The mediating role of social support on the relationship between secondary traumatic stress and burnout of nurses caring for COVID-19 patients: A cross-sectional study.

Social support can help nurses cope with occupational stress and trauma, and maintain overall well-being, particularly in stressful situations such as outbreaks. To determine the mediating role of social support on the relationship between secondary traumatic stress (STS) and burnout among nurses who cared for COVID-19 patients. A cross-sectional, correlational, descriptive design. Two hundred nurses who had provided direct care to COVID-19 patients were recruited from wards in two hospitals in Riyadh, Saudi Arabia. Data were collected using the Multidimensional Scale of Perceived Social Support and the Professional Quality of Life Scale tools. STS had a significant and positive correlation with burnout (r = 0.610, p = 0.000); social support from family, friends, and significant others were each significantly and negatively associated with STS (r = -0.147, p = 0.038; r = -0.547, p < 0.0001; r = -0.225, p = 0.001, respectively) and burnout (r = 0-0.282, p < 0.0001; r = -0.716, p = 0.026; r = -0.377, p < 0.0001, respectively). STS had a significant effect on social support (β = -0.21, p = 0.042) and burnout (β = 0.61, p < 0.0001). Social support had a significant and partial effect on the relationship between STS and burnout (Z = 2.99, p = 0.002). Social support can reduce and mitigate the negative effects of STS and burnout. This understanding could enhance nurses' occupational lives by assisting policymakers and nurse managers in creating positive work environments that promote social support. Such policies could reduce the incidence and impact of burnout and STS.

Shaqiqi W ，Abou El-Soud FA 《-》

The threat of COVID-19 and its influence on nursing staff burnout.

To evaluate whether the perceived threat of COVID-19 moderates the influence of work resources and demands on burnout. A cross-sectional study. We used a convenience sample of 771 nurses working in 10 hospitals in northern Spain. The data on burnout, demand, and resources at work and the perceived threat of COVID-19 were compiled in the second fortnight of April 2020 using an online questionnaire. We used several hierarchical linear regression models. Work overload, material and human resources and social support at work were significant in explaining burnout. The perceived threat of COVID-19 variable was also significant and presented the highest regression coefficient (β = 0.392). The perceived threat of COVID-19 moderated the relationship between social support at work and burnout. The perceived threat of COVID-19 helped to explain the degree of burnout in nurses and moderated the relationship between social support at work and burnout. Hospitals should implement strategies to ensure that health emergency situations are not perceived as a threat. In pandemics, the organization should maintain clear, fluid, and regular communication with the nursing staff, which would help increase staff members' confidence and sense of control.

Manzano García G ，Ayala Calvo JC 《-》

Burnout and perceived social support: The mediating role of secondary traumatization in nurses vs. physicians.

The study aimed to examine differences between paediatric nurses and physicians regarding burnout syndrome, secondary traumatic stress (STS) and perceived social support (PSS). Paediatric nurses and physicians encounter cumulative effects of treating sick and injured children and helping their families, in situations that might promote burnout and STS. Cross-sectional design. Nurses (n = 158) and physicians (N = 76) completed self-report questionnaires on STS, PSS and burnout. Nurses and physicians had similar rates of STS and burnout but showed significant differences in PSS. Furthermore, STS mediated the association between PSS and burnout for both groups; however, the effect was stronger for nurses in comparison to physicians. Paediatric nurses and physicians would benefit from participating in interventions geared towards reducing STS, thus minimizing burnout. Moreover, advocating social support within the organization is needed to bolster the ability for coping with sources of stress. Nurses' and physicians' involvement in the physical, physiological and mental needs of their paediatric patients might lead to burnout and secondary traumatic stress (STS). However, research on social support in the context of burnout and STS among nurses and physicians is scant. Secondary traumatic stress and burnout were similar for nurses and physicians, though perceived social support (PSS) was higher for nurses. Secondary traumatic stress plays a mediating role in the association between PSS and burnout among nurses and physicians. However, the mediation effect was stronger for nurses. Policy makers would be wise to advocate institutional stress management interventions to reduce secondary traumatic and to reinforce organizational support for nurses and physicians.

Hamama L ，Hamama-Raz Y ，Stokar YN ，Pat-Horenczyk R ，Brom D ，Bron-Harlev E ... -  《-》

Caring through crisis: The professional quality of pediatric nurses during the COVID-19 pandemic.

This study described pediatric nurses' professional quality of life during COVID-19 and explored demographic/clinical practice factors independently associated with compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS). The Relational Caring Complexity Theory was used. This study employed a cross-sectional, descriptive, correlational design to describe professional quality of life of pediatric nurses (demographic questionnaire and ProQOL 5 measure) working during the COVID-19 pandemic. From 150 pediatric nurses, the mean scores were CS 40.8 (± 4.8), BO 22.6 (± 4.7), and STS 22.8 (± 5.8). Results of the multiple regression revealed that two variables, deployed to the same unit versus not deployed (β = 2.424, p = .02) and currently practicing in perioperative/ambulation settings versus intensive care (β = -0.272, p = .03), were independently associated with CS. Deployed to the same unit versus not deployed was found to be independently and significantly associated with BO (β = -0.28, p = .005). The number of patients cared for with COVID-19 (β = 0.196, p = .03) was significantly associated with STS. While the overall response was positive, these nurses were more likely to experience BO when deployed to the same area (likely a COVID-19 adult unit) and STS as they cared for more patients with COVID-19. Leaders should be aware of the impact of caring in times of crisis. Decentralized staffing may help meet emergent needs on a particular shift, but ensuring deployed nurses are well-supported is vital.

Roney LN ，Rankin G ，Robertson B ，Budd T ，Zaino K ，Sylvestre V ，Brown J ，Parkosewich J ... -  《-》

A theoretical framework for Acute Care Nurse Stress Appraisal: Application of the transactional model of stress and coping.

To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID-19 pandemic. A secondary analysis of open-ended responses from a cross-sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID-19 pandemic. Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open-ended responses. Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post-traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense- of-duty and (4) personal strength from new possibilities. The COVID-19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth. Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision-making transparency are necessary. To better understand how frontline acute care nurses experienced stress during COVID-19, a data-informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post-traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post-traumatic growth in the post-COVID years. No patient or public contribution.

de Cordova PB ，Reilly LL ，Pogorzelska-Maziarz M ，Gerolamo AM ，Grafova I ，Vasquez A ，Johansen ML ... -  《-》