Nurses are regularly exposed to diverse potentially psychologically traumatic events (PPTEs) as a function of their work. Cumulative exposure to PPTEs can lead to clinically significant symptoms of mental disorders.
Purpose
We designed the current study to investigate the prevalence of different PPTEs among Canadian nurses and estimate the associations between diverse exposures and several mental disorders.
Methods
Canadian nurses (i.e., registered nurses, registered psychiatric nurses, licensed practical nurses, nurse practitioners) completed an online, self-reported survey. In total, 4067 participants (94.8% women) completed all relevant survey measures.
Results
Nurses reported exposures to several PPTE categories including severe human suffering, life threatening illness or injury, and physical assault, often 11 or more times. There were significant (p<.05) associations between diverse traumatic events and all mental disorders (i.e., Posttraumatic Stress Disorder, Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder) except Alcohol Use Disorder.
Conclusions
The current findings suggest that Canadian nurses are substantially exposed to traumatic events, which vary by several sociodemographic categories. PPTE exposures were significantly associated with mental disorders; that is, if PPTEs were eliminated among Canadian nurses in the sample, symptoms would be reduced between 42.0% and 58.0%.
AhmedB.FatmiZ.SiddiquiA. R. (2011).
Population attributable risk of unintentional childhood poisoning in Karachi Pakistan. PLoS One,
6(10), e26881. https://doi.org/10.1371/journal.pone.0026881
2.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
3.
AndrewsM. E.StewartN. J.MorganD. G.D'ArcyC. (2012).
More alike than different: A comparison of male and female RNs in rural and remote Canada. Journal of Nursing Management,
20(4), 561–570. https://doi.org/10.1111/j.1365-2834.2011.01195.x
4.
BaborT. F.Higgins-BiddleJ. C.SaundersJ. B.MonterioM. G. (2001). The alcohol use disorders identification test: Guidelines for use in primary care (2nd ed.).World Health Organization.
5.
BoltonJ. M.RobinsonJ. (2010).
Population-attributable fractions of axis I and axis II mental disorders for suicide attempts: Findings from a representative sample of the adult, noninstitutionalized US population. American Journal of Public Health,
100(12), 2473–2480. https://doi.org/10.2105/AJPH.2010.192252
Canadian Institute for Public Safety Research and Treatment. (2016). Peer support and crisis-focused psychological intervention programs in Canadian first responders: Blue paper.
10.
Canadian Institute for Public Safety Research and Treatment. (2019). Glossary of terms: A shared understanding of the common terms used to describe psychological trauma (version 2.0).
11.
CarletonR. N.AfifiT. O.TaillieuT.TurnerS.KrakauerR.AndersonG. S.MacPheeR. S.RicciardelliR.CrammH. A.GrollD.McCrearyD. R. (2019).
Exposures to potentially traumatic events among public safety personnel in Canada. Canadian Journal of Behavioural Science / Revue Canadienne Des Sciences du Comportement,
51(1), 37–52. https://doi.org/10.1037/cbs0000115
12.
CarletonR. N.AfifiT. O.TurnerS.TaillieuT.DuranceauS.LeBouthillierD. M.SareenJ.RicciardelliR.MacPheeR. S.GrollD.HozempaK.BrunetA.WeekesJ. R.GriffithsC. T.AbramsK. J.JonesN. A.BeshaiS.CrammH. A.DobsonK. S., . . . AsmundsonG. J. G. (2018).
Mental disorder symptoms among public safety personnel in Canada. The Canadian Journal of Psychiatry,
63(1), 54–64. https://doi.org/10.1177/0706743717723825
13.
CarletonR. N.AfifiT. O.TurnerS.TaillieuT.VaughanA. D.AndersonG. S.RicciardelliR.MacPheeR. S.CrammH. A.CzarnuchS.HozempaK.CampR. D. (2019).
Mental health training, attitudes toward support, and screening positive for mental disorders. Cognitive Behaviour Therapy,
49(1), 55–73. https://doi.org/10.1080/16506073.2019.1575900
14.
DokaK.RushtonC. H.ThorstensonT. A. (1994).
Healthcare ethics forum 94: Caregiver distress: If it is so ethical, why does it feel so bad?AACN Clinical Issues in Critical Care Nursing,
5(3), 346–352. https://doi.org/10.4037/15597768-1994-3017
15.
DuhouxA.MenearM.CharronM.Lavoie-TremblayM.AldersonM. (2017).
Interventions to promote or improve the mental health of primary care nurses: A systematic review. Journal of Nursing Management,
25(8), 597–607. https://doi.org/10.1111/jonm.12511
16.
FordK.MiddletonJ.PalmerB.FarringtonA. (1997).
Primary healthcare workers: Training needs in mental health. British Journal of Nursing,
6(21), 1244–1250. https://doi.org/10.12968/bjon.1997.6.21.1244
17.
GärtnerF. R.NieuwenhuijsenK.van DijkF. J. H.SluiterJ. K. (2010).
The impact of common mental disorders on the work functioning of nurses and allied health professionals: A systematic review. International Journal of Nursing Studies,
47(8), 1047–1061. https://doi.org/10.1016/j.ijnurstu.2010.03.013
HemingwayS.RogersM.ElsomS. (2014).
Measuring the influence of a mental health training module on the therapeutic optimism of advanced nurse practitioner students in the United Kingdom. Journal of the American Association of Nurse Practitioners,
26(3), 155–162. https://doi.org/10.1002/2327-6924.12028
20.
JacobowitzW. (2013).
PTSD in psychiatric nurses and other mental health providers: A review of the literature. Issues in Mental Health Nursing,
34(11), 787–795. https://doi.org/10.3109/01612840.2013.824053
21.
JandaR.JandováE. (2015).
Symptoms of posttraumatic stress disorder, anxiety and depression among Czech critical care and general surgical and medical ward nurses. Journal of Research in Nursing,
20(4), 298–309. https://doi.org/10.1177/1744987115584211
22.
JonesJ. W.BargeB. N.SteffyB. D.FayL. M.KunzL. K.WuebkerL. J. (1988).
Stress and medical malpractice: Organizational risk assessment and intervention. The Journal of Applied Psychology,
73(4), 727–735. https://doi.org/10.1037/0021-9010.73.4.727
LaposaJ. M.AldenL. E. (2003).
Posttraumatic stress disorder in the emergency room: Exploration of a cognitive model. Behaviour Research and Therapy,
41(1), 49–65. https://doi.org/10.1016/S0005-7967(01)00123-1
25.
LaposaJ. M.AldenL. E.FullertonL. M. (2003).
Work stress and posttraumatic stress disorder in ED nurses/personnel.Journal of Emergency Nursing,
29(1), 23–28. https://doi.org/10.1067/men.2003.7
26.
LastJ. M. (1986). A dictionary of epidemiology.
Oxford University Press.
27.
ManeaL.GilbodyS.McmillanD. (2015).
A diagnostic Meta-analysis of the patient health questionnaire-9 (PHQ-9) algorithm scoring method as a screen for depression. General Hospital Psychiatry,
37(1), 67–75. https://doi.org/10.1016/j.genhosppsych.2014.09.009
MealerM.BurnhamE. L.GoodeC. J.RothbaumB.MossM. (2009).
The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depression and Anxiety,
26(12), 1118–1126. https://doi.org/10.1002/da.20631
30.
MichaelR.JenkinsH. J. (2001).
Work-related trauma the experiences of perioperative nurses. Collegian (Royal College of Nursing, Australia),
8(3), 8–25. https://doi.org/10.1016/S1322-7696(08)60398-4
31.
MurakamiY.MiuraK.OkamuraT.UeshimaH., & EPOCH-JAPAN Research Group. (2011).
Population attributable numbers and fractions of deaths due to smoking: A pooled analysis of 180,000 Japanese. Preventive Medicine,
52(1), 60–65. https://doi.org/10.1016/j.ypmed.2010.11.009
32.
NewsonR. B. (2013).
Attributable and unattributable risks and fractions and other scenario comparisons. The Stata Journal: Promoting Communications on Statistics and Stata,
13(4), 672–698. https://doi.org/10.1177/1536867x1301300402
PayneF.HarveyK.JessoppL.PlummerS.TyleeA.GournayK. (2002).
Knowledge, confidence and attitudes towards mental health of nurses working in NHS direct and the effects of training. Journal of Advanced Nursing,
40(5), 549–559. https://doi.org/10.1046/j.1365-2648.2002.02413.x
PowellP. (1996). The prevalence of post traumatic stress disorder among registered nurses working Manitoba emergency and intensive care units: A replication study [Master’s thesis]. University of Manitoba Library.
37.
SareenJ.BelikS. L.AfifiT. O.AsmundsonG. J. G.CoxB. J.SteinM. B. (2008).
Canadian military personnel’s population attributable fractions of mental disorders and mental health service use associated with combat and peacekeeping operations. American Journal of Public Health,
98(12), 2191–2198. https://doi.org/10.2105/AJPH.2008.134205
38.
ShearM. K.BrownT. A.BarlowD. H.MoneyR.SholomskasD. E.WoodsS. W.GormanJ. M.PappL. A. (1997).
Multicenter collaborative panic disorder severity scale. The American Journal of Psychiatry,
154(11), 1571–1575. https://doi.org/10.1176/ajp.154.11.1571
39.
SpitzerR. L.KroenkeK.WilliamsJ. B. W.LöweB. (2006).
A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine,
166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092
40.
SwinsonR. P. (2006).
The GAD-7 scale was accurate for diagnosing generalised anxiety disorder. Evidence-Based Medicine,
11(6), 184. https://doi.org/10.1136/ebm.11.6.184
41.
TsarasK.PapathanasiouI.VusV.PanagiotopoulouA.KatsouM.KelesiM.FradelosE. (2018).
Predicting factors of depression and anxiety in mental health nurses: A quantitative cross-sectional study. Medical Archives (Sarajevo, Bosnia and Herzegovina),
72(1), 62–67. https://doi.org/10.5455/medarh.2017.72.62-67
42.
TurnerS.TaillieuT.CheungK.ZamorskiM.BoulosD.SareenJ.AfifiT. O. (2017).
Child abuse experiences and perceived need for care and mental health service use among members of the Canadian armed forces. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie,
62(6), 413–421. https://doi.org/10.1177/0706743717699177
43.
Van AmeringenM.ManciniC.PattersonB.BoyleM. H. (2008).
Post‐traumatic stress disorder in Canada. CNS Neuroscience & Therapeutics,
14(3), 171–181. https://doi.org/10.1111/j.1755-5949.2008.00049.x
44.
WeathersF. W.BlakeD. D.SchnurrP. P.KaloupekD. G.MarxB. P.KeaneT. M. (2013).
The life events checklist for DSM-5 (LEC-5). www.ptsd.va.gov
WinstanleyS.WhittingtonR. (2004).
Aggression towards health care staff in a UK general hospital: Variation among professions and departments. Journal of Clinical Nursing,
13(1), 3–10. https://doi.org/10.1111/j.1365-2702.2004.00807.x
47.
YoungT. K. (2004). Population health: Concepts and methods.
Oxford University Press.
