Post-traumatic stress symptoms and burnout in healthcare professionals working in neonatal intensive care units: Results from the STRONG study

Abstract

BackgroundNewborns’ deaths and life-threatening conditions represent extremely stressful events for parents and professionals working in NICUs, facilitating the onset of secondary traumatic stress symptoms. The STRONG study aims to better understand the psychological impact on Italian NICUs staff of bereavement care.MethodsThe STRONG (STress afteR lOss in NeonatoloGy) study is a cross-sectional study based on a web survey consisted of four sections: sociodemographic, CommuniCARE-Newborn questionnaire, the Maslach Burnout Inventory and the Impact of Event Scale-Revised.Results227 NICU workers (42.7% nurses, 23.3% midwives, 22.2% physicians, 11.8% other HCPs) answered the survey. The hardest tasks were “communicating baby’s death” and “informing on autopsy results”; 44.7% of HCPs did not receive formal training in communicating bad news, 44.2% ‘learned from the field’ by watching other colleagues; 41.2% declared that they do not have any communication strategy. More than 90% of professionals thought that training on bereavement care is necessary. The majority of HCPs showed some degree of post-traumatic stress symptoms: 34% medium and 35.3% severe. Professionals with training in bereavement care and/or in communication had less probability to develop stress symptoms. A multivariate analysis showed that higher levels of burnout were associated with 4 or more monthly losses and medium or severe stress symptoms. Having a well-defined communication strategy for breaking bad news was independently associated with a better personal accomplishment.ConclusionDealing with newborns’ deaths is a highly stressful task; professionals should receive proper support such as debriefing, psychological support and training in order to prevent post-traumatic stress symptoms and reduce professional burnout.

Trends and Factors Associated With Mortality Rates of Leading Causes of Infant Death: A CDC Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Database Analysis

“…The observed disparities across states, census divisions, and HHS regions emphasize the need for targeted interventions that address region-specific challenges and promote equitable access to quality healthcare. The findings of this study were found to be consistent with previously published studies [ 13 - 19 , 25 - 27 ].…”

“…Similar trends were reported by Holmes et al in an epidemiological study comparing the delivery methods of vaginal and cesarean section [ 23 ]. This association might reflect differences in postnatal care practices, recovery rates, and potential health implications associated with cesarean deliveries [ 13 - 17 , 24 ]. Strategies aimed at improving maternal education, enhancing healthcare access during pregnancy and childbirth, and promoting informed choices regarding delivery methods can potentially contribute to the reduction of infant mortality rates and overall improvement in child health.…”

“…The added burden of other losses and stressors, such as financial strain and employment issues, can further exacerbate the emotional toll of infant mortality. The psychological burden of infant mortality can also be significant for parents and families [ 13 ]. Parents who experience the death of a newborn in the neonatal intensive care unit, for example, may experience post-traumatic stress symptoms related to the trauma of the experience.…”

Trends and Determinants of Neonatal Mortality in Rural Ethiopia

“…Professionals who work in neonatal intensive care units are more likely to be present during the end-of-life time for neonates, which can hurt their emotions and practice. Coping with the death of newborns is a highly stressful task that can lead to post-traumatic stress symptoms and burnout in professionals [13].…”

Improving Well-being Among Women in Neonatology

“…Neonatology is one of the largest sub-specialties in pediatrics and rates of burnout among neonatologists are high 7,8 . As a subspecialty, neonatologists are confronted daily with high-intensity procedural and decision-making scenarios, emotional and ethical dilemmas surrounding the care of critically ill newborns, and sta ng models that contribute to long working hours 7,[9][10][11][12] . Additionally, productivity benchmarks are over two-fold higher for neonatologists than for other pediatric critical care subspecialties, and this increased workload contributes to decreased time per patient and reduced job satisfaction 13,14 .…”