Factors Influencing Secondary Traumatic Stress in Pediatric Nurses: An Integrative Review

Secondary traumatic stress is a significant occupational concern in pediatric nursing because frequent exposure to traumatic events can compromise nurses' emotional health, increase burnout, and reduce the quality of care. The aim of this integrative review is to synthesize the current evidence on the prevalence and contributing factors of secondary traumatic stress among pediatric nurses. A comprehensive search was conducted in CINAHL, EMBASE, PsycINFO, PubMed, and Web of Science for peer-reviewed articles published in English. A total of 24 studies met the inclusion criteria and were analyzed using Whittemore and Knafl's integrative review methodology. Reported prevalence rates of secondary traumatic stress ranged from 13% to 87%, which were higher than those of other healthcare professionals. Key contributing factors included patient deaths, parental grief, heavy workload, limited organizational support, and insufficient coping strategies. These factors encompassed the individual, work-related, and organizational domains. The review highlights the need for comprehensive strategies to support pediatric nurses' mental health and to develop interventions that address both personal and workplace contributors. Further high-quality research is warranted to deepen the understanding of this phenomenon and inform evidence-based practices that protect both nurse well-being and the quality of care provided to children and their families.