Decrease In Psychological Distress Research Articles

The Effect Of Exercise 24-hours Before Chemotherapy On Cardiac Function And Symptoms In Breast Cancer

Rodent studies have demonstrated that a single submaximal exercise bout can attenuate markers of cardiac damage caused by adriamycin chemotherapy injection 24 hr later. However, it is unclear whether this finding extends to humans. PURPOSE: To determine the effects of exercise 24 hr prior to the first chemotherapy treatment on cardiac function in breast cancer patients (BCP). METHODS: Patients were randomized to either: 1) no vigorous exercise for 72 hr prior to first treatment (n = 8), or 2) no vigorous exercise for 48 hrs, then 30 min of vigorous exercise (70% age-predicted heart rate reserve) 24 hr prior to first treatment (n = 9). Chemotherapy treatment included 60 mg/m2 adriamycin and 600 mg/m2 cyclophosphamide. Two-dimensional echocardiography and blood pressure were assessed pre- and 24-48 hr post-treatment. Key cardiac measures included speckle tracking-derived global longitudinal strain (GLS) and standard volumetric measures (e.g., end-diastolic volume (EDV)). Rotterdam Symptom Checklists were administered prior to the first and second treatments. Standardized physical and psychological distress scores were tabulated. Analysis included mixed methods ANOVA with p≤0.05. RESULTS: There were no significant interactions or group differences for GLS, EDV, systolic blood pressure, or resting heart rate. There were significant (p≤0.05) main effects for time (pre vs. post treatment) for GLS (-19.3 ± 1.5 to -21.2 ± 1.8 %), systolic blood pressure (107 ± 14 to 102 ± 14 mmHg) and a trend for EDV (80 ± 13 to 88 ± 16 mL, p=0.06). There was no significant change in heart rate (70 ± 10 to 68 ± 11 bpm). Physical distress increased post-treatment (14 ± 8 to 26 ± 11, p<0.01), while there was a trend toward a decrease in psychological distress (26 ± 13 to 18 ± 17, p=0.07). CONCLUSIONS: Within this initial small sample of BCP, there does not seem to be an effect of aerobic exercise 24 hr prior to receipt of the first adriamyacin chemotherapy treatment on the cardiac function parameters or symptoms measured. The acute effect of chemotherapy is an increase in GLS; and the trend in EDV may be suggestive of an increase in blood volume, but this requires further investigation. Receipt of the first treatment significantly increases physical symptoms, but may decrease the psychological distress associated with anticipation of the first treatment.

Mindfulness, self-compassion and psychological distress in pregnant women

IntroductionAnxiety, depression, and stress in pregnancy are risk factors for adverse outcomes for mothers and children (Glover, 2014). There is good evidence showing a decrease in psychological distress when pregnant women participate in interventions comprising mindfulness and self-compassion practices (Dunn et al., 2012). However, there are few studies on the relationship between mindfulness, self-compassion and psychological distress variables in pregnancy, without being within the scope of intervention trials (Cohen, 2010; Zoeterman, 2014).ObjectiveTo explore the association between mindfulness, self-compassion and psychological distress/PD in pregnant women.MethodsFour hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy (17.34 ± 4.790 weeks of gestation) completed the Facets of Mindfulness Questionnaire-10 (FMQ-10; Azevedo et al., 2015; to evaluate Non-udging of experience/NJ, acting with awareness/AA and observing and describing), Self-Compassion Scale (SCS; Bento et al., 2015; to evaluate self-kindness/SK, self-judgment, common humanity, isolation, mindfulness and over-identification) and Depression Anxiety and Stress Scale-21 (DASS-21; Xavier et al., 2015). Only variables significantly correlated with the outcomes (Total DASS-21, Stress, Anxiety and Depression) were entered in the multiple regression models.ResultsFMQ-10 and SCS Total scores were both significant predictors of DASS-21 (B = –.335,–.296). Stress predictors were NJ, AA, SK and isolation (B = –.164;–.196;–.087; .353); Anxiety predictors were NJ, SK and isolation (B = –.198;–.124; .268); depression predictors were NJ, SK and Isolation (B = –.277;–.128; .232) (all P &lt; .01).ConclusionsMindfulness and self-compassion dimensions, particularly non-udging of experience and self-Kindness are protective for PD in pregnancy. Isolation is a correlate of PD in pregnancy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Implementing a chronic disease self-management program into china: the happy life club™.

China is experiencing population aging, increased prevalence of chronic diseases, and reductions in the frequency of healthy lifestyle behaviors. In response to these significant transitions, China is implementing major reforms in health care services with a focus on strengthening primary health care. In this paper, we describe a 12-month diabetes management program, the Happy Life Club™ (HLC™), implemented in a primary health care setting in Beijing, that uses doctor and nurse health coaches trained in behavior change techniques and motivational interviewing (MI). This paper reports the results of this pilot study and discusses issues involved in the implementation of Chronic Diseases Self-Management Programs in China. The intervention group showed improvements in HbA1c levels at 6 months and both the control and intervention groups showed reductions in waist circumference over time. Systolic blood pressure improved over time in the intervention group. The intervention group showed improvement in quality of life across the intervention period and both groups showed decreases in psychological distress across the intervention. Doctor visits increased between baseline and 6 months, but there was no change in doctor visits between 6 and 12 months for both groups. The effects were modest, and further investigations are required to evaluate the long-term impact of health coach approaches in China.

Association of participation in the supplemental nutrition assistance program and psychological distress.

We assessed whether households' participation in the Supplemental Nutrition Assistance Program (SNAP) was associated with improvements in well-being, as indicated by lower rates of psychological distress. We used longitudinal data for 3146 households in 30 states, collected between October 2011 and September 2012 for the SNAP Food Security survey, the largest longitudinal national survey of SNAP participants to date. Analyses compared households within days of program entry to the same households approximately 6 months later. We measured psychological distress in the past 30 days on a 6-item Kessler screening scale and used multivariable regression to estimate associations between SNAP participation and psychological distress. A smaller percentage of household heads exhibited psychological distress after 6 months of participation in SNAP than at baseline (15.3% vs 23.2%; difference = -7.9%). In adjusted models, SNAP participation was associated with a decrease in psychological distress (adjusted relative risk = 0.72; 95% confidence interval = 0.66, 0.78). Continuing support for federal nutrition programs, such as SNAP, may reduce the public health burden of mental illness, thus improving well-being among vulnerable populations.

Disturbance in ADL from Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Cancer Patients: The Mediating Effect of Psychological Distress

The purpose of this study was to examine the mediation of psychological distress in the relationship between disturbance in ADL from chemotherapy induced peripheral neuropathy and quality of life in order to provide a basis for planning nursing interventions to improve the quality of life in cancer patients. A purposive sample of 130 patients treated with chemotherapy were recruited in the cross-sectional survey design. Data were collected using self-report questionnaires. The instruments were the Chemotherapy Induced Peripheral Neuropathy Assessment Tool (CIPNAT), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). The mean score for disturbance in ADL from chemotherapy induced peripheral neuropathy was 3.30. Overall quality of life was 2.48. The mean score was 1.04 for psychological distress. The prevalence was 35.4% for anxiety and 47.7% for depression. There were significant correlations among the three variables, disturbance in ADL from chemotherapy induced peripheral neuropathy, psychosocial distress, and quality of life. Psychosocial distress had a complete mediating effect (β=-.74, p<.001) in the relationship between disturbance in ADL from chemotherapy induced peripheral neuropathy and quality of life (Sobel test: Z=-6.11, p<.001). Based on the findings of this study, nursing intervention programs focusing on disturbance of ADL management, and decrease of psychological distress are highly recommended to improve quality of life in cancer patients.

Challenges in treatment of sexually abused preschoolers: A pilot study of TF-CBT in Quebec

Summary Symptoms of preschoolers following sexual abuse are not as well documented as for other age groups. This is true both in terms of the associated consequences as well as treatment outcomes. This limitation may be related to the fact that preschoolers represent a subgroup for which it is particularly challenging to substantiate sexual abuse allegations. Younger children also represent a challenge in intervention due to their level of cognitive development and their limited ability to comprehend such complex topics, such as sexuality. Assessing the effects of interventions with this subgroup of children therefore represents a priority in the field. The aim of this paper is to discuss the challenges inherent to the implementation of a cognitive behavioural treatment, namely the Trauma-Focused-Cognitive Behavioural Therapy (TF-CBT; Cohen et al., 2006) with sexually abused preschoolers and to present the results of a pilot study assessing it's effects with a sample of 25 children. Results reveal positive outcomes related to treatment participation both in children and in their accompanying parent. Preschoolers have demonstrated a significant decrease in internalised and externalised behaviour problems as well as a decrease in dissociation symptoms. A significant decrease in psychological distress and post-traumatic stress symptoms was also observed in children's parents following therapy. A follow-up assessment conducted 1 year following the initial assessment revealed that therapeutic gains were maintained over time. Clinical experience highlights specific challenges with preschoolers that are discussed in terms of treatment adaptation.

Psychological effects of fetal diagnoses of non-lethal congenital anomalies on the experience of pregnant women during the remainder of their pregnancy.

The aim of this study was to explore the effects of prenatal fetal diagnoses of non-lethal anomalies on the psychological well-being of pregnant women throughout their pregnancy. Fifty-five pregnant women were asked to complete a questionnaire (the Spielberger State-Trait Anxiety Inventory) to assess their anxiety levels at multiple follow-up visits. In-depth interviews were conducted with 20 pregnant women after completion of the questionnaire. We identified three stages of psychological distress. The intense negative psychological reaction stage was characterized by an intense psychological distress in response to the loss of an ideal child. The psychological healing stage was characterized by the emergence of coping mechanisms and a concomitant decrease in psychological distress. Finally, the intense negative psychological reaction re-emergence stage was characterized by an increase in psychological distress related to uncertainty regarding the future of the baby. Following a prenatal diagnosis of a non-lethal anomaly, both the nature and the intensity of the psychological distress experienced by pregnant women change throughout the remainder of their pregnancy. Throughout the remainder of their pregnancy, these women should be offered effective psychological support that accounts for each of the distinct psychological response stages identified in this study.

Protocol for the RT Prepare Trial: a multiple-baseline study of radiation therapists delivering education and support to women with breast cancer who are referred for radiotherapy

IntroductionThere is limited evidence to guide the preparation of patients for radiotherapy. This paper describes the protocol for an evaluation of a radiation therapist led education intervention delivered to patients...

Does Change in Self-reported Mindfulness Mediate the Clinical Benefits of Mindfulness Training? A Controlled Study Using the French Translation of the Five Facet Mindfulness Questionnaire

Mindfulness training improves mental health and psychological functioning. Although several questionnaires have been developed to measure mindfulness, the Five Facet Mindfulness Questionnaire (FFMQ) is currently one of the most widely used scales. However, uncertainty remains about whether the effects of mindfulness training can be unambiguously attributed to change in self-reported mindfulness. The present study was designed to answer three major questions: First, relative to a wait-list group, does participation in mindfulness training lead to changes in self-reported mindfulness among a mixed sample of individuals presenting stress-related problems, illness, anxiety, and chronic pain? Second, are changes in mindfulness associated with changes in psychological distress? Third, do changes in mindfulness mediate the effects of mindfulness training on the decrease in psychological distress? We used the French translation of the FFMQ in a Belgian sample. Relative to a wait-list control, mindfulness training led to a change in self-reported mindfulness and psychological distress. Further, changes in mindfulness mediated the effects of mindfulness training on a decrease in psychological distress.

Social cognitive intervention reduces stress in Hungarian university students.

A social cognitive intervention was developed and delivered as a credit course to improve mental distress of university students, based on findings in a previous health survey showing notable mental distress among future teachers in Hungary in 2007. The intervention included increasing information on psychoactive substances used for stress reduction; skills development in stress reduction methods; improving skills in communication and problem-solving. All students who participated in the previous health survey were targeted. Mental status of the participants was assessed by a questionnaire before (n: 128, 22% male, mean age 23.21 years) and after (n: 148, 30% male, mean age 23.54 years) the intervention. Specifically, self-efficacy as outcome was approximated by a trait measure (sense of coherence); psychological distress was measured by the 12-item General Health Questionnaire (Goldberg et al., 1997. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27, 191–197) after the intervention compared with that before. After the intervention, psychological distress was reduced among the participants (p: 0.013). Non-significant improvement occurred in the mean score for sense of coherence (from a mean 60.8 points before to 61.4 points after, p: 0.688). The intervention produced a modest but significant decrease in psychological distress in students at a cost of 54 US$ per 1 point improvement in mental distress. The intervention, a first example of the translation of the social cognitive theory into practice among students in higher education can be integrated into the curriculum as a standardized optional course.

A telephone-based intervention to promote diabetes management in veterans with posttraumatic stress symptoms.

The primary objective of this pilot study was to develop and implement a telephone intervention for veterans with diabetes and posttraumatic stress symptoms (PTSS). Additional objectives were to evaluate study feasibility and to conduct exploratory analyses of the influence of the intervention on diabetic self-care, quality of life, treatment adherence, and mental health functioning. Twenty-three veterans with PTSS and diabetes enrolled in the study and received an initial assessment interview and intervention session. Twenty participants completed the study protocol in its entirety and also received 7 weekly motivational telephone calls with a clinician and a final assessment. Results revealed high levels of compliance with telephone calls. Participants reported satisfaction with and benefit from the intervention that occurred during weekly telephone calls. Participants reported a statistically significant increase in exercise behaviors and healthy eating from pre- to postintervention. Results also revealed a decrease in psychological distress. Although these data are preliminary, they speak to the feasibility and benefits of a brief telephone intervention to address self-care behaviors critical to the management of diabetes for individuals with PTSS.

Outcome evaluation of peer support programme for helping Chinese parents under stress

The aim of the study was to evaluate the effectiveness of a support group programme using peer parent counsellors in reducing participant stress and enhancing social support. Participants included 173 Chinese parents with 134 providing complete data. They were randomly assigned to intervention and control groups at service-centre level. The results indicated that there was a significant decrease in psychological distress and increase in social support among intervention group participants at post-intervention, compared with the control group. Qualitative data also indicated that participants' stress was reduced through sharing with their peers. Implications for social service practice were discussed.

ERGONOMICS-JOB STRESS INTERVENSION (ERGO-JSI) REDUCES STRESS OF EMPLOYEES AT NATIONAL BANK IN DENPASAR

 Work stress may affect the quality of working life due to decrease of work ability, cognitive ability, and may also lead to risky behavior. The decrease in work stress could be reflected by the decrease in stressor, psychological distress and cortisol levels among employees. An ergonomic job stress intervention (Ergo-JSI) applied in this study has several advantages in regard to participatory ergonomics and individual orientation. The objective of this research is to analyze the decrease in job stress reflected by the decrease in stressor, psychological distress and cortisol levels among the employees of a National Bank in Denpasar, Bali, after the application of Ergo-JSI.This is an experimental study with treatment by subject design which was conducted from January to September 2011. Several dependent variables such as stressor and psychological distress were measured using the Indonesian version of Brief Job Stress Questionnaire (BJSQ), while the blood cortisol was measured using chemiluminescence technique. Totally 25 male employees of the Private National Bank in Denpasar 25 were used as the research subjects. They were randomly selected and their ages averaged 39.After the application of Ergo-JSI, a significant change (p &lt; 0.05), that is, a 6.8% decrease in stressor and a 23.7% fall in cortisol were found. Apart from that, a significant change (p&lt; 0.05), that is, a 28% decrease in psychological distress was also found.It could be concluded that the application of Ergo-JSI reduces job stress among the employees of the National Bank in Denpasar, Bali.

Effectiveness and cost-effectiveness of an internet intervention for family caregivers of people with dementia: design of a randomized controlled trial

BackgroundThe number of people with dementia is rising rapidly as a consequence of the greying of the world population. There is an urgent need to develop cost effective approaches that meet the needs of people with dementia and their family caregivers. Depression, feelings of burden and caregiver stress are common and serious health problems in these family caregivers. Different kinds of interventions are developed to prevent or reduce the negative psychological consequences of caregiving. The use of internet interventions is still very limited, although they may be a cost effective way to support family caregivers in an earlier stage and diminish their psychological distress in the short and longer run.Methods/designA pragmatic randomized controlled trial is designed to evaluate the effectiveness and cost-effectiveness of ‘Mastery over Dementia’, an internet intervention for caregivers of people with dementia. The intervention aims at prevention and decrease of psychological distress, in particular depressive symptoms. The experimental condition consists of an internet course with 8 sessions and a booster session over a maximum period of 6 months guided by a psychologist. Caregivers in the comparison condition receive a minimal intervention. In addition to a pre and post measurement, an intermediate measurement will be conducted. In addition, there will be two follow-up measurements 3 and 6 months after post-treatment in the experimental group only. To study the effectiveness of the intervention, depressive symptoms are used as the primary outcome, whereas symptoms of anxiety, role overload and caregiver perceived stress are used as secondary outcomes. To study which caregivers profit most of the internet intervention, several variables that may modify the impact of the intervention are taken into account. Regarding the cost-effectiveness, an economic evaluation will be conducted from a societal perspective.DiscussionThis study will provide evidence about the effectiveness and cost-effectiveness of an internet intervention for caregivers. If both can be shown, this might set the stage for the development of a range of internet interventions in the field of caregiving for people with dementia. This is even more important because future generations of caregivers will be more familiar with the use of internet.Trial registrationNTR-2051/RCT-DDB

Does transition into parenthood lead to changes in mental health? Findings from three waves of a population based panel study

BackgroundLongitudinal studies specifically looking at the transition into parenthood and changes in mental health in the general population are scarce. This study aimed to investigate the impact of transition into...

Screening for psychological distress in neurosurgical brain tumor patients using the Patient Health Questionnaire‐2

Psychological distress is highly prevalent but often undiagnosed in brain tumor patients. We evaluated the psychometric properties of the Patient Health Questionnaire-2 (PHQ-2) for screening of distressed neurosurgical brain tumor patients. A total of 226 (69% women; mean age 55.6 ± 14.7 years) consecutive patients on admission for elective brain tumor surgery were evaluated for psychological distress using the PHQ-2, the Hospital Anxiety and Depression Scale (HADS; n = 206), and the Beck Depression Inventory-II (BDI-II; n = 196). At discharge, the patients were reevaluated using the PHQ-2 and HADS. On admission, 43% and 18% of patients had moderate-severe psychological distress according to the HADS (HADS depression or anxiety score ≥ 11) and BDI-II (score ≥ 20), respectively. At discharge, there was a significant decrease in psychological distress among patients according to the PHQ-2 (p = 0.04) and HADS (p < 0.001) screening results. The PHQ-2 had marginal internal consistency (Cronbach's coefficient alpha = 0.68) and suboptimal test-retest reliability (intraclass correlation coefficient = 0.51). The PHQ-2 had acceptable psychometric properties for identifying patients with moderate-severe psychological distress according to the HADS (sensitivity = 74%, specificity = 68%, and positive predictive value (PPV) = 40%) and BDI-II (sensitivity = 71%, specificity = 65%, and PPV = 30%). Psychometric properties of the PHQ-2 were inferior for mild-severe psychological distress. Greater number of PHQ-2 depressive symptoms was associated with greater scores on the HADS and BDI-II (all ps < 0.001). Psychological distress is prevalent in brain tumor patients and can be successfully identified using the PHQ-2. The PHQ-2 has moderate internal consistency. The PHQ-2 should be considered for routine use in brain tumor patients for psychological distress screening purposes.

Taming the Adolescent Mind: Preliminary report of a mindfulness-based psychological intervention for adolescents with clinical heterogeneous mental health diagnoses

Mindfulness-based interventions such as Mindfulness-based Stress Reduction (MBSR) and Mindfulness Cognitive Behavior Therapy (MCBT) have been used to treat adults with psychiatric disorders. This article describes initial modification and development of a mindfulness-based intervention group program for adolescents with psychiatric disorders. It was hypothesized that the intervention would improve mindfulness, mental health outcomes and decrease psychological distress and symptoms. Adolescents from a mental health clinic attended a 5-week group pilot mindfulness-based intervention. Adolescents and parents completed questionnaires at pre- and post-intervention and at 3-month follow-up. Baseline measures indicated moderate to severe range of mental health symptoms. After the intervention, adolescents reported significant decreases in psychological distress and increases in mindfulness and self-esteem. Qualitative data revealed the intervention to be engaging and beneficial. Parents also reported significant overall improvements of adolescents' functioning. These promising preliminary results suggest that the intervention was feasible, acceptable and offered positive impact on mental health problems, and the intervention warrants further research in a randomized controlled study.

Observed trends in mental health: A strategy to adjust for nonresponse bias and demographic changes in survey data

To examine whether observed changes in self-reported psychological distress symptoms reflect true changes in psychological distress in the population, or more specifically, to present statistical methods to check for nonresponse bias and demographic changes. Lack of representativity, nonresponse bias and demographic changes were controlled for by weighing of data (sample-balancing or raking). Controlling for age, gender and education, or holding the demographic structure constant over time, slightly weakened the decrease in psychological distress from 1998 to 2002, and left the changes in psychological distress from 2002 to 2008 almost unchanged. When the level of psychological distress was held constant across years in every subgroup defined by age, gender and education, in order to isolate the effects of changes in demography, the distress scores showed only minor variation across data collection occasions from 1998 to 2008. The observed modest decrease in psychological distress from 1998 to 2002 may partly be explained by selection and demographic changes, while this is not the case with the more pronounced changes from 2002 to 2008.

TCC pour premiers épisodes de psychose : pourquoi la thérapie de groupe obtient les meilleurs résultats ?

Cet article fait un survol des études en TCC pour personnes en début de psychose, incluant une étude randomisée (RCT) de notre équipe et tente d’expliquer pourquoi les résultats des études de TCC auprès des premiers épisodes varient et pourquoi la thérapie en format de groupe obtient à ce jour les meilleurs résultats. Nous présentons les ingrédients actifs de la TCC pour la psychose débutante et soulignons les avantages de l’approche de groupe de manière plus spécifique pour cette clientèle-cible. Nous présentons en surcroît les résultats d’une étude où nous avons utilisé une approche combinée de TCC et de psychoéducation pour les proches des personnes en début de psychose. The present paper attempts to understand and offer a potential explanation regarding the mostly unimpressive results cognitive behaviour therapy for early psychosis has obtained in large randomized controlled trials. The Socrates study from the UK as well as the Cope study from Australia are good examples of high quality studies offering CBT for psychosis (or for recovery) by expert therapists with results not giving any strong advantage for CBT sessions over regular first episode treatment, supportive or befriending sessions. These results are surprising, given the strong empirical support for CBT for psychosis offered to individuals with many years struggling with the illness and considered treatment resistant. CBT for psychosis has also proven very useful for older individuals with schizophrenia, and even for individuals judged at risk for developing psychosis. We suggest that the answer lies in the format of the therapy: individual therapy might not be as effective as group therapy for individuals with early psychosis. We justify our hypothesis with theoretical concepts (such as developmental: the need to belong to a group of peers), stronger impact of specific CBT techniques in a group format (normalization) as well as with the results from our own large randomized controlled trial with early psychosis (previously published). Our trial has demonstrated that CBT for early psychosis in a group format is not only effective in reducing symptoms but offers advantages above and beyond those of more typical skills training for symptom management in terms of increased self-esteem, more active coping strategies when confronted with stress, and increased social support. Some of these results were maintained at 1-year follow-up (e.g. social support) whereas others were not (e.g. positive symptoms) although the beliefs underlying these symptoms had changed. This paper also presents a novel multi-family intervention that integrates psycho education and CBT for psychosis in order to help family members of those receiving group CBT for early psychosis. The module entitled WITH (for Wellness, Inform, Talk, Help) can be offered over the course of 16 hours up to 24 hours. A detailed description of the content of each session is offered. We also present the results of a pilot study with 40 family members, mostly parents, who participated in the 16 hour version of the WITH multi-family group. Although significant changes in perceived support were not detected, the results show a significant clinical and statistical decrease in psychological distress in the parents who took part in the group, compared to their baseline scores. The qualitative information obtained also suggests that the group was appreciated and that the parents had integrated some CBT skills as well as notions regarding recovery and how to maintain a healthier relationship with their relative receiving psychiatric care. Most agreed that the WITH group had been helpful. We conclude by further emphasizing the need to offer group CBT for early psychosis, and also group CBT with psycho education for family members of individuals with early psychosis.

The impact of traumatic events on emergency room nurses: Findings from a questionnaire survey

BackgroundEmergency Nurses are routinely confronted with work related traumatic events and hectic work conditions. Several studies report a high prevalence of post-traumatic stress disorder (PTSD) in these nurses. Coping and social support seem to play an important role in the development of PTSD. ObjectivesThis study examines (1) the frequency of exposure to and the nature of traumatic events in Emergency Nurses, (2) the percentage of nurses that report symptoms of PTSD, anxiety, depression, somatic complaints and fatigue at a sub-clinical level, and (3) the contribution of traumatic events, coping and social support to PTSD symptoms, psychological distress, somatic complaints, fatigue and sleep disturbances. DesignCross-sectional data from 248 Emergency Nurses, from 15 Flemish (Belgian) general hospitals, were analyzed. ResultsEmergency Nurses were found to be confronted frequently with work related traumatic events. Death or serious injury of a child/adolescent was perceived as the most traumatizing event. Almost one out of three nurses met sub-clinical levels of anxiety, depression and somatic complaints and 8.5% met clinical levels of PTSD. Levels of fatigue were high but not directly related to the frequency of exposure to traumatic events. Emotional coping was related to an increase in all outcomes; avoidant coping was related to more somatic complaints; problem focused coping was related to a decrease in psychological distress and perceived fatigue. Social support from colleagues and supervisor (head nurse) was found to have a protective effect on the occurrence of PTSD symptoms. ConclusionEmergency Nurses are especially vulnerable to post-traumatic stress reactions due to repetitive exposure to work related traumatic incidents. This not only personally affects the nurses, but can also impact quality of care. Hospital management should act on the findings of this study and invest in supportive, communicative, empathic and anticipatory leadership, and provide time-out facilities, cognitive-behavioral interventions and psychological counseling for Emergency Nurses on demand.