focus on improving research designs and sample sizes to pinpoint risk factors and develop prevention strategies.Registration: PROSPERO CRD42022301167.

Secondary traumatic stress is considered an occupational hazard for nurses. Emergency department nurses, in particular, face a greater risk of secondary traumatic stress compared to other professions.While various studies have investigated the prevalence of secondary traumatic stress among these nurses, findings have been inconsistent.The pooled prevalence of secondary traumatic stress among emergency nurses is 65%. Subgroup analysis by region shows that Asia experiences the highest combined prevalence at 74%, with North America at 59% and Europe at 53%. Emergency department nurses in the COVID-19 outbreak period had a higher prevalence of secondary traumatic stress (70%, 95% CI: 62%­78%).

Post-traumatic stress in war veterans and secondary traumatic stress among parents of war veterans five years after the 2014 Israel-Gaza military conflict.

Secondary traumatic stress (STS) has been studied in therapists, spouses, and mainly in children of traumatised individuals. To date, the relationship between children's posttraumatic stress disorder (PTSD) symptoms and their parents' mental health outcomes have been understudied, and specifically, long term STS symptoms of parents of war veterans were not investigated. The current study examined PTSD symptoms among veterans of the 2014 Israel-Gaza war and STS among their parents, five years after the war. The control group consisted of veterans from combat military units who were on active duty at the time of the war but did not actively participate in the war (stand-by units) - providing a natural experiment condition. We found that PTSD symptoms were almost twice as high in the directly active war veterans (DAV, N = 32) group compared to the indirectly active war veterans (IAV, N = 26) group. Results showed that mothers had higher STS symptoms in general, and DAV PTSD symptoms correlated with their fathers STS symptoms. The current study provides novel evidence for: (a) subclinical PTSD symptoms in war veterans 5 years after the war, and (b) transmission of trauma from war veterans to their parents. The overall negative effect of sending a child to war on the parents are also discussed.

The current study examined post-traumatic stress symptoms among undiagnosed war veterans of the 2014­2014 Israel-Gaza Military Conflict compared to matched control who were on active military duty at the same time but did not actively participate in the war. We found higher post-traumatic stress symptoms in the veterans who actively participated in the war, roughly five years after the war.Parents of veterans who actively participated in the war exhibited higher secondary traumatic stress compared to parents of veterans who did not actively participate in the war. This is especially interesting given that parents of all veterans were not aware of their whereabouts during the war. Overall, mothers exhibited higher secondary traumatic stress compared to fathers. However, fathers were more 'in-sync' with their sons' traumatic experience as evident by a significant correlation between the war veterans' post-traumatic stress and the fathers' secondary traumatic stress symptoms.

Workplace humour, compassion, and professional quality of life among medical staff.

Background: Professional quality of life pertains to the balance between compassion fatigue and compassion satisfaction. In recent years, there was an increase in compassion fatigue among medical staff due to the pandemic, all over the world, while compassion satisfaction was reported at a moderate level.Objectives: The aim of this study was to identify the relationship between workplace humour and professional quality of life among medical staff, as well as the moderating role of compassion in this relationship.Method: The sample consisted of 189 participants (Mage = 41.01; SD = 9.58). Of the total sample, 57.1% are physicians, 32.3% are nurses and 6.9% are clinical psychologists. The participants completed scales measuring compassion, workplace humour, and professional quality of life.Results: The results showed that self-enhancing and affiliative humour were positively related, while self-defeating humour was negatively related to compassion satisfaction. Burnout and secondary traumatic stress were negatively related to self-enhancing humour and positively related to self-defeating humour. Compassion moderated the relationship between affiliative humour and secondary traumatic stress.Conclusions: Encouraging coping strategies based on adaptive humour (i.e. affiliative humour, self-enhancing) and raising awareness about negative humour strategies (i.e. self-defeating) could contribute to an increase of quality of life among healthcare providers. Another conclusion derived from the present study sustains that compassion is a valuable personal resource positively related to compassion satisfaction. Compassion also facilitates the relationship between affiliative humour and low secondary traumatic stress. Thus, encouraging compassionate skills could be beneficial for the optimal professional quality of life.

Self-enhancing and affiliative humour were positively related, while self-defeating humour was negatively related to compassion satisfaction.Burnout and secondary traumatic stress were negatively related to self-enhancing humour and positively related to self-defeating humour.Compassion moderated the relationship between affiliative humour and secondary traumatic stress.

Factors associated with secondary traumatic stress and burnout in neonatal care staff: A cross-sectional survey study.

INTRODUCTION: High rates of secondary traumatic stress and burnout have been found across nursing populations. However, few studies have focused on neonatal staff. OBJECTIVE: The objectives of this article are to explore the prevalence and severity of secondary traumatic stress (STS) and burnout in neonatal staff, and identify risk factors and protective factors for STS and burnout within this population with the aim of informing future staff support. METHODS: A quantitative, cross-sectional study using a survey design was conducted; 246 neonatal staff reported measures of STS, burnout, self-compassion and satisfaction with ward climate. RESULTS: Neonatal staff reported high rates of moderate-severe STS and burnout. STS and burnout were negatively associated with self-compassion and satisfaction with ward climate, suggesting them to be protective factors against STS and burnout. STS was found to be a risk factor for burnout and vice versa. CONCLUSION: Interventions that increase understanding of STS and burnout, nurture self-compassion, provide support and enhance stress management could help mitigate the impact of STS and burnout amongst neonatal staff.

Risk and protective factors of secondary traumatic stress in Intensive Care Units: An exploratory study in a hospital in Madrid (Spain). / Factores de riesgo y protección del estrés traumático secundario en los cuidados intensivos: un estudio exploratorio en un hospital terciario de Madrid.

AIM: To propose a predictive model of secondary traumatic stress. DESIGN: A descriptive cross-sectional study was carried out. CONTEXT: The study was conducted in the Intensive Care Units of a hospital in Madrid (Spain). PARTICIPANTS: The sample comprised 103 health professionals. INTERVENTIONS: A series of questionnaires were created and completed by the participants. Network analysis and multiple regression were used for data analysis. VARIABLES OF INTEREST: Sociodemographic variables such as gender, years of experience and position, secondary traumatic stress, passion for work, work stressors, emotional effort, empathy and self-compassion were evaluated. RESULTS: The result identified the following: a) years of experience as a risk factor for compassion fatigue (ß=0.224 and P=0.029), and harmonious passion as a protector (ß=-0.363 and P=0.001); b) emotional effort and empathy as risk factors for shattered assumptions (ß=0.304 and P=0.004; ß=0.394 and P=0.000, respectively); and c), work stressors and empathy as risk factors for symptomatology (ß=0.189 and P=0.039; ß=0.395 and P=0.000, respectively), and years of experience as a protector (ß=-0.266 and P=0.002). CONCLUSIONS: This predictive model of secondary traumatic stress identifies protective factors which could be reinforced, such as harmonious passion, and risk factors which should be reduced, such as empathy and emotional effort, with a view to promoting quality of care and quality of life among these professionals.

Estrés traumático secundario (ETS) en periodistas Mexicanos y defensores de derechos humanos / Secondary traumatic stress (STS) in Mexican journalists and human dights defenders

El objetivo del presente estudio descriptivo fue identificar la prevalencia de síntomas de estrés traumático secundario (ETS) en una muestra conjunta de periodistas mexicanos y defensores de derechos humanos (N igual 88), cuyo trabajo profesional demanda regularmente un contacto cercano con víctimas de violencia. Se encontró que 36.4 por ciento de los participantes presentaron sintomatología "alta” o “severa” de ETS. Sin embargo, no se ubicaron diferencias significativas entre ambos grupos. Por otra parte, las mujeres y quienes laboraban más de 40 horas a la semana, sí mostraron síntomas significativamente más altos. Los resultados de esta investigación transversal reflejan el considerable desgaste psicológico que pueden generar las exposiciones secundarias en profesionistas que documentan y establecen vínculos sistemáticos con personas traumatizadas por la violencia social en México.

The main goal of this descriptive study was to identify the prevalence of secondary traumatic stress (STS) symptoms in a pooled sample of Mexican journalists and human right defenders (N same 88), whose activities regularly demand a close contact with victims of violence. It was found that 36.4 percen of the participants presented “high” or “severe” STS symptoms. However, no significant differences between these groups of professionals were observed. Conversely, women and those who worked more than 40 hours a week presented significantly more severe symptoms. The results of this transversal investigation reflect the psychologic wear that these secondary exposures can generate in professionals who establish systematic links with subjects who have been traumatized by the social violence prevalent in modern Mexican society.

La evaluación del estrés traumático secundario: estudio comparado en bomberos y paramédicos de los Servicios de Emergencia de Guadalajara, México / Secondary traumatic stress assesment: compared study in firemen and paramedics in emergency services

El estrés traumático secundario, se refiere a un proceso por el cual "un individuo que observa el sufrimiento de otro, experimenta paralelamente las mismas respuestas emocionales a las emociones reales o esperadas de la otra persona", Moreno, Morante, Rodríguez & Garrosa (2004). A partir de esta noción, Moreno, Garrosa, Morante, Rodríguez & Losada (2004b) diseñaron el cuestionario de estrés traumático secundario (CETS). Se presenta un estudio comparado en dos muestras de bomberos y paramédicos con un total de 427 sujetos. Los paramédicos se percibieron con mayor presión social y mayor nivel de comprensibilidad, los bomberos con mayor percepción de sobrecarga laboral, mayor nivel de empatía y consecuencias sociales. Las mujeres se percibieron con mayor presión social en el trabajo y los hombres con mayor sobrecarga laboral y sentido del humor. Se reportan correlaciones entre las sub escalas del CETS, que confirman la relación entre las dimensiones de un modelo procesual desarrollado por Moreno, Morante, Rodríguez & Rodríguez (2008).

The concept of secondary traumatic stress refers to a process whereby "an individual who observes the suffering of another, parallel experience the same emotional responses to actual or anticipated emotions of another person," Moreno, Morante, Rodríguez & Garrosa (2004). Based in this model Moreno, Garrosa, Morante, Rodríguez & Losada (2004b) designed the secondary traumatic stress questionnaire (STSQ). This study presents a comparative study of secondary traumatic stress realized with 427 subjects divided in two samples of firefighters and emergency paramedics. Emergency paramedics perceived more social pressure and a higher level of comprehension, while firefighters had a higher perception of work overload, high level of empathy and social consequences. Gender differences show that women perceived more social pressure at work and men perceived more overload and sense of humor. Correlations between the subscales of STSQ, confirm the relationship between the dimensions of the process model developed by Moreno, Morante, Rodríguez & Rodríguez (2008).

Efectos de una intervención cognitivo-conductual en el aumento de conductas de autocuidado y disminución del estrés traumático secundario en psicólogos clínicos / Effects of a cognitive-behavioral treatment on the increase of self-care behaviors and decrease of secondary traumatic stress on clinical psychologists

En la presente investigación se evalúa la efectividad de un taller de autocuidado de orientación cognitivo conductual diseñado para ser aplicado a psicólogos clínicos con altos niveles de estrés traumático secundario. El objetivo del taller es aumentar la frecuencia de emisión de conductas de autocuidado y disminuir los niveles de estrés traumático secundario en los psicólogos. Mediante un diseño cuasi-experimental se evalúan los efectos del taller. Los resultados indican que, después de las 5 sesiones que dura el taller, los psicólogos que participaron en él (n=9) aumentaron significativamente sus conductas de autocuidado y disminuyeron significativamente sus niveles de desgaste. En cambio, los psicólogos que no participaron del taller (n=12) no variaron en la frecuencia del autocuidado y aumentaron el estrés traumático secundario. En virtud de estos resultados se concluye que el taller es efectivo y se constituye como una alternativa para prevenir y tratar el desgaste laboral en psicólogos clínicos.

In the present investigation, we evaluate the effectiveness of a group therapy program for self-care with cognitive-behavioral orientation, designed to be used on clinical psychologists with high levels of secondary traumatic stress. The object of this group therapy program is to increase the frequency of emissions of self-care behaviors and decrease the levels of secondary traumatic stress in psychologists. By a quasi-experimental design, we evaluate the group therapy program effects. The results indicate that, after 5 sessions that lasts the group therapy program, the psychologists that participated in it (n = 9) increased significantly their self-care behaviors and decreased significantly their secondary traumatic stress levels. Instead, the psychologists that did not participate in the group therapy program (n = 12) did not show variation on self-care frequency and they increased secondary traumatic stress. These results are conclusive that the group therapy program is effective and it represents an alternative to prevent and treat work related burnout in clinical psychologists.

Estrés traumático secundario en recursos humanos en salud: concepciones teóricas y presentación de estudio descriptivo en el Hospital Vilardebó / Secondary traumatic stress in human resources in health: theoretical conceptions and presentation of descriptive study in Vilardebó Hospital

El objetivo de la presentación es transmitir concepciones teóricas y conceptuales sobre el Estrés Traumático Secundario y presentar un estudio de prevalencia realizado con RHS del Hospital Vilardebó. El objetivo del estudio fue estimar la prevalencia del Estrés Traumático Secundario en los profesionales que desempeñan su actividad laboral en el Hospital Vilardebó y confirmar su relación con otros procesos psicológicos y estrategias conductuales descritas en la literatura científica como relevantes para su evolución. Para ello se desarrolló un estudio de campo basado en una metodología de encuesta con un diseño transversal. Los participantes fueron 82 trabajadores y el acceso a la muestra fue de tipo incidental, no probabilístico. Se encontró una prevalencia considerable de ETS entre los participantes en el estudio. Aproximadamente 4 de cada 10 participantes presenta alta frecuencia de conductas intrusivas, evitativas y de activación, propias ETS. En esta muestra, el porcentaje de mujeres con la afección fue más de cinco veces mayor que en los varones. Se confirmó la asociación de tipo negativo con el Mindfulness, la Separación Emocional, las Conductas de Autocuidado, el Recovery y Realización Personal. Por otra parte, se confirmaron relaciones positivas con la historia de trauma personal del trabajador, la frecuencia de exposición a contenidos traumáticos de los usuarios, los niveles de agotamiento emocional y despersonalización. Los autores sugieren tener en consideración las limitaciones del estudio a la hora de extrapolar las conclusiones a la población objetivo. Se plantean recomendaciones estratégicas a los administradores en RHS para el diseño de programas de intervención en salud que tengan en cuenta el desgaste producto de llevar a cabo actividades laborales con población traumatizada. Por otra parte, se considera fundamental continuar realizando estudios relacionados con el ETS tanto para estimar los niveles de prevalencia en los diferentes servicios de salud como para poder establecer relaciones de causalidad entre las variables y el desarrollo del fenómeno estudiado. (AU)