Vicarious trauma, coping strategies and nurses' health outcomes: An exploratory study

Background: The COVID-19 outbreak played a significant psychological impact on nurses, as they coped with intense emotional and cognitive demands, in a context in which the Health System was not prepared to face the emergency. Literature showed that pandemics influenced the nurses' stress and psychosocial health due to poor rest, high work overloads, a lack of control over the patient flows, and a frequent isolation from family. Under these circumstances, nurses experienced severe psychological and mental stressors that generated mental health problems. Recent literature showed that coping strategies, especially those that were positive, promoted mental health in workers and helped them to face stressors. Objective: The study aimed to investigate the relationship between vicarious traumas and the impact of traumatic events on nurses' mental health. In addition, we analyzed the role of coping strategies in moderating the effect of vicarious traumas on mental health. Methods: The study was performed in November 2020, during the first wave of the COVID-19 pandemic. A self-reported structured questionnaire was administered via an online method to reduce face-to-face contact. Logistic regressions were conducted to analyze the relationship between both vicarious traumas and the impact of traumatic events impact and mental health. An interaction analysis with the PROCESS macro was performed to analyze the role of coping strategies in moderating the relationship between vicarious traumas and mental health. Results: A total of 183 nurses answered to the questionnaire. A moderation analysis showed that positive coping strategies such as physical activity, reading/music, and yoga/meditation showed to be protective in reducing the effect of vicarious traumas on the nurses' mental health problems. Conversely, negative coping strategies strengthened that relationship and may compromise their quality of working life. Conclusion: These findings provide further support for considering positive coping strategies as an important resource to alleviate psychological distress, thus helping the professional to reduce the negative effects of stress.