Compassion Fatigue and Family Caregivers Caring in End-Stage Heart Failure.

Background: Compassion fatigue is a negative consequence impacting caregivers of chronic illness, such as heart failure. Reliance on family caregivers is expected to rise, placing importance on recognizing family caregiver characteristics that contribute to compassion fatigue. Purpose: This study specifically examined the associations of characteristics of family caregivers caring for end-stage heart failure, compassion satisfaction, social desirability, and the family caregiver-nursing provider relationship on compassion fatigue. Methods: An adapted interaction model of client health behavior guided this cross-sectional survey, which comprised a demographic questionnaire, the Professional Quality-of-Life Scale, the caregiver-provider relationship assessment, the Marlowe-Crowne Social Desirability Scale Short Form (Form C), and the Bakas Caregiving Outcomes Scale. Results: There were 127 family caregivers (FCGs), primarily those who have been a caregiver for longer than 1 year (78.4%), who completed the entire survey. Increased compassion satisfaction and positive caregiving effects were associated with decreased compassion fatigue (p < .001), while increased social desirability was associated with increased compassion fatigue (p < .001). A positive family caregiver-nursing provider relationship was related to decreased compassion fatigue (p < .001). More compassion fatigue was seen with lower spiritual status (p < .001). Implications: The chronic progression of heart failure presents opportunities for nursing providers to assess caregivers and offer frequent interventions. Family caregivers may not ask for help. Nursing providers must foster relationships with family caregivers to prevent negative consequences and mitigate compassion fatigue. Future research on the nursing provider relationship and FCGs is needed.

The Impact of COVID-19 on Family Caregivers of Individuals With End-Stage Heart Failure.

Before the COVID-19 pandemic, family caregivers were providing a tremendous amount of care for family members with heart failure with the prevalence of caregiver reliance in heart failure expected to increase in the United States. Social distancing and other restrictions during the COVID-19 pandemic may have added further challenges to caregiving routines. The purpose of this study was to examine the family caregiver perception of the effect of COVID-19 on caregiving routines. To determine caregiver perception of COVID-19's impact, 1 Likert question and 1 open-ended response were asked. Braun and Clark's method guided open-ended response thematic analysis. The 113 replies to the open-response question yielded themes such as social isolation, added fear, anxiety, or worry, changed appointments, wearing masks, and living status change. Social isolation (41.6%) was the most common theme; the most significant theme was living status change ( P = .003), and family caregivers reported that the pandemic affected their routines either negatively or somewhat negatively (62.1%). Family caregivers are affected during times of crisis. Research and policies that recognize the residual effects of COVID-19 on caregiving practices and support care transitions for family caregivers in the heart failure population are needed.

Validating the Secondary Traumatic Stress Scale for Pediatric Nurses.

BACKGROUND AND PURPOSE: Secondary traumatic stress is a state of mental distress resulting from indirect exposure to the traumatic situation of another individual. The literature indicates that secondary traumatic stress is a problem in some areas of nursing and may cause nurses to leave the profession. This article examines the psychometrics of the Secondary Traumatic Stress Scale (STSS) with a sample of pediatric nurses. METHODS: The STSS was completed by a random sample of 350 Certified Pediatric Nurses. Exploratory and confirmatory factor analyses were completed to assess the STSS and its subscales. RESULTS: Cronbach's αs ranged from 0.81 to 0.87 for each factor, and was 0.92 for the STSS as a whole. Fit indices were similar for all models. CONCLUSIONS: Reliability statistics and fit indices support the previous psychometric studies.

Secondary Traumatic Stress in Pediatric Nurses.

PURPOSE: Secondary traumatic stress affects many in the helping professions, and has been identified in many nursing specialty areas. The purpose of this study was to expand the knowledge of secondary traumatic stress in pediatric nursing by examining the statistical relationships between secondary traumatic stress, age of the nurse, and years of nursing experience, and coping responses. DESIGN AND METHODS: A convenience sample of Certified Pediatric Nurses (n = 338) were surveyed using the Secondary Traumatic Stress Scale, the Brief COPE, the Marlowe-Crowne Social Desirability-Short Form, and a demographics form. Hierarchical multiple linear regression and descriptive statistics were utilized to examine secondary traumatic stress and the other variables of interest. RESULTS: Secondary traumatic stress affected more than half of pediatric nurses surveyed. Age and years of experience did not predict secondary traumatic stress. Looking at coping responses pediatric nurses with higher emotional support and instrumental support scores also demonstrated higher secondary traumatic stress scores. Denial and behavioral disengagement were also associated with an increase in secondary traumatic stress scores. CONCLUSION: Secondary traumatic stress impacts many pediatric nurses. Further research is needed to determine which factors predispose pediatric nurses to secondary traumatic stress and which coping responses help pediatric nurses best manage this stress. PRACTICE IMPLICATIONS: Acknowledging secondary traumatic stress in this population by promoting awareness, and providing educational programs will help to protect nurses' psychological health, and may prevent nurses from leaving the profession due to work-related stress.

Transitioning from Departments to Schools of Nursing: A Qualitative Analysis of Journeys by Ten Deans.

Transitioning from a department to a school of nursing creates an environment that is more conducive to attracting qualified faculty and enhancing program growth to meet the projected nursing workforce needs. A comprehensive review of the literature revealed limited research to guide nursing programs considering this transition. This qualitative study explored the conditions and outcomes associated with successful or unsuccessful attempts to transition from a department to school of nursing from the perspective of 10 deans affiliated with the American Association of Colleges of Nursing (AACN). Meleis' transitions theory (2010) guided this study in its exploration of facilitating and inhibiting conditions. With institutional review board approval and participant permission, interviews were conducted in-person or by telephone, audio-recorded, and transcribed verbatim. Transcripts were independently reviewed and coded for emerging themes. Content analysis revealed the following themes: titles matter, support is essential, voice at the table, buy-in or dissension, it just brings nursing to totally different level, think differently, and legitimizing your position. For these deans, consideration of the facilitating and inhibiting conditions is critical in determining whether decisions are favorable and in support of the transition. Developing an understanding from the experiences of these 10 deans offers guidance to nursing academic administrators who are contemplating transitioning from a department to a school of nursing. Future research is needed to explore conditions relative to faculty governance and infrastructure, examine the experiences of those undergoing transitions, and expand study findings to develop a self-study guide for programs in assessing their readiness for such a transition.

Developing a dedicated education unit in long-term care: a pilot project.

Within long-term care, the transitional care setting provides post-acute and short-stay rehabilitation to older adults, easing the transition between the acute care hospital and home or long-term care. The current nursing shortage makes it difficult for these facilities to attract and retain qualified nursing staff. In order to meet the rehabilitation needs for this patient population while at the same time addressing the challenge in nursing education of limited clinical placements and severe nurse faculty shortages, an academic-practice partnership was developed to establish a Dedicated Education Unit (DEU). The DEU is an innovative clinical education model in which experienced staff nurses serve as clinical teachers to nursing students. This paper describes the process of developing a DEU using the Partners in Caring Model as the framework. Formative and summative evaluation results and recommendations for program improvement of this pilot project are discussed.

Sense of humor, childhood cancer stressors, and outcomes of psychosocial adjustment, immune function, and infection.

The diagnosis, treatment, and side effects of childhood cancer have been described as extremely stressful experiences in the life of a child. Anecdotally, children report that a sense of humor helps them cope with the daily experiences of living with cancer; however, no research has examined sense of humor and childhood cancer stressors. This study investigated the effect of sense of humor on the relationship between cancer stressors and children's psychosocial adjustment to cancer, immune function, and infection using Lazarus and Folkman's theory of stress, appraisal, and coping. A direct relationship was observed between sense of humor and psychosocial adjustment to cancer, such that children with a high sense of humor had greater psychological adjustment, regardless of the amount of cancer stressors. A moderating effect was observed for incidence of infection. As childhood cancer stressors increase, children with high coping humor scores reported fewer incidences of infection than low scorers.

Humor: a coping strategy for pediatric patients.

In the past 20 years, nurses have become concerned with children's response to stressors and their ability to cope with them. Humor is one strategy that pediatric nurses can use to help children cope with illness and hospitalizations. Although there is little scientific research, there is some theoretical and anecdotal support for the use of humor as a coping strategy. Understanding the developmental aspect of humor is essential for nurses and families, and McGhee's developmental stages of humor are linked to Piagetian stages of cognitive development. Additional discussion describes related diagnoses, assessment, and outcomes for humor interventions as well as considerations for determining the appropriate and inappropriate use of humor. Numerous activities to implement humor in pediatric clinical settings are presented. The need for further research to evaluate humor intervention as an effective coping strategy is recommended.