Assessment of Secondary Traumatic Stress in Health Care Professionals Working in Tertiary Care Hospitals of Islamabad

severity & factors associated with secondary traumatic stress symptoms among health care professionals working with trauma victims in tertiary care hospitals of Islamabad. Methods: A cross-sectional study was carried out in which 170 healthcare professionals participated from both public and private tertiary care hospitals of Islamabad. Data were collected by using STS Scale, TIPI and demographics. Analyses was done using independent t-test, ANOVA and Pearson's Correlation Coe�cient. Results: The results showed, 94(55.3%) and 71(41.7 %) little and mild to moderate level of STS in healthcare professionals respectively. Female gender was signi�cantly associated with STS (p = 0.01) along with MBBS graduates (p = 0.02) and junior doctors (p = 0.01) showed symptoms of STS. Those who were exposed to trauma multiple times had signi�cant association STS. Emotionally stable personality trait of the healthcare professionals had an indirect relation with the development STS symptoms (r= -0.46). Conclusions: The results emphasized hospital administration to take measures in order to reduce stress level especially among female HCWs, junior doctors and those who had multiple exposure of trauma. If necessary steps are not taken, this stress may lead to worse mental health of this target population

dissatisfaction, long working hours, often working over the hours, loss of personal and social life. This eventually leads to a state where psychological burden coupled with poor decision-making leads to unintentional ethical and medical errors [3]. The emotional, physical and mental exhaustion of healthcare professionals has negative repercussions on their ability to work e ciently. As the work of a health professional is directly concerned with the lives of their patients it adds more to the already negative outcomes of their psychological state [4]. Compassion fatigue another term that has a similar meaning as that of STS. Where former term especially affects the feeling of empathy towards the patients' ailments and other conditions [5]. As Assessment of Secondary Traumatic Stress in Health Care Professionals

I N T R O D U C T I O N
Health care professionals are at a higher risk of developing secondary traumatic stress due to various factors related to the nature of their job. Objectives: To assess the level, severity & factors associated with secondary traumatic stress symptoms among health care professionals working with trauma victims in tertiary care hospitals of Islamabad. Methods: A cross-sectional study was carried out in which 170 healthcare professionals participated from both public and private tertiary care hospitals of Islamabad. Data were collected by using STS Scale, TIPI and demographics. Analyses was done using independent t-test, ANOVA and Pearson's Correlation Coe cient. Results: The results showed, 94(55.3%) and 71(41.7 %) little and mild to moderate level of STS in healthcare professionals respectively. Female gender was signi cantly associated with STS (p = 0.01) along with MBBS graduates (p = 0.02) and junior doctors (p = 0.01) showed symptoms of STS. Those who were exposed to trauma multiple times had signi cant association STS. Emotionally stable personality trait of the healthcare professionals had an indirect relation with the development STS symptoms (r= -0.46).

Conclusions:
The results emphasized hospital administration to take measures in order to reduce stress level especially among female HCWs, junior doctors and those who had multiple exposure of trauma. If necessary steps are not taken, this stress may lead to worse mental health of this target population Sample size was calculated after taking the total population of emergency respondents from each of the selected hospital, with 50% proportion and 5% nonresponse rate a total of 170. HCP who met inclusion criteria, were conveniently included in this study. Data were collected by questionnaire which consisted of sociod e m o g r a p h i c i n fo r m a t i o n o f t h e H C P a n d t w o internationally validated tools of Ten Item Personality Trait Inventory and Secondary Traumatic Stress Scale. A total score below 28 corresponded to "little or no STS," a score between 28 and 37 means "mild STS," between 38 and 43 "moderate STS," between 44 and 48 "high STS," and beyond 49 "severe STS [12]. The IBM SPSS, version 26.0 was used to verify the obtained data. The data analysis was divided into three stages. First descriptive analyses were run for sociodemographics variables which included frequencies and percentages. In second stage independent sample t-test a n d A N OVA we r e r u n fo r a ss o c i a t i o n o f s o c i odemographics variables with the STSS. In the third phase Pearson's Correlation was applied to ten item personality traits to the STSS. P value more than 0.05 is considered

R E S U L T S
The demographic characteristics of the samples are presented in   The Secondary traumatic stress scale has a range of 51, with minimum score 0 and maximum 51, with a mean of 25.54±10.12. Study results showed that more than half respondents have little to no secondary traumatic stress (Figure 1).

Figure 1: Secondary Traumatic Stress categories
The signi cant factors associated with STS was gender, educational status, designation of the respondents and how many times these respondents experienced trauma (p<0.05). Details of associated factors is given in table 3.   . Secondary traumatic stress can be affected by number of factors, one of that is the personality type of the individual. In this study the relationship of the personality trait of healthcare professional was assessed with the secondary traumatic stress. In the current study it was found that Emotional Stability of health care professionals was indirectly associated with secondary traumatic stress. The reason for this, could be the fact that emotional stable personality traits remain calm and stable. The emotional reaction of the individuals who exhibit emotional stability is less and do not get easily upset. A study conducted in Australia showed that health care providers who were found to be emotionally stable, showed more effective work engagement [18]. Similarly in China nurses who were found to be emotional stable showed gentle responses to work-related stressors and were found to have impulse control [19]. On the other hand, neurotic personality trait had a positive relation in the development of burnout, showed by a study conducted in Spain [7]. Another similar nding is a previous study where neuroticism was a positive predictor in the development of burnout in healthcare workers, in Greece [20].

C o n  i c t s o f I n t e r e s t C O N C L U S I O N S
The results of this study were suggestive of that hospital administrations need to take measures to reduce the levels of stress especially among the female health care professionals, junior doctors and those who have experienced trauma multiple times. Emotional stability of the health care professionals should be evaluated before appointing in those departments where work-related stressors are known to be high.