Working in a healthcare environment has negative effects on the mental and psychological well-being of healthcare workers [1-3]. Healthcare professionals (HCPs) working in high-morbidity specialties, such as emergency and critical care [4 ,5], neurology [6-9], cardiology [10], pulmonology [11], and mental health [12-16] are particularly vulnerable to psychological impairment. Listening to the stories of patients’ suffering, pain, and worries may result in similar feelings among HCPs providing care for those patients [17-19]. According to a study on the relationship between secondary traumatic stress (STS) and occupation, 67.7% of doctors, 59.3% of emergency medical technicians, 53.8% of paramedics, 62.5% of health officers, 30% of nurses, and 80% of anesthesia technicians were affected by a trauma that someone they treated, or cared for, had experienced [20].
STS disorder involves the development of symptoms related to indirect exposure to trauma or post-traumatic stress disorder (PTSD) among HCPs serving patients at emergency departments (EDs). It occurs among physicians and HCPs serving traumatized populations, including patients suffering from various health challenges [17]. Symptoms of STS can negatively impact the health of HCPs, as they are susceptible to making poor professional decisions for their patients undergoing treatment, including misdiagnosis, poor treatment planning, or abuse of patients [17, 21-24].
STS can be manifested as the characteristic symptoms related to PTSD, which warrant the physician to undergo treatment related to STS disorder [25]. The symptoms related to STS can occur in terms of hyper-vigilance, intrusion, irritability, and avoidance/numbing. Most importantly, HCPs can re-experience symptoms related to traumatic events again and again. It is related to intrusion-associated clustered symptoms and can include recollections of events in the form of thoughts, perceptions, or images. It can also include distressing dreams or nightmares, a feeling of the reoccurrence of events, intense psychological distress, and exposure to internal or external cues that are related to an aspect of the distressing event. Constant stimuli associated with a traumatic event can lead to distressing thoughts, physiological reactivity, and feelings of detachment [26-28]. A study of nurses revealed that they felt they had lost their optimism, energy, and compassion for their patients and even the realization that they were growing distant from them and their coworkers [29]. Numerous studies have revealed that the development of compassion fatigue (CF) among HCPs has a significant impact on specialization, time spent with patients, and treatment outcomes [30]. According to reports, HCPs have to deal with new issues in addition to professional stress, like being verbally and physically attacked by crowds [31]. HCPs have many concerns about the lack of personal protective equipment (PPE) [32]. Other risk factors, such as younger age, being new to the area, pre-existing anxiety and mood disorders, prior traumatic experiences, and less than ideal coping mechanisms, like distancing or detaching, can exacerbate or increase the impact of STS [33].
Additionally, high rates of CF were reported among physical therapists (PTs) in various American, European, and Middle Eastern countries [34-37]. Physical therapists are distinctive and crucial members of today's multidisciplinary healthcare teams, contributing to the health economy in areas, such as acute care and rehabilitation, primary care, prevention, and public health [38]. Patients with semi-urgent and non-urgent musculoskeletal issues are under the care of ED-PTs. They conduct patient interviews and examinations, order tests, including X-rays, make diagnoses, put into practice appropriate interventions, refer patients for ongoing management, and coordinate patient release [39]. In order to decrease avoidable hospitalizations, PTs may also assist with the care of patients with acute respiratory problems (for example, performing secretion clearing procedures) or help patients with their transition from ED discharge back into the community, as greater numbers of PTs are placed in the hospital ED. Despite there only being a few studies that have evaluated healthcare outcomes for patients managed by PTs in the ED [40], the results have generally been encouraging. Similar clinical outcomes (namely pain, function, and representation rate) of patients served in the conventional ED model demonstrate that the management of peripheral soft tissue injuries by ED-PTs is of a suitable quality [41, 42]. Early in the healing process, following specific injury types, PTs can assist patients in starting their journey to recovery [43]. In addition to the degree of STS that care provider’s experience, the practice environment of PTs may also have an impact on how far they progress along the compassion continuum. PTs living and working in humanitarian crises, such as conflict zones [44], places of civil unrest [45] or disaster situations [46] may experience higher levels of STS. However, data is scarce on the prevalence of STS among PTs arduously treating chronic conditions (e.g., spinal cord injuries, strokes, and cerebral palsy), progressive conditions (e.g., heart failure and cancer), and degenerative conditions (e.g., Parkinson's disease, muscular dystrophy, arthritis, and other bone diseases), and who remain with patients for hours and build close bonds with them, particularly in the countries of the Middle East, including Saudi Arabia. STS disorder needs to be correctly analyzed based on occupation and not from the broad perspective of all HCPs. Appropriate planning parameters must be put in place, for which fundamental data from each set-up is required. This study investigated STS among PTs in Saudi Arabia. Our findings may help managers and employers support clinicians in developing their skills and put STS management measures into practice. The study could also raise awareness of the difficulties and barriers faced by PTs in the ED.
Purpose of the Present Study
This study’s objective was to determine the prevalence of STS disorder among PTs working in critical care, emergency, neurology, cardiology and pulmonology departments between July 2021 and July 2022.