Providing Care for Many in the Context of Few Resources: Secondary Traumatic Stress, Burnout and Moral Distress Experienced by Healthcare Providers in Rural Uganda

<p>In the context of the global nursing shortage, and particularly in low-resource settings, nurses are at an increased risk for work-related stress problems like secondary traumatic stress (STS), burnout, and moral distress. These three work-related mental health consequences, sometimes associated with absenteeism and intent to leave the profession, could potentially contribute further to the shortage of nurses. This two-part study is a longitudinal examination of the work-related mental health consequences experienced by healthcare providers in rural Uganda. In Study 1, participants (n=208; 159 students and 49 experienced health workers) completed self-report, psychosocial measures at baseline and 134 of the students completed the measures again 13-months later. Study 1, which was primarily quantitative, assessed the prevalence of mental health consequences and common coping strategies and examined associations among coping strategies and symptoms over time. In Study 2, participants (n=13) completed in-depth qualitative interviews about their experiences as healthcare providers. Qualitative data from both studies were used to contextualize and illustrate quantitative findings. Almost all participants endorsed clinically significant symptoms of at least STS, burnout or moral distress. Participants reported most commonly utilizing religion, planning, and other active, problem-focused coping strategies such as improvising in order to cope with challenging work circumstances. However, based on follow-up data for students, symptoms of STS and burnout were stable across the 13 months and individual differences in coping strategies had little effect on the progression of symptoms. Findings underscore the need for increased mental health awareness and targeted stress reduction programs in addition to infrastructural changes within the healthcare and health education systems in rural Uganda and other low-resource settings. The implications and suggestions are discussed in light of Uganda’s cultural context and plans for development.</p>

Name thesis:degree_name

Doctor of Philosophy

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Psychology

Grantor

The Graduate School and University Center of The City University of New York

Year dc:date.available

2016

Author dc:creator

• Dewey, Lauren Michelle

Advisor dc:contributor.advisor

• Maureen A. Allwood

Committee members dc:contributor.committeemember

• Brett G. Stoudt
• Kevin L. Nadal
• Adeyinka M. Akinsulure-Smith
• Andrew Rasmussen

• Clinical Psychology
• Nursing
• Public Health
• burnout
• community-based research
• low-resource setting
• moral distress
• rural healthcare
• secondary traumatic stress

Repository record dc:identifier

https://academicworks.cuny.edu/gc_etds/1519

OAI identifier oai:identifier

oai:academicworks.cuny.edu:gc_etds-2533