Compassion Fatigue among Healthcare Personnel in Acute Care Contexts: An Integrative Review

Healthcare workers in acute care settings experience considerable emotional exhaustion on a daily basis, which might lead to the manifestation of compassion fatigue that adversely impacts their wellbeing. There has been an increasing awareness in understanding compassion fatigue on healthcare workers recently, but the literature within this area remains ambiguous due to the use of different terminology. This integrative review aims to synthesize the existing research knowledge of the manifestation of compassion fatigue and the related concepts in acute care contexts. A total of 27 full-text research articles were retrieved for analysis. The interpretation of the selected articles yielded four main categories, which included the prevalence, risk factors, protective factors, and consequences regarding compassion fatigue among healthcare workers. These findings provide an outline for decision makers of healthcare organizations to formulate a strategic plan for helping healthcare workers to cope with compassion fatigue in everyday work and disaster events

The transition challenges faced by new graduate nurses in their first year of professional experience

Though nurses form the largest group of healthcare professionals in most of the healthcare systems, the transition from an academic to a real-world setting is characterized by high stress and reality shock, which contributes to a high turnover rate during the first year of practice. This qualitative study aimed to illustrate the transition experience of new graduate nurses and to identify the factors affecting their adaptation processes. Registered nurses who had completed university nursing training program and possessed about a year of professional nursing experience in Hong Kong were recruited for semi-structured, face-to-face individual interviews. The data was saturated after 14 new graduate nurses had been interviewed. The participants experienced complicated perceptions with fluctuating feelings ranging from frustration to a sense of accomplishment during the transition period. Four interrelated human and work related factors were illuminated to influence their adaptation to transition: 1) professional accountability and competency, 2) personal adaptation attitude and ability, 3) interpersonal relationships with colleagues and 4) institutional/workplace support and orientation. The findings demonstrated a close link between perceptions and the interrelated factors affecting transition experiences and adaptation processes. Education and healthcare institutions should provide more training and support in the promotion of emotional well-being, the improvement of professional knowledge and skills, and in-service adaptation enhancement programs before and during the transition. Further comprehensive studies with longitudinal designs are recommended to explore the perceptions of new graduate nurses. Keyword

Emergency Nurses’ Experience on End-of-life Care: An Integrative Review

Emergency nurses are regarded as the key healthcare professional (HCP) in the emergency department endof-life (ED-EOL) care. The emergency nurses encountered the dying and death on a regular base. Still, they find the EOL care is another aspect and caring from their usual practice. With the successful ED-EOL care delivery, it can help to meet the needs of the imminent patients and families. Emergency nurses admired the pain and symptoms management helping the ED-EOL patients. This paper reviewed the existing literature on the emergency nurses’ perception of ED-EOL care. A systematic search of the literature published between January 2005 and January 2016 was conducted to identify published studies concerning emergency nurses’ practice and the influencing factors in EOL care provision. The final sample for this integrative review was comprised of 23 studies. It is suggested in the results of the included studies that emergency nurses’ EOL care in the clinical context could involve the care of the dying patients and their families in both physical, psychosocial and spiritual aspects. Further study of the emergency nurses and different ED-HCPs are encouraged which could make the ED-EOL care more fruitful and bright in the future

Knowledge, Attitude and Practice of Breast Selfexamination among Nursing Students in Hong Kong: A Cross-sectional Study

Breast cancer is a global public health concern. Currently, the crude incidence rate of breast cancer in Hong Kong is increasing. Although breast self-examination (BSE) is an effective screening method which able to reduce mortality rates, only a few women perform it monthly. As nurses play a significant role in promoting BSE, this study aims to study the knowledge, attitude, and practice of BSE for nursing students. A crosssectional design was employed, and 372 nursing students participated in this study. Results reveal that even BSE are compulsory in nursing curriculum, poor knowledge (“don’t know” 46.9%, incorrect 9.4%.), poor attitude (mean = 24.29, SD = 3.49) and limited practice (mean = 7.69, SD = 4.66) were found. Regression analysis support that knowledge and attitude predict practice of BSE. It is important to promote and build up the awareness of BSE to nursing students by enhancing their knowledge and attitude

Psycho-behavioural responses of the general population to COVID-19 after mass vaccination: a cross-sectional study

Abstract Background Previous studies have examined public psycho-behavioural responses in the early stages of the epidemic, little is known after mass vaccination has been implemented. This study aimed to investigate the public's behavioural (adoption of COVID-19 precautionary measures) and psychological (depression, anxiety and stress) responses to COVID-19 and their relationships after the launch of the territory-wide vaccination programme in Hong Kong. Methods A cross-sectional survey study using anonymous online or face-to-face questionnaires was conducted between June 2021 and September 2021. A convenience sample of Hong Kong Chinese residents aged ⩾18 years were recruited online by referrals and from a university-run community vaccination centre. Results A total of 1893 valid questionnaires were received. The results showed that Hong Kong residents have high levels of adoption of precautionary measures and low levels of depression, anxiety and stress after the mass vaccination. Hierarchical regression analysis identified that in the fully adjusted model, the adoption of precautionary measures was a consistent protective factor (β ranged −1.51 to −1.67, p < 0.001) for depression, anxiety and stress amid the COVID-19 pandemic. Conclusions This study offers new information on the public's psycho-behavioural responses to the pandemic, as well as insights into public health planning after introducing the mass vaccination

COULD FAMILY WELL-BEING MODERATE THE RELATIONSHIP BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND SOMATOFORM DISSOCIATION? A PRELIMINARY INVESTIGATION

16 pagesThe impacts of adverse childhood experiences (ACEs) have been well documented. One possible consequence of ACEs is dissociation, which is a major feature of post-traumatic psychopathology and is also associated with considerable impairment and health care costs. Although ACEs are known to be associated with both psychoform and somatoform dissociation, much less is known about the mechanisms behind this relationship. Little is known about whether social and interpersonal factors such as family environments would moderate the relationship between ACEs and somatoform dissociation. This paper discusses the importance of having a positive and healthy family environment in trauma recovery. We then report the findings of a preliminary study in which we examined whether the association between ACEs and somatoform dissociation would be moderated by family well-being in a convenience sample of Hong Kong adults (N = 359). The number of ACEs was positively associated with somatoform dissociative symptoms, but this association was moderated by the level of family well-being. The number of ACEs was associated with somatoform dissociation only when the family well-being scores were low. These moderating effects were medium. The findings point to the potential importance of using family education and intervention programs to prevent and treat trauma-related dissociative symptoms, but further investigation is needed

Trauma and dissociation among inpatients diagnosed with schizophrenia spectrum disorders in Taiwan

Background: The overlapping symptoms of schizophrenia and dissociation have been increasingly recognized. This paper explains why it is reasonable to expect that there would be a substantial subgroup of patients diagnosed with schizophrenia spectrum disorders (SSDs) who suffer from pathological dissociation. Objective: As little is known about the prevalence of dissociative disorders and symptoms among patients with SSDs, we investigated the prevalence of dissociative disorders and symptoms among patients with SSDs. Method: We used both self-report measures and structured interviews to examine dissociative disorders and symptoms in a randomly recruited sample of inpatients with a clinical diagnosis of SSDs in Taiwan (N = 100). Results: Over 60% of participants exhibited pathological dissociation, and 54% had a dissociative disorder according to structured interview data; three participants met the DSM-5 diagnostic criteria for dissociative identity disorder. The concurrent validity of pathological dissociation in this sample was similar to that of depression among patients with schizophrenia reported in the literature. Participants with a dissociative disorder were more likely to report high-betrayal traumas and meet DSM-5 criteria for post-traumatic stress disorder; they also reported more psychotic symptoms than those without a dissociative disorder. Conclusions: This was one of very few studies that used structured interviews to examine pathological dissociation in patients with SSDs. The results indicate that pathological dissociation in SSDs is not uncommon. Clinical assessment should include measures of dissociation to facilitate early identification

The Effectiveness of Disaster Education for Undergraduate Nursing Students’ Knowledge, Willingness, and Perceived Ability: An Evaluation Study

As future healthcare professionals, nursing students should possess the appropriate knowledge, skills, and positive attitude to respond to public health emergencies or disasters worldwide. This study evaluated the effectiveness of a disaster management training course at improving Hong Kong nursing students’ disaster knowledge, willingness, and perceived ability. A mixed-method design using a single group with pre- and post-intervention comparisons followed by qualitative focus group interviews, was conducted. A 45-h disaster management training course with theoretical and practical inputs was conducted. A total of 157 students participated in and completed the pre- and post-intervention questionnaires. Positive significant results in disaster knowledge (t(156) = −8.12, p &lt; 0.01, d = −0.84) and perceived ability (t(156) = −7.95, p &lt; 0.01, d = −0.72) were found, but no substantial change in willingness to respond to disasters was observed. The participants expressed various concerns regarding their willingness to respond, which can be summarized and grouped as (1) personal risk perceptions, (2) contextual factors of the disaster events, and (3) organizational support. Incorporating disaster training into the tertiary education curricula for basic nursing professionals’ training could be a long-term strategy to prepare and expand the competent workforce for future disasters. Government or healthcare organizations are recommended to provide strategies and adequate support to alleviate nursing professionals’ concerns and enhance their willingness

Persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms: a one-year follow-up study

ABSTRACTBackground: Recent studies found that post-traumatic and dissociative symptoms are common in people with depressive symptoms. Although a trauma-related subtype of depression has been proposed, little is known about the persistence and clinical consequences of these symptoms.Objective: This one-year follow-up study investigated the persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms.Methods: We analyzed longitudinal data from an international sample of people self-reporting depressive emotions (N = 152) (mean Patient Health Questionnaire-9 score = 17.27; SD = 6.31).Results: More than half (58.4%) of participants with baseline post-traumatic stress disorder (PTSD) still met the criteria for PTSD after one year. Participants with dissociative symptoms at baseline were significantly more likely to report lifetime psychiatric hospitalization (31.2% vs 14.7%), past-year use of psychiatric hospitalization (10.4% vs 0%) and emergency services (16.9% vs 4%) than those without dissociative symptoms. All post-traumatic and dissociative symptom clusters were cross-sectionally (r = .286 to .528, p < .001) and longitudinally (r = .181 to .462, p < .001) correlated with depressive symptoms. A sense of current threat (β = .146, p < .05) and negative self-concept (β = .173, p < .05) at baseline significantly predicted depressive symptoms after one year.Conclusions: These findings contribute to the increasing body of knowledge regarding the PTSD/dissociation-depression comorbidity. Given their persistence and clinical consequences, we recommend that post-traumatic and dissociative symptoms be regularly screened for in clinical settings. The existence of a possible trauma-related subtype of depression should receive more attention in both research and clinical practice

Dissociative symptoms among community health service users in Hong Kong: a longitudinal study of clinical course and consequences

ABSTRACTBackground: Previous studies have demonstrated the high prevalence of dissociative symptoms and their association with considerable healthcare costs. However, there is a lack of studies that describe whether dissociative symptoms persist and lead to other clinical outcomes over time in the community.Objectives: This study investigated the persistence, predictors, and consequences of dissociative symptoms in the community.Methods: We analyzed longitudinal data in a sample of community health service users in Hong Kong (N = 173).Results: A relatively high proportion (63.6%) of participants with baseline dissociative symptoms continued to exhibit dissociative symptoms after approximately 9 months. Baseline non-betrayal trauma predicted subsequent dissociative symptoms (β = .141, p = .024). Participants with baseline dissociative symptoms were more likely to have received subsequent emergency mental health services (9.1% vs 0.7%, p = .005). Baseline dissociative symptoms significantly predicted subsequent post-traumatic symptoms (β = .165 to .191, p < .05) and difficulty in social and occupational participation (β = −.152 to −.182, p < .05) even after controlling for baseline scores, trauma exposure, and use of professional support. The predictive role of dissociative symptoms on subsequent disturbances in self-organization symptoms and social participation difficulty remained significant after applying the Bonferroni correction.Conclusions: This is one of the very few studies showing that dissociative symptoms are persistent to a certain degree and could predict other symptoms and subsequent impairments even in community settings. Factors that affect the trajectory of dissociative symptoms should be further investigated. Regular screening for dissociative symptoms is recommended. Considering its prevalence, persistence, and clinical and social consequences, dissociation should be given greater public health attention