The Relations between Violence Exposure, Posttraumatic Stress Symptoms, Secondary Traumatization, Vicarious Post Traumatic Growth and Illness Attribution among Psychiatric Nurses

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Abstract

This study examined posttraumatic stress disorder symptoms (PTSD), secondary traumatization (ST) and vicarious posttraumatic growth (VG) among Israeli psychiatric nurses (PN) who were compared to community nurses (CN). Furthermore, we examined the contribution of PN perceptions of the etiology of their patients’ mental illness to their PTSD, ST and VG. Results show that PN reported higher levels of both PTSD and ST symptoms, but lower levels of VG, as compare to CN. While ST symptoms were positively related to VG among CN, PTSD and ST symptoms were negatively associated among PN. Finally, exposure to patients' violence, PTSD or ST symptoms, and illness attribution dimensions of 'powerful others', predicted nurses' VG. PN are an at-risk population for work-related stress residues.

Section snippets

Posttraumatic stress disorder and secondary traumatization symptoms

Psychiatric nurses working in hospitals and wards are exposed to high levels of work-stress. In their daily routines psychiatric nurses may directly experience high rates of physical and verbal violence, sexual harassment (Chen et al., 2008, Moylan and Cullinan, 2011), and even encounter incidence of completed suicides (Takahashi et al., 2011). It is no surprise that the stress of exposure to assault and the fear of potential assault appear to impact nurses’ emotional states in the form of

Vicarious posttraumatic growth

The study of the salutogenic aspects of human experience in the face of adversity has been gaining momentum in the last decade (e.g. Almedom & Glandon, 2007). The current theoretical definition of posttraumatic growth (PTG) describes it is a positive outlook following trauma, manifested by one's relation to others, perception of new possibilities, enhanced personal strength, a spiritual change, and a higher appreciation for life. A person who has developed PTG needs to develop beyond his

Illness attribution

Attribution theory assumes that people strive to attain a causal understanding of the world and thus develop ‘theories’ that explain the causes of the occurrence of various events in their world (Weiner, 1992). In the same line of reasoning, Rotter (1966) conceptualized 'locus of control' as the way people react to environmental events as dependent on the meaning that they attribute to an event. People with internal locus of control attribute the responsibility of what happened to them to their

Design and Sample

A descriptive, comparative cross-sectional study was conducted in 2012–2013.

Participants were 196 Israeli nurses that consisted of two groups: (1) psychiatric nurses (research group); and (2) community clinic nurses (comparison group).

Demographic Characteristics

We started our analysis by comparing socio-demographic characteristics between the study groups. It is worth noting that the rate of participants that responded to the socio-demographic questionnaire among the research group was lower than in the control group, probably due to fear of detection violations of promised anonymity. No significant differences were found between participants in the research and comparison group on age, country of birth or vocational training. The two groups did

Discussion

The main findings of this study indicated that psychiatric nurses reported higher levels of both PTSD and ST symptoms, but lower levels of VG dimensions of 'new possibilities' and 'personal strength', as compared to community nurses. While PTSD and ST symptoms were found to positively relate to VG among community nurses, these variables were negatively associated among psychiatric nurses. Furthermore, the illness attributions dimension of 'potential vulnerability' contributed to psychiatric

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    • Cited by (0)

    Authors' contribution: a) conception and design: Gadi Zerach and Tal ben-Itzchak Shalev; b) analysis and interpretation of data: Gadi Zerach and Tal ben-Itzchak Shalev; c) drafting or critical revision: Gadi Zerach; d) final approval: Gadi Zerach and Tal ben-Itzchak Shalev.

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