Secondary traumatic stress and dissociative coping strategies in nurses during the COVID-19 pandemic: The protective role of resilience

George Tsouvelas; Argyroula Kalaitzaki; Alexandra Tamiolaki; Michael Rovithis; George Konstantakopoulos

doi:10.1016/j.apnu.2022.08.010

Secondary traumatic stress and dissociative coping strategies in nurses during the COVID-19 pandemic: The protective role of resilience

Arch Psychiatr Nurs. 2022 Dec:41:264-270. doi: 10.1016/j.apnu.2022.08.010. Epub 2022 Aug 31.

Authors

George Tsouvelas¹, Argyroula Kalaitzaki², Alexandra Tamiolaki³, Michael Rovithis⁴, George Konstantakopoulos⁵

Affiliations

¹ Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: tsouvelasgiorgos@gmail.com.
² Department of Social Work, Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Affiliated Researcher of the Research Centre 'Institute of Agri-Food and Life Sciences', Hellenic Mediterranean University, CP: 71004 Heraklion, Greece. Electronic address: akalaitzaki@hmu.gr.
³ Department of Social Work, Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Hellenic Mediterranean University, CP: 71004 Heraklion, Greece.
⁴ Department of Nursing, Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life, Affiliated Researcher of the Research Centre 'Institute of Agri-Food and Life Sciences', Health Sciences Faculty, Hellenic Mediterranean University, CP: 71004 Heraklion, Crete, Greece. Electronic address: rovithis@hmu.gr.
⁵ Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece; Department of Clinical, Education and Health Psychology, University College London, London, UK. Electronic address: gekonst@otenet.gr.

Abstract

During the COVID-19 pandemic, nurses are repeatedly exposed to acute stress at their workplace, and therefore, they are at high risk for developing mental health symptoms. The prolonged exposure of healthcare professionals may lead to Secondary Traumatic Stress (STS). STS is an aspect of "cost of care", the natural consequence of providing care to people who suffer physically or psychologically. The purpose of this study was to investigate the levels of STS in nurses during the first phase of the COVID-19 pandemic in Greece and to detect aggravating and protective factors. Participants were 222 nurses (87.4 % women; mean age 42.3 years) who completed an online survey. The questionnaire comprised of the Secondary Traumatic Stress Scale, the Brief Resilience Scale, and the Brief Coping Orientation to Problems Experienced Inventory. Nurses had high levels of STS. The hierarchical regression analyses showed that STS and its dimensions Avoidance and Arousal were positively predicted mainly by denial and self-distraction coping strategies and inversely by resilience. Resilience exhibited a protective (partial mediation) effect on the strong relationship between the dissociative coping strategies (denial, self-distraction, venting and behavioral disengagement) and STS. Trauma-informed care psychosocial interventions are needed to support the already overburdened nursing staff during the coronavirus pandemic.

Keywords: Coronavirus; Dissociation; Nurses; Resilience; Secondary traumatic stress; Structural equation model.

MeSH terms

Adaptation, Psychological
Adult
Burnout, Professional* / psychology
COVID-19*
Compassion Fatigue* / epidemiology
Compassion Fatigue* / psychology
Female
Humans
Male
Pandemics
Stress Disorders, Post-Traumatic* / psychology