The Role of Music to Promote Relaxation in Intensive Care Unit Patients

BACKGROUND: The intensive care unit (ICU) is one of the most stressful environments for patients among various clinical settings in a hospital. ICU patients are not only compromised by illness but also faced with a wide range of stressors. Most of the time, pharmacological therapies are commonly used to control the distress, but are expensive and lead to high hospital care costs. It is thought that music can act as a nursing intervention to relieve both physiological and psychological responses and increase comfort of patients. OBJECTIVE: The aim of the study was to identify, review and evaluate the literature regarding the role of music listening to promote relaxation for patients in the ICU together with considerations for future research. METHODS: MEDLINE, PubMed, CINAHL, AMED and PsycINFO databases were searched for the terms “music therapy”, “music medicine” and “music listening”. In addition, an internet search using Google Scholar was performed. RESULTS: Literature research shows that music can influence a wide range of physiological and psychological effects and is effective in decreasing stress and facilitating relaxation responses. Different types of music and music preference of the individual patient may have a different effect. Moreover, live music is considered more important than pre-recorded music. CONCLUSION: Music therapy has been widely used in a variety of cultures for centuries to decrease patients’ perception of pain, anxiety and depression, and boost their feelings of relaxation. Music can be used as a safe and inexpensive non-pharmacologic antianxiety intervention to enhance relaxation and decrease stress in ICU patients. The key implication is to educate doctors and nurses on modern aspects of music therapy

An integrative review of the impact of indirect trauma exposure in health professionals and potential issues of salience for midwives

Aims: To explore responses to indirect trauma reported by health professionals and to identify issues of potential salience for midwives. Background: Indirect exposure to a traumatic event can lead to the development of distressing and potentially enduring responses. Little is understood about the impact that perinatal trauma exposure could have on midwives. Design: An integrative review design was used. Data sources: PsychInfo, Medline, PsychArticles, Web of Knowledge, CINAHL, MIDIRS and Scopus databases were search for papers published between 1980–November 2012. Review methods: Studies providing quantitative or qualitative exploration of healthcare professionals' responses to indirectly experienced traumatic events were selected. Results: Forty‐two papers fulfilled the inclusion criteria. Four of these studies included professionals engaged in maternity care or exposed to traumatic perinatal events. Findings indicate evidence of intrusion, avoidance and arousal in healthcare professionals, with differing degrees of frequency. Empathy, work‐related stress and the extent of professional experience were identified as associated with traumatic stress responses. Conclusions: Evidence derived from healthcare professionals suggests that indirect exposure to the traumatic events of recipients of care can sometimes elicit traumatic stress responses. Factors increasing risk for traumatic stress were identified as empathy and organizational stress. These factors hold specific salience in midwifery. Responding to trauma in a midwifery context, as informed by findings from other healthcare professionals, could adversely affect midwives' well‐being, care provided to women and contribute to an adverse organizational climate. Large‐scale research considering the experiences of midwives is recommended

The influence of secondary traumatic stress on the productivity of health professionals focus on ICU and psychiatric nurses

Introduction: Nurses often find satisfaction in assisting people who experience extremely stressful events, yet the stress associated with these efforts can have a negative impact on them. Secondary traumatic stress (STS) or compassion fatigue (CF) has emerged as a natural consequence of caring for clients who are in pain, suffering or traumatized. STS has been associated with higher rates of physical illness, greater use of sick leave, higher turnover, lower morale, lower productivity, negative public opinion and may eventually lead to patient care errors. Objectives: The primary aim of this study was to investigate the risk of STS among ICU and psychiatric nurses and its influence on their productivity. Additional goals of the study were: 1. The investigation of differences between ICU and psychiatric nurses as regards their a) demographic, personal and occupational characteristics, b) professional quality of life (compassion satisfaction - CS, burnout - BO and CF/STS), c) prevalence and treatment of commonly occurring health problems (chronic medical conditions), d) productivity (absenteeism, presenteeism – quality and quantity of work while on the job – and critical incidents on the job - work-related successes, failures and accidents) and 2. The investigation of the relationship between all these concepts. Methods: The sample consisted of 509 registered and assistant nurses (404 women and 105 men) with mean age 34.84±7.24, working in ICU’s (n=335) and psychiatric clinics (n=174) in Athens greater area. Study instruments included the Professional Quality of Life Scale: Compassion Satisfaction, Burnout and Compassion Fatigue/Secondary Trauma (ProQOL-CSF-R-IV) Scales, the Work Health Organization Health and Work Performance Questionnaire (HPQ) and a set of items on general information of the sample (demographic, personal and occupational characteristics). Assurances were given to nurses concerning confidentiality and anonymity. Results: The majority of participants are at the high level of risk for BO (ICU: 56.1%, psychiatric clinics: 49.4%) and STS (ICU: 57.9%, psychiatric clinics: 44.8%), while they report low potential for CS (ICU: 61.5%, psychiatric clinics: 64.9%). BO (r=-.46) and STS (r=-.14) were found to correlate with CS, and the correlation was negative. Also, there is a strong positive correlation between BO and STS (r=.60). STS was found to have a negative influence on the absenteeism over the past 7 days (p=.022) and on the presenteeism (p=.027), while the absenteeism over the past 4 weeks was found to correlate mostly with health (mental and physical) - related factors, which usually lead to greater use of sick leave, such as headaches (p=.006) and hypertension (p=.024), and with work-related factors, such as shift work (p=.003) and patient-to-nurse ratios (p=.041). Additionally, this study investigated the factors associated with BO, CS, STS and chronic medical conditions of the sample. Conclusions: Nurses must contend with not only the normal stress and dissatisfaction of work (burnout), but also with the personal feelings for people’s suffering (compassion fatigue). High prevalence of STS in the sample indicates that large numbers of ICU and psychiatric nurses may be experiencing its negative effects. STS should be a concern not only for individual providers, but also for health care administration and policy, because its presence may affect the quality of care.Εισαγωγή: Οι νοσηλευτές συχνά νιώθουν ικανοποίηση από την παροχή βοήθειας σε ανθρώπους που έχουν βιώσει εξαιρετικά στρεσογόνα γεγονότα, το στρες όμως που συσχετίζεται με αυτές τις προσπάθειες μπορεί να έχει αρνητική επίδραση στους ίδιους. Το δευτερογενές τραυματικό στρες ή κόπωση συμπόνιας, αποτελεί την φυσική συνέπεια της παροχής φροντίδας σε ανθρώπους που πονάνε, υποφέρουν ή είναι τραυματισμένοι και αφορά το «κόστος της φροντίδας» για τους επαγγελματίες υγείας. Το δευτερογενές τραυματικό στρες έχει συσχετιστεί με υψηλά επίπεδα σωματικών ασθενειών και χρήση αναρρωτικών αδειών, αυξημένο ρυθμό αλλαγής θέσεων εργασίας ή και εγκατάλειψη επαγγέλματος, χαμηλό ηθικό, μειωμένη παραγωγικότητα, αρνητική κοινή γνώμη και μπορεί τελικά να οδηγήσει σε λάθη στην φροντίδα των ασθενών. Σκοπός: Ο κύριος σκοπός της παρούσας μελέτης ήταν η διερεύνηση του κινδύνου για δευτερογενές τραυματικό στρες στους νοσηλευτές που εργάζονται σε ΜΕΘ και σε Ψυχιατρικές Κλινικές ελληνικών δημόσιων νοσοκομείων και της επίδρασης του στην παραγωγικότητα τους. Οι επιμέρους στόχοι ήταν: 1. Η διερεύνηση των διαφορών που παρουσιάζουν οι νοσηλευτές που εργάζονται σε ΜΕΘ από τους νοσηλευτές που εργάζονται σε Ψυχιατρικές Κλινικές ως προς α) τα δημογραφικά, ατομικά και επαγγελματικά χαρακτηριστικά τους, β) την επαγγελματική ποιότητα ζωής (ικανοποίηση συμπόνιας-compassion satisfaction, επαγγελματική εξουθένωση-burnout και δευτερογενές τραυματικό στρες ή κόπωση συμπόνιας - secondary traumatic stress/compassion fatigue), γ) την γενική κατάσταση υγείας τους (ύπαρξη και θεραπεία χρόνιων προβλημάτων υγείας-chronic medical conditions) δ) την αξιολόγηση της παραγωγικότητας τους (απουσία από την εργασία– absenteeism, απόδοση στην εργασία, δηλαδή ποιότητα και ποσότητα εργασίας-presenteeism και κρίσιμα γεγονότα, δηλαδή σχετιζόμενες με την εργασία επιτυχίες, αποτυχίες και ατυχήματα–critical incidents) και 2. Η διερεύνηση της συσχέτισης όλων αυτών των μεταβλητών μεταξύ τους. Υλικό και Μέθοδος: Στην μελέτη συμμετείχαν 509 νοσηλευτές (404 γυναίκες και 105 άνδρες), όλων των κατηγοριών εκπαίδευσης, ηλικίας 34.84±7.24 ετών, που εργάζονται σε ΜΕΘ (n=335) και Ψυχιατρικές Κλινικές (n=174) σε 27 δημόσια νοσοκομεία στην ευρύτερη περιοχή της Αττικής. Για την συλλογή των δεδομένων χρησιμοποιήθηκε η Κλίμακα Επαγγελματικής Ποιότητας Ζωής: Υποκλίμακες Ικανοποίησης Συμπόνιας, Επαγγελματικής Εξουθένωσης και Κόπωσης Συμπόνιας ή Δευτερογενές Τραυματικό Στρες (ProQOL-CSF-R-IV), το Ερωτηματολόγιο Υγείας και Παραγωγικότητας στην Εργασία του Παγκόσμιου Οργανισμού Υγείας (HPQ) και ένα ερωτηματολόγιο καταγραφής των δημογραφικών, ατομικών και επαγγελματικών χαρακτηριστικών του δείγματος. Η συμπλήρωση των ερωτηματολογίων ήταν ανώνυμη. Αποτελέσματα: Η πλειοψηφία των ερωτηθέντων και στα δύο δείγματα είναι σε μεγάλο κίνδυνο για επαγγελματική εξουθένωση (56.1% στις ΜΕΘ και 49.4% στις Ψυχιατρικές Κλινικές) και δευτερογενές τραυματικό στρες (57.9% στις ΜΕΘ και 44.8% στις Ψυχιατρικές Κλινικές), ενώ είναι σε χαμηλό επίπεδο για ικανοποίηση συμπόνιας (61.5% στις ΜΕΘ και 64.9% στις Ψυχιατρικές Κλινικές). Η ικανοποίηση συμπόνιας έχει σημαντική αρνητική σχέση με την επαγγελματική εξουθένωση (r=-.46) και το δευτερογενές τραυματικό στρες (r=-.14), ενώ οι δύο τελευταίες έννοιες παρουσιάζουν θετική σχέση μεταξύ τους (r=.60). Το δευτερογενές τραυματικό στρες βρέθηκε να επιδράει αρνητικά στην απουσία από την εργασία τις προηγούμενες 7 ημέρες (p=.022) και στην απόδοση στην εργασία (p=.027), ενώ η απουσία από την εργασία τις προηγούμενες 4 εβδομάδες βρέθηκε να συσχετίζεται κυρίως με παράγοντες που αφορούσαν προβλήματα με την ψυχική ή σωματική υγεία των ατόμων που συχνά οδηγούσαν σε χρήση αναρρωτικών αδειών, όπως οι πονοκέφαλοι (p=.006) και η υπέρταση (p=.024) και με εργασιακούς παράγοντες, όπως το ωράριο εργασίας (p=.003) και η αναλογία ασθενών ανά νοσηλευτή (p=.041). Επίσης, η επαγγελματική εξουθένωση βρέθηκε να συσχετίζεται με τον σχετικό αριθμό ωρών εργασίας τις προηγούμενες 7 ημέρες (p=.029). Επιπλέον, διερευνήθηκαν οι παράγοντες που σχετίζονται με την επαγγελματική εξουθένωση, την ικανοποίηση και την κόπωση συμπόνιας, καθώς και με την γενική κατάσταση της υγείας των ερωτηθέντων. Συμπεράσματα: Οι νοσηλευτές πρέπει να αντιμετωπίσουν όχι μόνο το στρες και την δυσαρέσκεια για την εργασία τους (επαγγελματική εξουθένωση), αλλά πρέπει να έρθουν αντιμέτωποι και με τα προσωπικά τους συναισθήματα για τον άνθρωπο που πονάει και υποφέρει (κόπωση συμπόνιας). Το υψηλό ποσοστό δευτερογενούς τραυματικού στρες στο δείγμα υποδεικνύει ότι πιθανώς μεγάλος αριθμός νοσηλευτών που εργάζονται σε ΜΕΘ και Ψυχιατρικές Κλινικές βιώνει τις αρνητικές συνέπειες αυτής της κατάστασης. Δεδομένου ότι το δευτερογενές τραυματικό στρες επηρεάζει και την ποιότητα της φροντίδας που παρέχεται στους ασθενείς, εκτός από τις επιπτώσεις που μπορεί να έχει στην υγεία του επαγγελματία που το βιώνει, θα πρέπει να συγκεντρώνει και το ενδιαφέρον της διοίκησης του νοσοκομείου και της πολιτείας

Greek mental health nurses' practices and attitudes in the management of acute cases

The aim of this study was to identify nurses' interventions, views, and attitudes concerning critical incidents. Using semi-structured interviews, a descriptive study was conducted among mental health nurses working in three major psychiatric hospitals. Analysis of nurses' audio-recorded data indicated that they had used a number of different interventions under six main categories: counseling, performing security practices, monitoring thinking disturbances, contacting the psychiatrist on-call, contacting the chief nurse on-call, and administering medication. The need for specialized training was noticed and problems like accountability, nurse-patient interactions, and nurse-doctor relationships were considered crucial by the mental health nurses. © 2013 Informa Healthcare USA, Inc

Prevalence of Secondary Traumatic Stress Among Psychiatric Nurses in Greece

The aim of this study was to investigate the prevalence of secondary traumatic stress/compassion fatigue (STS/CF), burnout (BO) and compassion satisfaction (CS) in psychiatric nurses, and their risk factors. The Professional Quality of Life Scale (ProQOL R-IV) and a demographic and work related characteristics questionnaire were distributed to 174 psychiatric nurses in 12 public hospitals in Greece. The majority of participants were at the high risk category for STS/CF (44.8%) and BO (49.4%), while only 8.1% of nurses expressed high potential for CS. Awareness of the factors associated with STS may help nurses to prevent or offset the development of this condition. © 2015 Elsevier Inc

Containment and therapeutic relationships in acute psychiatric care spaces: the symbolic dimensions of doors

Background: There is an increasing trend of door locking practices in acute psychiatric care. The aim of the present study was to illuminate the symbolic dimensions of doors in Greek mental health nurses’ experiences of open and locked working spaces. Results: A sequential mixed-method designexplored the experiences of nurses working in both open and locked psychiatric acute care units. Participants experiences revealed four types of doors related to the quality of recovery-oriented care: (a) the open door, (b) the invisible door, (c) the restraining door, and (d) the revolving door. Open doors and permeable spacesgenerated trust and facilitated the diffusion of tension and the necessary perception of feeling safe in order to be involved in therapeutic engagement. When the locked unit was experienced as a caring environment, the locked doors appeared to be “invisible”. The restraining doors symbolized loss of control, social distance and stigma echoing the consequences of restrictingpeople’s crucial control over spaceduring the COVID-19 pandemicin relation toviolence within families, groups and communities. The revolving door (service users’ abscondence/re-admission) symbolised the rejection of the offered therapeutic environment and was a source of indignation and compassion fatigue in both open and locked spaces attributed to internal structural acute care characteristics (limited staffing levels, support, resources and activities for service users) as well as ‘locked doors’ in the community (limited or no care continuity and stigma). Conclusions: The impact of COVID-19 restrictions on people’s crucial control of space provides an impetus for erecting barriers masked by the veil of habit and reconsidering the impact of the simple act of leaving the door open/locked to allow both psychiatric acute care unit staff and service users to reach their potential. © 2021, The Author(s)

Wounded healers during the COVID-19 syndemic: Compassion fatigue and compassion satisfaction among nursing care providers in Greece

Purpose: The aim of this study was to investigate compassion fatigue (CF) and compassion satisfaction (CS) in nursing care providers in COVID-19 units. Methods: A mixed-method study with 105 nurses. Results: 23% of participants reported high CF risk while 77% expressed high to moderate potential for CS. Adequate preparation/education, clear and accountable leadership, and team sharing of feelings, experiences, and responsibilities during the transition in the COVID-19 unit helped participants to deal with overwhelming anxiety which if unattended could bring about frustration and long-lasting feelings of powerlessness. Practical Implications: In the face of the present and future pandemics, there is a clear need to prepare healthcare organizations and nursing care providers to cope with the emotional content of public health emergencies while protecting themselves and avoid absorbing unmanageable emotions. © 2021 Wiley Periodicals LLC

Anxiety, Stress and the Resilience of University Students during the First Wave of the COVID-19 Pandemic

The COVID-19 pandemic had an impact on everyone’s daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The present study aimed to assess the psychological difficulties experienced by the university students of Greece during the first wave of the outbreak. Methods: 288 university nursing students completed an electronic questionnaire after consent. The sample included students from all years of study. The questionnaire included demographic data and questions about mental health status, resilience level, coping strategies, positive and negative emotions and an optimism assessment. Results: Depression (44.8%), anxiety (36.8%) and stress (40.3%) were experienced by the students. Females had significantly greater anxiety and stress signs compared to males (p < 0.001). The resilience score was significantly greater in males, as it was for the Positive Affect Score. Students in the fourth year of study used significantly more active/positive coping strategies than students in the first (p = 0.016) or second year of study (p = 0.005). Conclusion: Several students experienced serious mental disorders during the first period of the COVID-19 outbreak. Variables such as gender, year of study, age, positive and negative affect score, life orientation test score and coping strategies were identified as factors contributing to this situation. Special attention must be paid to female students as they mentioned negative emotions more frequently than males. Further research on the academic population could be beneficial to university administrators