# A model for predicting secondary traumatic stress in emergency nurses: the roles of occupational stress, empathy, and psychological resilience

## TL;DR

This study identifies factors like stress, empathy, and resilience that predict secondary traumatic stress in emergency nurses and builds a model to help improve their mental health and patient care.

## Contribution

A novel regression model predicting secondary traumatic stress in ED nurses using occupational stress, empathy, and psychological resilience.

## Key findings

- Nursing stress and empathy are positively linked to higher secondary traumatic stress (STS) scores.
- Psychological resilience acts as a protective factor against STS.
- The model explains 56% of the variance in STS scores using key predictors like personal distress and emotional resonance.

## Abstract

The high-stress environment of the emergency department (ED) predisposes nurses to significant occupational stress, which can precipitate compassion fatigue and secondary traumatic stress (STS). STS adversely affects nurses’ wellbeing and may compromise both their professional performance and patient care quality. Investigating the predictive roles of nursing stress, empathy, and psychological resilience on STS in ED nurses, and constructing a reliable predictive model, is therefore clinically imperative.

This study aimed to develop a predictive model for STS among ED nurses based on nursing stress, empathy, and psychological resilience, intending to inform psychological support strategies and management practices.

A cross-sectional survey was conducted using convenience sampling to recruit 186 ED nurses from a single hospital. Data were collected via questionnaires, including the Vicarious Traumatization Questionnaire (VTQ), the Chinese version of the Interpersonal Reactivity Index (IRI-C), the Perceived Stress Scale (PSS), and the Connor-Davidson Resilience Scale (CD-RISC). Data analysis involved descriptive statistics, correlation analysis, and multiple linear regression to build a multidimensional model of factors influencing STS.

The results indicated that nursing stress, empathy, and psychological resilience were significantly associated with STS. Higher levels of nursing stress and empathy, along with lower levels of psychological resilience, were positively correlated with higher STS scores. Sub-factors such as personal distress, emotional resonance, and exposure to traumatic events had the strongest associations. The regression model, incorporating these predictors, explained 56.00% of the variance in STS scores.

STS in ED nurses is influenced by multiple factors, including nursing stress, empathy, and psychological resilience, with resilience serving as an important protective factor. The developed regression model provides valuable insights into these associations and holds clinical utility in guiding interventions aimed at enhancing nurse mental health, refining the work environment, and improving patient care quality. These findings suggest the need for targeted psychological support strategies in ED settings.