Abstract
Psychological risk assessment is a legal obligation for companies and part of occupational safety and employment protection in Germany. However, data from psychological risk assessments in nursing staff are scarce, although this population is at increased risk for secondary traumatic stress by patient experienced trauma. Therefore, our study aimed at examining the frequency of reported secondary trauma events, secondary traumatic stress, and its possible consequences for psychological well-being and work ability in nurses. N = 320 nurses (n = 280 female) were assessed at a University Hospital in Germany as part of the psychological risk assessment. Secondary traumatic events, secondary traumatic stress, and symptoms of depression and anxiety were measured using self-report questionnaires (PHQ-2, GAD-2), and work ability was assessed using a modified version of the questionnaire for workplace analysis (KFZA). Of 320 nurses, 292 (91.2%) experienced secondary trauma, and 74 nurses (25.3%) reported secondary traumatic symptoms. Nurses with secondary traumatic symptoms reported higher depression (p < 0.001) and anxiety scores (p < 0.001) compared to nurses without secondary trauma experience, and to nurses with secondary trauma experience but without secondary traumatic stress (both p < 0.001). Further, nurses with secondary traumatic stress reported significantly reduced work ability, social support and control over work, and increased emotional strain and labor time. Nurses with secondary traumatic stress may be at increased risk of developing major depression and anxiety disorders, and particularly need support in overcoming secondary traumatic experiences. Psychological risk assessment is a useful tool to identify groups at risk, and pave the way to implement strategies to improve mental well-being and prevent work ability in high risk groups.
Highlights
Work-related stress belongs to the most concerning issues in occupational health in industrialized countries [1]
Secondary traumatic events were reported by 292 nurses (91.2%), of whom 74 (25.3%) reported that these events lead to continuous rumination and/or flashbacks (Table 1)
Reports so far demonstrated relatively high levels of STS in nurses [19], described risk factors [26] and emotional consequences such as compassion fatigue and burnout [27, 28]. Our study expands these studies by showing high amounts of secondary traumatic experiences in nurses from different nursing specialties, demonstrating that those who are burdened by secondary traumatic stress report higher levels of anxiety and depression symptoms, and demonstrating consequences in the workplace
Summary
Work-related stress belongs to the most concerning issues in occupational health in industrialized countries [1]. The implementation of psychological risk assessments has been a legal obligation for German companies since 2013 [4]. There are no regulations regarding the instruments used to assess psychological risk at work, it was proposed to use questionnaires and/or structured interviews to capture data from employees. This offers the opportunity to assess work-related psychological risk factors such as secondary traumatic stress and relate them to measures of psychological health and work ability
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