What we talk about when we talk about psychiatric mental health nurses' work-related distress: An umbrella review and...

Work-related distress contributes to high turnover rates and mental health challenges among psychiatric and mental health nurses. Nurses' work-related distress is characterized by multiple, often overlapping constructs such as burnout, compassion fatigue, or secondary traumatic stress. Conceptual ambiguity and overlap among these constructs limits a clear understanding of the nature and scope of nurses' work-related distress.

This study aimed to clarify similarities and differences among nurses' work-related distress constructs by examining how they are used within the nursing literature. The patterns in which these constructs are examined alongside other variables provide a "footprint" of how work-related distress is conceptualized by researchers.

A mixed-method, concept mapping umbrella review included systematic reviews, meta-analyses, and meta-syntheses that examined psychiatric and mental health nurses' work-related distress through focal constructs: burnout, compassion fatigue, moral injury, secondary traumatic stress, and post-traumatic stress disorder. Variables that were studied in association with these constructs in any review (e.g., depression, stress, education level) were extracted and then organized into a common dataset. A co-occurrence matrix was created to reveal patterns according to which constructs were examined together. The co-occurrence matrix was used to generate network diagrams for each focal construct.

Out of 84 review articles yielded by an initial search, 15 articles met the inclusion criteria for this umbrella review. 52 variables that were examined in association with the focal constructs were identified. These were organized into 11 categories. Among the networks of co-occurrence among variables linked with each focal construct, the greatest overlap was observed between compassion fatigue and moral distress. The least overlap was observed between burnout and post-traumatic stress disorder. Networks related to moral distress and secondary traumatic stress tended to include individualized distress variables rather than systemic factors, suggesting a potential gap in the literature.

Examining patterns of construct use across reviews can reveal important trends in the literature and provide insight into the overlap and divergence among constructs. A holistic, integrated approach to addressing work-related distress in the psychiatric nursing field, that integrates individual and systemic factors might meaningfully inform interventions to support, retain, and enhance the wellbeing of psychiatric nursing professionals.

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