PTSD Increasingly Concerning for Nurses

Nurses are particularly at risk for developing PTSD symptoms because of their indirect or direct exposure to traumatic situations during the course of their care to vulnerable patient populations.

A team, led by Michelle Schuster, MSN, RN, CPHON, Boston Children’s Hospital, examined the prevalence of PTSD in nurses and identified the associated factors based on existing literature.

The investigators conducted a literature of existing databases, with independent reviewers extracting data and performing quality assessments on the studies found.

The data analysis procedures consisted of data reduction, data display, data comparison, and conclusion drawing and verification. Overall, they found 24 articles that met their criteria for review.

The investigators found vastly different PTSD prevalence from the studies, likely because of the variability in measurements.

The 4 themes that emerged from the synthesis of factors influencing PTSD among nurses were: 'The Workplace Matters,' 'Relationships Matter,' 'It Hurts to Care,' and 'Interpersonal Strengths.'

The investigators concluded that the 4 themes captured a multitude of factors that occur across 3 different levels of influence—organization, interpersonal, and intrapersonal.

Mental health of frontline healthcare workers has been especially important recently, since the beginning of the coronavirus disease 2019 (COVID-19) pandemic.

Recently, a team, led by Chenxi Zhang, Nanfang Hospital, Southern Medical University, investigated the prevalence rate of insomnia and confirmed the related social psychological factors among medical staff members in hospitals during the COVID-19 pandemic.

Overall, the individuals with insomnia had significantly higher levels of depression than healthcare workers included in the study who did not suffer from insomnia (87.1% vs 31%). This was particularly true in moderate (22.9% vs 2.8%) and severe (16.7% vs 1.8%) cases.

Using a multiple binary logistic regression model, the investigators discovered insomnia symptoms are associated with the education level of high school or below (OR, 2.69; P = .042; 95% CI, 1.0-7.0), occupation of doctor (OR, 0.44; P = 0.44; 95% CI, 0.2-0.8), currently work in an isolation unit (OR, 1.71; P = .038; 95% CI, 1.0-2.8), and worry about being infected (OR, 2.30; P <.001; 95% CI, 1.6-3.4).

Insomnia was also linked to a perceived a lack of helpfulness in terms of psychological support from news or social media with regard to COVID-19 (OR, 2.10; P = .001; 95% CI, 1.3-3.3) and having very strong uncertainty regarding effective disease control )OR, 3.30; P = .013; 95% CI, 1.3-8.5).

The authors of the PTSD study concluded that multitargeted efforts directed at the organization, interpersonal, and intrapersonal factors identified could help mitigate the harmful impact of PTSD and promote nurse well-being.

“This integrative review highlights PTSD as a growing concern in the nursing profession,” the authors wrote. “The thematic analysis and associated subthemes provide a framework for the design of interventions to reduce the risk of PTSD symptom development among nurses working in inpatient settings.”

The study, “Post&#8208;traumatic stress disorder in nurses: An integrative review,” was published online in the Journal of Clinical Nursing.