Factores de riesgo y protección del estrés traumático secundario en los cuidados intensivos: un estudio exploratorio en un hospital terciario de Madrid / Risk and protective factors of secondary traumatic stress in Intensive Care Units: An exploratory study in a hospital in Madrid (Spain)

OBJETIVO: Proponer un modelo de predictores del estrés traumático secundario. DISEÑO: Se trata de un diseño transversal descriptivo. Ámbito: El estudio se llevó a cabo en las unidades de cuidados intensivos de un hospital terciario de Madrid. PARTICIPANTES: La muestra estuvo formada por 103 profesionales sanitarios. INTERVENCIONES: Se creó una batería de cuestionarios que fue rellenada por los profesionales. Respecto al análisis de datos, se utilizó una metodología de redes y análisis de regresión jerárquica. Variables de interés: Se evaluaron variables sociodemográficas tales como género, años de experiencia y puesto, el estrés traumático secundario, la pasión por el trabajo, los estresores laborales, el esfuerzo emocional, la empatía, la autocompasión. RESULTADOS: Se establece: a) para la fatiga por compasión, los años de experiencia como factor de riesgo (β = 0,224 y p = 0,029) y la pasión armoniosa como protector (β = −0,363 y p = 0,001); b) para la sacudida de creencias, el esfuerzo emocional y la empatía como factores de riesgo (β = 0,304 y p = 0,004; β = 0,394 y p = 0,000, respectivamente) y c) para la sintomatología, los estresores laborales y la empatía como factores de riesgo (β = 0,189 y p = 0,039; β = 0,395 y p = 0,000, respectivamente) y los años de experiencia como protector (β = −0,266 y p = 0,002). CONCLUSIONES: Este modelo predictivo del estrés traumático secundario asienta factores protectores que podrían aumentarse, como la pasión armoniosa, y factores de riesgo que sería conveniente reducir, como la empatía y el esfuerzo emocional, con el fin de mejorar la calidad asistencial y de vida de los profesionales

AIM: To propose a predictive model of secondary traumatic stress. DESIGN: A descriptive cross-sectional study was carried out. Context: The study was conducted in the Intensive Care Units of a hospital in Madrid (Spain). PARTICIPANTS: The sample comprised 103 health professionals. INTERVENTIONS: A series of questionnaires were created and completed by the participants. Network analysis and multiple regression were used for data analysis. Variables of interest: Sociodemographic variables such as gender, years of experience and position, secondary traumatic stress, passion for work, work stressors, emotional effort, empathy and self-compassion were evaluated. RESULTS: The result identified the following: a) years of experience as a risk factor for compassion fatigue (β=0.224 and P=0.029), and harmonious passion as a protector (β=−0.363 and P=0.001); b) emotional effort and empathy as risk factors for shattered assumptions (β=0.304 and P=0.004; β=0.394 and P=0.000, respectively); and c), work stressors and empathy as risk factors for symptomatology (β=0.189 and P=0.039; β=0.395 and P=0.000, respectively), and years of experience as a protector (β=−0.266 and P=0.002). CONCLUSIONS: This predictive model of secondary traumatic stress identifies protective factors which could be reinforced, such as harmonious passion, and risk factors which should be reduced, such as empathy and emotional effort, with a view to promoting quality of care and quality of life among these professionals

Risk and protective factors of secondary traumatic stress in Intensive Care Units: An exploratory study in a hospital in Madrid (Spain). / Factores de riesgo y protección del estrés traumático secundario en los cuidados intensivos: un estudio exploratorio en un hospital terciario de Madrid.

AIM: To propose a predictive model of secondary traumatic stress. DESIGN: A descriptive cross-sectional study was carried out. CONTEXT: The study was conducted in the Intensive Care Units of a hospital in Madrid (Spain). PARTICIPANTS: The sample comprised 103 health professionals. INTERVENTIONS: A series of questionnaires were created and completed by the participants. Network analysis and multiple regression were used for data analysis. VARIABLES OF INTEREST: Sociodemographic variables such as gender, years of experience and position, secondary traumatic stress, passion for work, work stressors, emotional effort, empathy and self-compassion were evaluated. RESULTS: The result identified the following: a) years of experience as a risk factor for compassion fatigue (ß=0.224 and P=0.029), and harmonious passion as a protector (ß=-0.363 and P=0.001); b) emotional effort and empathy as risk factors for shattered assumptions (ß=0.304 and P=0.004; ß=0.394 and P=0.000, respectively); and c), work stressors and empathy as risk factors for symptomatology (ß=0.189 and P=0.039; ß=0.395 and P=0.000, respectively), and years of experience as a protector (ß=-0.266 and P=0.002). CONCLUSIONS: This predictive model of secondary traumatic stress identifies protective factors which could be reinforced, such as harmonious passion, and risk factors which should be reduced, such as empathy and emotional effort, with a view to promoting quality of care and quality of life among these professionals.

Intervención breve basada en ACT y mindfulness: estudio piloto con profesionales de enfermería en UCI y Urgencias / Brief intervention based on ACT and mindfulness: pilot study with nursing staff in intensive care unit and emergency services

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Nurses develop their work in a highly stressful context, where their emotional, attentional and well-being resources are frequently impaired. Because the health care work context is a dynamic and changing context, it is necessary to continue implementing and evaluating the efficacy of brief interventions that consider the organizational needs. The aim of the current paper is showing the result of a pilot study, which implemented and assessed the efficacy of a brief intervention based on Acceptance and Commitment Therapy and Mindfulness to improve nurses levels of psychological flexibility, mindfulness and well-being. Intervention was conducted in a public and tertiary-level hospital in Madrid, specifically in their Intensive Care Units and Emergency Room. For this pilot study, 50 nurses were randomly selected of a total professional population of 164. They were assigned to two groups: the experimental and the waiting-list group. Between-group comparison showed that the intervention had significant benefits in terms of vitality and purpose of life among participants when compared with controls. Intra-group comparisons also showed significant benefits on nurses’ psychological flexibility and negative affect when both groups received the intervention. The intervention also significantly changed nurses’ vitality at follow-up. These results were discussed in terms of strengths and limitations that a brief intervention of these characteristics could have in the work context (AU)

Application of artificial neural networks to a study of nursing burnout.

Nursing is generally considered to be a profession with high levels of emotional and physical stress that tend to increase. These high stress levels lead to a high risk of burnout. The objective was to assess whether artificial neural network (ANN) paradigms offer greater predictive accuracy than statistical methodologies, which are commonly used in the field of burnout. A radial basis function (RBF) network and hierarchical stepwise regression was used to assess burnout. The comparison of the two methodologies was carried out by analysing a sample of 462 nurses and student nurses. The subjects were from three hospitals in Madrid (Spain), who completed the 'Nursing Burnout Scale' survey. A RBF network was better suited for the analysis of burnout than hierarchical stepwise regression. The outcomes indicate furthermore that the relationship with the burnout process of the predictive variables age, job status, workload, experience with pain and death, conflictive interaction, role ambiguity and hardy personality is not entirely linear. The usage of ANNs in the field of burnout has been justified due to their superior ability to capture non-linear relationships, which is relevant for theory development. STATEMENT OF RELEVANCE: Due to the superior ability to capture non-linear relationships, ANNs are better suited to explain and predict burnout and its subdimensions than common statistical methods. From this perspective, more specific programmes to prevent burnout and its consequences in the workplace can be designed.

El desgaste profesional de enfermería. Desarrollo y validación factorial del CDPE / The nursing burnout. development and factorial validation of the CDPE

Objetivos: el estudio muestra el desarrollo y la validación factorial del Cuestionario de Desgaste Profesional de Enfermería (CDPE), instrumento construido para la evaluación específica del desgaste profesional (burnout) en el colectivo de enfermería. Este cuestionario recoge escalas centradas en la evaluación de las variables más relevantes del proceso de desgaste profesional dentro de esta profesión. A través del presente estudio se analiza la estructura interna del cuestionario, examinando su validez factorial, la consistencia interna de sus escalas y la interdependencia estructural existente entre ellas. Métodos: la elaboración del cuestionario se basó en el análisis de la información teórica existente, el desarrollo de diversas entrevistas semiestructuradas y posteriores discusiones de grupo. Tras su aplicación a una muestra piloto de 30 personas, el cuestionario resultante de este proceso fue contestado por 389 enfermeros/as que desarrollan su trabajo en 5 hospitales de Madrid capital. Se llevó a cabo un análisis factorial para cada uno de los bloques que integran el cuestionario (aspectos antecedentes, consecuentes, mediadores y específicos del síndrome de Desgaste profesional) por el método de ejes principales y empleando una rotación oblicua (oblimín directo). El análisis de la consistencia interna de las escalas se basó en el cálculo de los coeficientes alfa de Cronbach. Por último, se llevó a cabo un análisis de las correlaciones existentes entre las escalas de los distintos bloques para determinar el grado de interdependencia existente entre ellas. Resultados: la solución factorial obtenida constituye un elemento de apoyo a la validez de constructo del instrumento y se ajusta al marco teórico de partida. Se hallaron índices de fiabilidad elevados para la práctica totalidad de las escalas del CDPE, existiendo relaciones entre ellas que confirman la estructura teórica planteada. Conclusión: el análisis del CDPE muestra resultados favorables respecto a su fiabilidad y a su validez de constructo, aunque parece necesario el desarrollo de nuevos trabajos que suministren una mayor información sobre los criterios de bondad del instrumento (AU)