Other Titles

Factors Influencing Secondary Traumatic Stress in Neonatal Intensive Care Unit Nurses: A Mixed-Methods Study [Poster Title]

Other Titles

Rising Star Poster/Presentation

Abstract

Secondary traumatic stress is a significant occupational hazard for healthcare providers, particularly neonatal intensive care unit nurses, who are frequently exposed to traumatic events while caring for newborns and managing the emotional distress of the newborns’ families. This study aimed to assess the prevalence of secondary traumatic stress among neonatal intensive care unit nurses, identify its influencing factors.

This cross-sectional study recruited 131 neonatal intensive care unit nurses from 22 hospitals in South Korea using convenience sampling. Among them, 13 nurses were selected for qualitative interviews through purposive sampling. Data were collected via an e-survey and in-depth interviews from August to October 2024. The study was guided by the Empathy-Based Stress Process Model. Secondary traumatic stress was measured using the Secondary Traumatic Stress Scale. Descriptive statistics summarized participant characteristics, traumatic event exposure, and Secondary traumatic stress levels. Linear mixed-effects modeling was used to account for intra-individual correlations and hospital-related factors. Qualitative data were analyzed using Creswell’s mixed-methods qualitative analysis approach.

Among the neonatal intensive care unit nurses, 68.1% reported moderate-to-severe secondary traumatic stress levels based on Secondary traumatic stress scores. The most frequently reported traumatic events were caregivers experiencing profound sadness or despair and patients undergoing continuous or repeated medical procedures. Influencing factors included the interaction between nurse sensitivity and exposure to traumatic events as well as hospital-specific variations in traumatic experiences. Qualitative analysis identified three core themes: A Fierce Fight for a Small Life, Trauma Impacting Daily Life, and Care and Compassion in the neonatal intensive care unit. These themes illustrate the emotional and professional challenges experienced by neonatal intensive care unit nurses.

Neonatal intensive care unit nurses experienced high levels of secondary traumatic stress, driven by individual sensitivity and repeated exposure to traumatic events. The emotional burden of caring for critically ill neonates and distressed caregivers underscores the need for targeted interventions. Further research should explore long-term impacts and evaluate effective interventions

Notes

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association.

Arnold, T. (2020). An evolutionary concept analysis of secondary traumatic stress in nurses. Nursing Forum, 55(2), 149-156. https://doi.org/10.1111/nuf.12409

Beck, C. T., Cusson, R. M., Gable, R. K., Dowling, D., & Thibeau, S. (2017). Secondary traumatic stress in NICU nurses. Advances in Neonatal Care, 17(6), 478-488.

Bian, W., Cheng, J., Dong, Y., et al. (2023). Experience of pediatric nurses in nursing dying children—a qualitative study. BMC Nursing, 22(1), 126.

Creswell, J. W., Klassen, A. C., Plano Clark, V. L., & Smith, K. C. (2011). Best practices for mixed methods research in the health sciences. National Institutes of Health, 541-545.

Favrod, C., Jan du Chêne, L., Martin Soelch, C., et al. (2018). Mental health symptoms and work-related stressors in hospital midwives and NICU nurses: A mixed methods study. Frontiers in Psychiatry, 9, 364.

Figley, C. R. (1995). Compassion fatigue: Toward a new understanding of the costs of caring.

Rauvola, R. S., Vega, D. M., & Lavigne, K. N. (2019). Compassion fatigue, secondary traumatic stress, and vicarious traumatization: A qualitative review and research agenda. Occupational Health Science, 3, 297-336.

Description

This study examined secondary traumatic stress (STS) among neonatal intensive care unit (NICU) nurses in South Korea, finding that 68.1% of nurses experienced above moderate STS. Factors influencing STS included nurses' sensitivity and exposure to trauma. The study emphasizes the need for targeted interventions and further research on STS and its long-term effects.

Author Details

Heemoon Lim, PhD, RN; Hyejung Lee, PhD, RN

Sigma Membership

Lambda Alpha at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Mixed/Multi Method Research

Keywords:

Cultural Context and Care, Secondary Traumatic Stress, NICU, Neonatal Intensive Care Unit, NICU Nurses

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Invited Presentation

Acquisition

Proxy-submission

Date of Issue

2025-12-09

Funder(s)

Yonsei University Nursing College, Seoul Nursing Association

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Factors Influencing Secondary Traumatic Stress in Neonatal Intensive Care Unit Nurses

Indianapolis, Indiana, USA

Secondary traumatic stress is a significant occupational hazard for healthcare providers, particularly neonatal intensive care unit nurses, who are frequently exposed to traumatic events while caring for newborns and managing the emotional distress of the newborns’ families. This study aimed to assess the prevalence of secondary traumatic stress among neonatal intensive care unit nurses, identify its influencing factors.

This cross-sectional study recruited 131 neonatal intensive care unit nurses from 22 hospitals in South Korea using convenience sampling. Among them, 13 nurses were selected for qualitative interviews through purposive sampling. Data were collected via an e-survey and in-depth interviews from August to October 2024. The study was guided by the Empathy-Based Stress Process Model. Secondary traumatic stress was measured using the Secondary Traumatic Stress Scale. Descriptive statistics summarized participant characteristics, traumatic event exposure, and Secondary traumatic stress levels. Linear mixed-effects modeling was used to account for intra-individual correlations and hospital-related factors. Qualitative data were analyzed using Creswell’s mixed-methods qualitative analysis approach.

Among the neonatal intensive care unit nurses, 68.1% reported moderate-to-severe secondary traumatic stress levels based on Secondary traumatic stress scores. The most frequently reported traumatic events were caregivers experiencing profound sadness or despair and patients undergoing continuous or repeated medical procedures. Influencing factors included the interaction between nurse sensitivity and exposure to traumatic events as well as hospital-specific variations in traumatic experiences. Qualitative analysis identified three core themes: A Fierce Fight for a Small Life, Trauma Impacting Daily Life, and Care and Compassion in the neonatal intensive care unit. These themes illustrate the emotional and professional challenges experienced by neonatal intensive care unit nurses.

Neonatal intensive care unit nurses experienced high levels of secondary traumatic stress, driven by individual sensitivity and repeated exposure to traumatic events. The emotional burden of caring for critically ill neonates and distressed caregivers underscores the need for targeted interventions. Further research should explore long-term impacts and evaluate effective interventions