Zasiekina Larysa, Martyniuk Anastasiia
Department of Psychology, University of Exeter, Exeter, UK.
Department of General and Clinical Psychology, Lesya Ukrainka Volyn National University, Lutsk, Ukraine.
BMC Nurs. 2025 Jan 6;24(1):16. doi: 10.1186/s12912-024-02668-4.
At the beginning of 2022, Central Europe entered a state of emergency due to the Russian invasion of Ukraine. Nurses were particularly vulnerable to a decline in their professional quality of life, facing repeated exposure to military trauma, ethical dilemmas, prolonged working hours, and increased stress and fatigue. This study aimed to contribute to our understanding of the potential mediating effect of war-related continuous traumatic stress on the association between moral distress and professional quality of life, including compassion satisfaction and compassion fatigue, represented by burnout and secondary traumatic stress.
This study used the Professional Quality of Life (ProQOL) Scale to assess compassion fatigue, including burnout, secondary traumatic stress, and compassion satisfaction; the Moral Distress Questionnaire for Nurses to examine everyday moral distress in healthcare facilities and everyday ethical dilemmas of nurses; and the Continuous Traumatic Stress Response (CTSR) Scale to assess ongoing threats, resulting in exhaustion/rage, and fear/betrayal. The sample consisted of 130 female nurses (mean age 40.20 ± 12.15 years) from general surgery, neurosurgery, trauma and orthopaedic surgery, and urgent care who had been undergoing advanced training to work with injured military personnel at the Volyn Medical Institute (Ukraine) from March to May 2023. All nurses had experienced direct and indirect exposure to military trauma, and 105 participants were working with injured military personnel.
The results of the mediation analysis indicated that war-related continuous traumatic stress fully mediated the relationship between moral distress and different components of professional quality of life, namely, compassion fatigue, including burnout and secondary traumatic stress, and compassion satisfaction.
Research has shown that continuous traumatic stress has a significant effect on the relationship between moral distress and various aspects of professional quality of life, underscoring the need for targeted interventions for nurses facing war-related trauma.
2022年初，由于俄罗斯对乌克兰的入侵，中欧进入紧急状态。护士特别容易出现职业生活质量下降的情况，他们反复接触军事创伤、面临伦理困境、工作时间延长，压力和疲劳感增加。本研究旨在帮助我们理解与战争相关的持续性创伤应激对道德困扰与职业生活质量之间关联的潜在中介作用，职业生活质量包括以倦怠和继发性创伤应激为代表的同情疲劳和同情满足感。
本研究使用职业生活质量（ProQOL）量表来评估同情疲劳，包括倦怠、继发性创伤应激和同情满足感；使用护士道德困扰问卷来调查医疗机构中的日常道德困扰以及护士的日常伦理困境；使用持续性创伤应激反应（CTSR）量表来评估持续存在的威胁，这些威胁会导致疲惫/愤怒以及恐惧/背叛。样本包括来自普通外科、神经外科、创伤与矫形外科以及紧急护理科室的130名女护士（平均年龄40.20±12.15岁），她们于2023年3月至5月在沃伦医学院（乌克兰）接受了与受伤军事人员合作的高级培训。所有护士都直接或间接接触过军事创伤，其中105名参与者正在护理受伤的军事人员。
中介分析结果表明，与战争相关的持续性创伤应激完全中介了道德困扰与职业生活质量不同组成部分之间的关系，即同情疲劳（包括倦怠和继发性创伤应激）和同情满足感。
研究表明，持续性创伤应激对道德困扰与职业生活质量各个方面之间的关系有显著影响，这凸显了针对面临与战争相关创伤的护士进行针对性干预的必要性。
