Health and Social Care Professionals’ Experience of Psychological Safety Within Their Occupational Setting: A Thematic Synthesis Review
Abstract
:1. Introduction
1.1. The Importance of Psychological Safety at Work
1.2. The Neurophysiology of Psychological Safety
1.3. The Role of Psychological Safety in HSCPs’ Wellbeing
2. Focus of the Scoping Review
3. Objective of the Review
4. Research Questions
- Primary Question
- Secondary Questions
- What are the characteristics of participants included in the sources of evidence identified?
- What research designs underpin the literature on PS as experienced by HSCPs?
- What factors are effective in facilitating (enablers) or reducing (barriers) PS among HSCPs?
- What gaps exist in the literature regarding PS as experienced by HSCPs?
5. Method
6. Inclusion Criteria
6.1. Population
6.2. Context
6.3. Date of Publication
6.4. Types of Evidence
6.5. Languages
7. Exclusion Criteria
8. Calibration
9. Sources of Evidence
10. Search Strategy
- Initial Search: The first step involved performing an initial search of two databases, namely MEDLINE (Ovid) and APA PsycInfo. Text words used in the titles and abstracts of relevant papers identified within this search were extracted and analysed alongside the index terms describing the articles.
- Comprehensive Database Search: These terms were then used in step two, where a further search was conducted across all relevant databases: MEDLINE, APA PsycINFO, Embase, CINAHL, Scopus, Web of Science, and Cochrane Library.
- Reference List Examination: Lastly, step three included examining the reference lists of articles included in the review to identify further relevant sources.
11. Data Extraction Process
12. Risk of Bias
13. Data Synthesis
14. Results
Study Characteristics
15. Quality Assessment
16. Thematic Synthesis
17. Enablers of Psychological Safety
18. Personal Factors
18.1. Skills and Experience
18.2. Social Support and Self-Care
19. Feeling Safe Within the Team
20. Barriers to Psychological Safety
21. Normalisation of Traumatic Incidents
22. Unsupportive Team and Management
23. Organisational Factors
24. Lack of Knowledge and Training
25. Discussion
26. Limitations of the Review
27. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Public Involvement Statement
Guidelines and Standards Statement
Use of Artificial Intelligence
Conflicts of Interest
References
- Grant, L.; Bostock, L.; Reid, C.; Ali, N.; Factor, F. Supporting health and social care students stay and stay well: A conceptual framework for implementing integrated care into higher education. Int. J. Integr. Care 2025, 25, 2. [Google Scholar] [CrossRef] [PubMed]
- Charzyńska, E.; Habibi Soola, A.; Mozaffari, N.; Mirzaei, A. Patterns of work-related stress and their predictors among emergency department nurses and emergency medical services staff in a time of crisis: A latent profile analysis. BMC Nurs. 2023, 22, 98. [Google Scholar] [CrossRef] [PubMed]
- Chirico, F.; Afolabi, A.A.; Ilesanmi, O.S.; Nucera, G.; Ferrari, G.; Sacco, A.; Szarpak, L.; Crescenzo, P.; Magnavita, N.; Leiter, M. Prevalence, risk factors and prevention of burnout syndrome among healthcare workers: An umbrella review of systematic reviews and meta-analyses. J. Health Soc. Sci. 2021, 6, 465–491. [Google Scholar]
- Ding, Y.; Qu, J.; Yu, X.; Wang, S. The Mediating Effects of Burnout on the Relationship between Anxiety Symptoms and Occupational Stress among Community Healthcare Workers in China: A Cross-Sectional Study. PLoS ONE 2014, 9, e107130. [Google Scholar] [CrossRef]
- Kinman, G.; Teoh, K.; Harriss, A. Supporting the well-being of healthcare workers during and after COVID-19. Occup. Med. 2020, 70, 294–296. [Google Scholar] [CrossRef] [PubMed]
- Merrick, A.D.; Grieve, A.; Cogan, N. Psychological impacts of challenging behaviour and motivational orientation in staff supporting individuals with autistic spectrum conditions. Autism 2017, 21, 872–880. [Google Scholar] [CrossRef]
- Montero-Tejero, D.J.; Jiménez-Picón, N.; Gómez-Salgado, J.; Vidal-Tejero, E.; Fagundo-Rivera, J. Factors influencing occupational stress perceived by emergency nurses during prehospital care: A systematic review. Psychol. Res. Behav. Manag. 2024, 17, 501–528. [Google Scholar] [CrossRef]
- Singh, J.; Karanika-Murray, M.; Baguley, T.; Hudson, J. A systematic review of job demands and resources associated with compassion fatigue in mental health professionals. Int. J. Environ. Res. Public Health 2020, 17, 6987. [Google Scholar] [CrossRef]
- Cogan, N.; Craig, A.; Milligan, L.; McCluskey, R.; Burns, T.; Ptak, W.; Kirk, A.; Graf, C.; Goodman, J.; De Kock, J. ‘I’ve got no PPE to protect my mind’: Understanding the needs and experiences of first responders exposed to trauma in the workplace. Eur. J. Psychotraumatol. 2024, 15, 2395113. [Google Scholar] [CrossRef]
- Backé, E.M.; Seidler, A.; Latza, U.; Rossnagel, K.; Schumann, B. The role of psychosocial stress at work for the development of cardiovascular diseases: A systematic review. Int. Arch. Occup. Environ. Health 2012, 85, 67–79. [Google Scholar] [CrossRef]
- Ezber, R.; Gülseven, M.E.; Koyuncu, A.; Sari, G.; Sari, G.; Şimşek, C. Evaluation of cardiovascular disease risk factors in healthcare workers. Fam. Med. Prim. Care Rev. 2023, 25, 150–154. [Google Scholar] [CrossRef]
- Pérez-Valdecantos, D.; Caballero-García, A.; Del Castillo-Sanz, T.; Bello, H.J.; Roche, E.; Córdova, A. Stress salivary biomarkers variation during the work day in Emergencies in healthcare professionals. Int. J. Environ. Res. Public Health 2021, 18, 3937. [Google Scholar] [CrossRef] [PubMed]
- Rice, V.; Glass, N.; Ogle, K.R.; Parsian, N. Exploring physical health perceptions, fatigue and stress among health care professionals. J. Multidiscip. Healthc. 2014, 7, 155–161. [Google Scholar] [CrossRef] [PubMed]
- Kivimäki, M.; Pentti, J.; Ferrie, J.E.; Batty, G.D.; Nyberg, S.T.; Jokela, M.; Virtanen, M.; Alfredsson, L.; Dragano, N.; Fransson, E.I.; et al. Work stress and risk of death in men and women with and without cardiometabolic disease: A multicohort study. Lancet Diabetes Endocrinol. 2018, 6, 705–713. [Google Scholar] [CrossRef]
- Beadle, E.S.; Walecka, A.; Sangam, A.V.; Moorhouse, J.; Winter, M.; Munro Wild, H.; Trivedi, D.; Casarin, A. Triggers and factors associated with moral distress and moral injury in health and social care workers: A systematic review of qualitative studies. PLoS ONE 2024, 19, e0303013. [Google Scholar] [CrossRef]
- Fronteira, I.; Mathews, V.; Dos Santos, R.L.B.; Matsumoto, K.; Amde, W.; Pereira, A.; Poz, M.R.D. Impacts for health and care workers of COVID-19 and other public health emergencies of international concern: Living systematic review, meta-analysis and policy recommendations. Hum. Resour. Health 2024, 22, 10. [Google Scholar] [CrossRef]
- Isobel, S.; Thomas, M. Vicarious trauma and nursing: An integrative review. Int. J. Ment. Health Nurs. 2021, 31, 247–259. [Google Scholar] [CrossRef] [PubMed]
- Purdy, L.M.; Antle, B.F. Reducing Trauma in Residential Direct Care Staff. Resid. Treat. Child. Youth 2021, 39, 179–191. [Google Scholar] [CrossRef]
- Smith, B.A.; Georgiopoulos, A.M.; Mueller, A.; Abbott, J.; Lomas, P.; Aliaj, E.; Quittner, A.L. Impact of COVID-19 on mental health: Effects on screening, care delivery, and people with cystic fibrosis. J. Cyst. Fibros. Off. J. Eur. Cyst. Fibros. Soc. 2021, 20 (Suppl. S3), 31–38. [Google Scholar] [CrossRef]
- Umbetkulova, S.; Kanderzhanova, A.; Foster, F.; Stolyarova, V.; Cobb-Zygadlo, D. Mental health changes in healthcare workers during COVID-19 pandemic: A systematic review of longitudinal studies. Eval. Health Prof. 2024, 47, 11–20. [Google Scholar] [CrossRef]
- Awan, S.; Diwan, M.N.; Aamir, A.; Allahuddin, Z.; Irfan, M.; Carano, A.; Vellante, F.; Ventriglio, A.; Fornaro, M.; Valchera, A.; et al. Suicide in healthcare workers: Determinants, challenges, and the impact of COVID-19. Front. Psychiatry 2022, 12, 792925. [Google Scholar] [CrossRef] [PubMed]
- Agata, S.; Grzegorz, W.; Ilona, B.; Violetta, K.; Katarzyna, S. Prevalence of burnout among healthcare professionals during the COVID-19 pandemic and associated factors–a scoping review. Int. J. Occup. Med. Environ. Health 2023, 36, 21. [Google Scholar]
- Lewis, S.; Willis, K.; Smallwood, N. The collective experience of moral distress: A qualitative analysis of perspectives of frontline health workers during COVID-19. Philos. Ethics Humanit. Med. 2025, 20, 1. [Google Scholar] [CrossRef]
- Cogan, N.; Archbold, H.; Deakin, K.; Griffith, B.; Sáez Berruga, I.; Smith, S.; Flowers, P. What have we learned about what works in sustaining mental health care and support services during a pandemic? Transferable insights from the COVID-19 response within the NHS Scottish context. Int. J. Ment. Health 2022, 51, 164–188. [Google Scholar] [CrossRef]
- Ahmed, F.; Xiong, Z.; Faraz, N.A.; Arslan, A. The interplay between servant leadership, psychological safety, trust in a leader and burnout: Assessing causal relationships through a three-wave longitudinal study. Int. J. Occup. Saf. Ergon. 2023, 29, 912–924. [Google Scholar] [CrossRef]
- Schein, E.H.; Bennis, W.G. Personal and Organizational Change Through Group Methods: The Laboratory Approach; Wiley: Hoboken, NJ, USA, 1965. [Google Scholar]
- Kahn, W.A. Psychological conditions of personal engagement and disengagement at work. Acad. Manag. J. 1990, 33, 692–724. [Google Scholar] [CrossRef]
- Edmondson, A. Psychological safety and learning behavior in work teams. Adm. Sci. Q. 1999, 44, 350–383. [Google Scholar] [CrossRef]
- Okuyama, A.; Wagner, C.; Bijnen, B. Speaking up for patient safety by hospital-based health care professionals: A literature review. BMC Health Serv. Res. 2014, 14, 61. [Google Scholar] [CrossRef]
- Edmondson, A.C.; Lei, Z. Psychological safety: The history, renaissance, and future of an interpersonal construct. Annu. Rev. Organ. Psychol. Organ. Behav. 2014, 1, 23–43. [Google Scholar] [CrossRef]
- Grailey, K.E.; Murray, E.; Reader, T.; Brett, S.J. The presence and potential impact of psychological safety in the healthcare setting: An evidence synthesis. BMC Health Serv. Res. 2021, 21, 773. [Google Scholar] [CrossRef]
- Sullivan, C.M.; Goodman, L.A.; Virden, T.; Strom, J.; Ramirez, R. Evaluation of the effects of receiving trauma-informed practices on domestic violence shelter residents. Am. J. Orthopsychiatry 2018, 88, 563. [Google Scholar] [CrossRef]
- Morton, L.; Cogan, N.; Kolacz, J.; Calderwood, C.; Nikolic, M.; Bacon, T.; Pathe, E.; Williams, D.; Porges, S.W. A new measure of feeling safe: Developing psychometric properties of the Neuroception of Psychological Safety Scale (NPSS). Psychol. Trauma Theory Res. Pract. Policy 2022, 16, 701. [Google Scholar] [CrossRef] [PubMed]
- Hudson, H.L.; Schill, A.L.; Richards, R. An exploratory, qualitative study of how organizations implement the hierarchy of controls applied to Total Worker Health®. Int. J. Environ. Res. Public Health 2021, 18, 10032. [Google Scholar] [CrossRef]
- Porges, S.W. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation (Norton Series on Interpersonal Neurobiology); WW Norton & Company: New York, NY, USA, 2011. [Google Scholar]
- Porges, S.W. Polyvagal theory: A science of safety. Front. Integr. Neurosci. 2022, 16, 871227. [Google Scholar] [CrossRef] [PubMed]
- Szwamel, K.; Kaczorowska, A.; Lepsy, E.; Mroczek, A.; Golachowska, M.; Mazur, E.; Panczyk, M. Predictors of the Occupational Burnout of Healthcare Workers in Poland during the COVID-19 Pandemic: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2022, 19, 3634. [Google Scholar] [CrossRef]
- Porges, S.W. Polyvagal Theory: The Neuroscience of Safety in Trauma-Informed Practice. In The Handbook of Trauma-Transformative Practice: Emerging Therapeutic Frameworks for Supporting Individuals, Families or Communities Impacted by Abuse and Violence; Jessica Kingsley Publishers: London, UK, 2024; p. 51. [Google Scholar]
- Cogan, N.; Campbell, J.; Morton, L.; Young, D.; Porges, S. Validation of the Neuroception of Psychological Safety Scale (NPSS) among health and social care workers in the UK. Int. J. Environ. Res. Public Health 2024, 21, 1551. [Google Scholar] [CrossRef] [PubMed]
- Kessel, M.; Kratzer, J.; Schultz, C. Psychological safety, knowledge sharing, and creative performance in healthcare teams. Creat. Innov. Manag. 2012, 21, 147–157. [Google Scholar] [CrossRef]
- Moore, L.; McAuliffe, E. To report or not to report? Why some nurses are reluctant to whistleblow. Clin. Gov. Int. J. 2012, 17, 332–342. [Google Scholar] [CrossRef]
- O’Donovan, R.; McAuliffe, E. A systematic review exploring the content and outcomes of interventions to improve psychological safety, speaking up and voice behaviour. BMC Health Serv. Res. 2020, 20, 101. [Google Scholar] [CrossRef]
- Nembhard, I.M.; Edmondson, A.C. Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J. Organ. Behav. Int. J. Ind. Occup. Organ. Psychol. Behav. 2006, 27, 941–966. [Google Scholar] [CrossRef]
- Edmondson, A.C.; Higgins, M.; Singer, S.; Weiner, J. Understanding psychological safety in health care and education organizations: A comparative perspective. Res. Hum. Dev. 2016, 13, 65–83. [Google Scholar] [CrossRef]
- Frazier, M.L.; Fainshmidt, S.; Klinger, R.L.; Pezeshkan, A.; Vracheva, V. Psychological safety: A meta-analytic review and extension. Pers. Psychol. 2017, 70, 113–165. [Google Scholar] [CrossRef]
- Newman, A.; Donohue, R.; Eva, N. Psychological safety: A systematic review of the literature. Hum. Resour. Manag. Rev. 2017, 27, 521–535. [Google Scholar] [CrossRef]
- Poli, A.; Miccoli, M. Validation of the Italian version of the Neuroception of Psychological Safety Scale (NPSS). Heliyon 2024, 10, e27625. [Google Scholar] [CrossRef]
- Ganeshkumar, P.; Gopalakrishnan, S. Systematic Reviews and meta-analysis: Understanding the Best Evidence in Primary Healthcare. J. Fam. Med. Prim. Care 2013, 2, 9–14. [Google Scholar] [CrossRef]
- Peters, M.D.; Marnie, C.; Tricco, A.C.; Pollock, D.; Munn, Z.; Alexander, L.; McInerney, P.; Godfrey, C.M.; Khalil, H. Updated methodological guidance for the conduct of scoping reviews. JBI Evid. Synth. 2020, 18, 2119–2126. [Google Scholar] [CrossRef]
- Tricco, A.C.; Lillie, E.; Zarin, W.; O’Brien, K.K.; Colquhoun, H.; Levac, D.; Moher, D.; Peters, M.D.J.; Horsley, T.; Weeks, L.; et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann. Intern. Med. 2018, 169, 467–473. [Google Scholar] [CrossRef]
- Thomas, J.; Harden, A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med. Res. Methodol. 2008, 8, 45. [Google Scholar] [CrossRef]
- Hoegh, J.; Rice, G.; Shetty, S.; Ure, A.; Cogan, N.; Peddie, N. Health and Social Care Professionals Experience of Psychological Safety within their Occupational Setting: A Thematic Synthesis Scoping Review Protocol. COJ Nurs. Healthc. 2024, 8, 915–920. Available online: https://crimsonpublishers.com/cojnh/fulltext/COJNH.000700.php (accessed on 15 February 2025).
- Kastner, M.; Tricco, A.C.; Soobiah, C.; Lillie, E.; Perrier, L.; Horsley, T.; Welch, V.; Cogo, E.; Antony, J.; Straus, S.E. What is the most appropriate knowledge synthesis method to conduct a review? Protocol for a scoping review. BMC Med. Res. Methodol. 2012, 12, 114. [Google Scholar] [CrossRef]
- Thomas, A.; Lubarsky, S.; Varpio, L.; Durning, S.J.; Young, M.E. Scoping reviews in health professions education: Challenges, considerations and lessons learned about epistemology and methodology. Adv. Health Sci. Educ. 2020, 25, 989–1002. [Google Scholar] [CrossRef] [PubMed]
- Mak, S.; Thomas, A. Steps for conducting a scoping review. J. Grad. Med. Educ. 2022, 14, 565–567. [Google Scholar] [CrossRef]
- Ouzzani, M.; Hammady, H.; Fedorowicz, Z.; Elmagarmid, A. Rayyan—A web and mobile app for systematic reviews. Syst. Rev. 2016, 5, 210. [Google Scholar] [CrossRef]
- McGowan, J.; Sampson, M.; Salzwedel, D.M.; Cogo, E.; Foerster, V.; Lefebvre, C. PRESS peer review of electronic search strategies: 2015 guideline statement. J. Clin. Epidemiol. 2016, 75, 40–46. [Google Scholar] [CrossRef] [PubMed]
- Cooke, A.; Smith, D.; Booth, A. Beyond PICO: The SPIDER Tool for Qualitative Evidence Synthesis. Qual. Health Res. 2012, 22, 1435–1443. [Google Scholar] [CrossRef] [PubMed]
- Khalil, H.; Peters, M.D.; Tricco, A.C.; Pollock, D.; Alexander, L.; McInerney, P.; Godfrey, C.M.; Munn, Z. Conducting high quality scoping reviews-challenges and solutions. J. Clin. Epidemiol. 2021, 130, 156–160. [Google Scholar] [CrossRef]
- Long, H.A.; French, D.P.; Brooks, J.M. Optimising the value of the critical appraisal skills programme (CASP) tool for quality appraisal in qualitative evidence synthesis. Res. Methods Med. Health Sci. 2020, 1, 31–42. [Google Scholar] [CrossRef]
- Nadelson, S.; Nadelson, L.S. Evidence-based practice article reviews using CASP tools: A method for teaching EBP. Worldviews Evid. Based Nurs. 2014, 11, 344–346. [Google Scholar] [CrossRef]
- Fisher, M.; Qureshi, H.; Hardyman, W.; Homewood, J. Using Qualitative Research in Systematic Reviews: Older People’s Views of Hospital Discharge; Social Care Institute for Excellence: London, UK, 2006. [Google Scholar]
- Tricco, A.C.; Lillie, E.; Zarin, W.; O’brien, K.; Colquhoun, H.; Kastner, M.; Levac, D.; Ng, C.; Sharpe, J.P.; Wilson, K. A scoping review on the conduct and reporting of scoping reviews. BMC Med. Res. Methodol. 2016, 16, 15. [Google Scholar] [CrossRef]
- Addo, B.; Amoah, H.; Eshun, S.; Ocran, H. Moral distress among midwives working in the labour ward of a hospital in Ghana. Eur. J. Midwifery 2020, 4, 24. [Google Scholar] [CrossRef]
- Alilu, L.; Zamanzadeh, V.; Fooladi, M.M.; Valizadeh, L.; Habibzadeh, H. Towards an understanding of clinical nurses challenges that leads intention to leave. Acta Paul. De Enferm. 2016, 29, 534–541. [Google Scholar] [CrossRef]
- Alwesmi, M.B.; Dator, W.L.; Karavasileiadou, S. Lived Experiences of Female Nurses with COVID-19 Deaths on Their Watch. Behav. Sci. 2022, 12, 470. [Google Scholar] [CrossRef] [PubMed]
- Appleton, L.; Atkins, C.; Watmough, S.; Cherry, M.G.; Poole, H. Exploring the impact of COVID-19 on the psychological well-being of oncology healthcare professionals. J. Adv. Nurs. 2023, 79, 3787–3799. [Google Scholar] [CrossRef]
- Beattie, J.; Griffiths, D.; Innes, K.; Morphet, J. Workplace violence perpetrated by clients of health care: A need for safety and trauma-informed care. J. Clin. Nurs. 2018, 28, 116–124. [Google Scholar] [CrossRef] [PubMed]
- Beng, T.S.; Chin, L.E.; Guan, N.C.; Yee, A.; Wu, C.; Pathmawathi, S.; Yi, K.T.; Kuan, W.S.; Jane, L.E.; Meng, C.B.C. The Experiences of Stress of Palliative Care Providers in Malaysia. Am. J. Hosp. Palliat. Med. 2013, 32, 15–28. [Google Scholar] [CrossRef]
- Blanco, K.; Ely, E.; DeAlmeida, K.; Bohr, N.L. Transitioning to independent nursing practice during COVID-19: A mixed methods study. West. J. Nurs. Res. 2023, 45, 432–442. [Google Scholar] [CrossRef]
- Cankaya, S.; Erkal Aksoy, Y.; Dereli Yılmaz, S. Midwives’ experiences of witnessing traumatic hospital birth events: A qualitative study. J. Eval. Clin. Pract. 2021, 27, 847–857. [Google Scholar] [CrossRef]
- Catalan, J.; Ridge, D.; Hedge, B.; Cheshire, A. The interactive dimensions of encounters in HIV care: From trauma to relational traumatic growth. Health Expect. 2022, 25, 3114–3123. [Google Scholar] [CrossRef]
- Chen, D.; Hayes, M.J.; Holden, A.C. Investigation into the enablers and barriers of career satisfaction among Australian oral health therapists. Community Dent. Oral Epidemiol. 2023, 51, 301–310. [Google Scholar] [CrossRef]
- Cramond, L.; Fletcher, I.; Rehan, C. Experiences of clinical psychologists working in palliative care: A qualitative study. Eur. J. Cancer Care 2020, 29, e13220. [Google Scholar] [CrossRef]
- Craw, E.S.; Buckley, T.M.; Miller-Day, M. “This Isn’t Just Busy, This is Scary”: Stress, Social Support, and Coping Experiences of Frontline Nurses During the COVID-19 Pandemic. Health Commun. 2022, 38, 2047–2057. [Google Scholar] [CrossRef]
- Dennis, D.; Vernon van Heerden, P.; Knott, C.; Khanna, R. The nature and sources of the emotional distress felt by intensivists and the burdens that are carried: A qualitative study. Aust. Crit. Care 2023, 36, 52–58. [Google Scholar] [CrossRef] [PubMed]
- Emmarco, A.K.; Toy, B.K.; Pavone, J.M.; Keller, R.K.; Smith, D.E. Experience of Nurses Caring for COVID-19 Patients Supported by Venovenous Extracorporeal Membrane Oxygenation (ECMO) After ECMO Educational Crash Course. SAIO J. 2022, 69, 267–271. [Google Scholar] [CrossRef] [PubMed]
- Ezeobele, I.E.; Mock, A.; McBride, R.; Mackey-Godine, A.; Harris, D.; Russell, C.D.; Lane, S.D. Patient-on-Staff Assaults: Perspectives of Mental Health Staff at an Acute Inpatient Psychiatric Teaching Hospital in the United States. Can. J. Nurs. Res. 2021, 53, 084456212090462. [Google Scholar] [CrossRef]
- Fairman, N.; Montross Thomas, L.P.; Whitmore, S.; Meier, E.A.; Irwin, S.A. What Did I Miss? A Qualitative Assessment of the Impact of Patient Suicide on Hospice Clinical Staff. J. Palliat. Med. 2014, 17, 832–836. [Google Scholar] [CrossRef] [PubMed]
- Galuska, L.; Hahn, J.; Polifroni, E.C.; Crow, G. A Narrative Analysis of Nurses’ Experiences With Meaning and Joy in Nursing Practice. Nurs. Adm. Q. 2018, 42, 154–163. [Google Scholar] [CrossRef]
- Griffiths, A.; Knight, A.; Harwood, R.; Gladman, J.R.F. Preparation to care for confused older patients in general hospitals: A study of UK health professionals. Age Ageing 2013, 43, 521–527. [Google Scholar] [CrossRef]
- Ham, E.; Ricciardelli, R.; Rodrigues, N.C.; Hilton, N.Z.; Seto, M.C. Beyond workplace violence: Direct and vicarious trauma among psychiatric hospital workers. A qualitative study. J. Nurs. Manag. 2021, 30, 1482–1489. [Google Scholar] [CrossRef]
- Jakobsson Larsson, B.; Mannberg, M.; Pöder, U.; Hedström, M.; Karlsson, A.C. Registered nurses’ experiences on job satisfaction in nursing home settings. Nurs. Open 2024, 11, e2224. [Google Scholar] [CrossRef]
- Jeong, J.S.; Son, H.M.; Jeong, I.S.; Son, J.S.; Shin, K.; Yoonchang, S.W.; Jin, H.Y.; Han, S.H.; Han, S.H. Qualitative content analysis of psychologic discomfort and coping process after needlestick injuries among health care workers. Am. J. Infect. Control 2016, 44, 183–188. [Google Scholar] [CrossRef]
- Jiang, J.; Han, P.; Huang, X.; Liu, Y.; Shao, H.; Zeng, L.; Duan, X. Post-traumatic growth experience of first-line emergency nurses infected with COVID-19 during the epidemic period—A qualitative study in Shanghai, China. Front. Public Health 2022, 10, 1015316. [Google Scholar] [CrossRef]
- Ketelaar, S.M.; Nieuwenhuijsen, K.; Frings-Dresen, M.H.W.; Sluiter, J.K. Exploring novice nurses’ needs regarding their work-related health: A qualitative study. Int. Arch. Occup. Environ. Health 2015, 88, 953–962. [Google Scholar] [CrossRef] [PubMed]
- Lases, S.S.; Slootweg, I.A.; Pierik, E.G.J.M.; Heineman, E.; Lombarts, M.J.M.H. Efforts, rewards and professional autonomy determine residents’ experienced well-being. Adv. Health Sci. Educ. 2018, 23, 977–993. [Google Scholar] [CrossRef] [PubMed]
- Lewis, S.L. Exploring NICU Nurses’ Affective Responses to End-of-Life Care. Adv. Neonatal Care 2017, 17, 96–105. [Google Scholar] [CrossRef]
- Lewis-O’Connor, A.; Linzer, P.B.; Goldstein, E. Nurses’ Experience After First Wave of COVID-19: Implications for a Trauma-Informed Workforce. Perm. J. 2023, 28, 124–134. [Google Scholar] [CrossRef] [PubMed]
- McNamara, K.; Meaney, S.; O’Donoghue, K. Intrapartum fetal death and doctors: A qualitative exploration. Acta Obstet. Gynecol. Scand. 2018, 97, 890–898. [Google Scholar] [CrossRef]
- Mediavilla, R.; Monistrol-Mula, A.; McGreevy, K.R.; Felez-Nobrega, M.; Delaire, A.; Nicaise, P.; Palomo-Conti, S.; Bayón, C.; Bravo-Ortiz, M.-F.; Rodríguez-Vega, B.; et al. Mental health problems and needs of frontline healthcare workers during the COVID-19 pandemic in Spain: A qualitative analysis. Front. Public Health 2022, 10, 956403. [Google Scholar] [CrossRef]
- Michael, R.; Jenkins, H.J. Recovery from work-related trauma by perioperative nurses: The effects of social and personal resources. Collegian 2001, 8, 8–13. [Google Scholar] [CrossRef]
- Pavithra, A.; Sunderland, N.; Callen, J.; Westbrook, J. Unprofessional behaviours experienced by hospital staff: Qualitative analysis of narrative comments in a longitudinal survey across seven hospitals in Australia. BMC Health Serv. Res. 2022, 22, 410. [Google Scholar] [CrossRef]
- Peng, X.; Yang, Y.; Gao, P.; Ren, Y.; Hu, D.; He, Q. Negative and positive psychological experience of frontline nurses in combatting COVID-19: A qualitative study. J. Nurs. Manag. 2021, 30, 2185–2193. [Google Scholar] [CrossRef]
- Powell, N.; Ford, L.; Rochinski, D.; McEvoy, V. The Lived Experience of Workplace Violence Among Emergency Nurses. J. Emerg. Nurs. 2022, 49, 425–430. [Google Scholar] [CrossRef] [PubMed]
- Ramalisa, R.J.; du Plessis, E.; Koen, M.P. Increasing coping and strengthening resilience in nurses providing mental health care: Empirical qualitative research. Health SA Gesondheid 2018, 23, 1–9. [Google Scholar] [CrossRef] [PubMed]
- Remtulla, R.; Hagana, A.; Houbby, N.; Ruparell, K.; Aojula, N.; Menon, A.; Thavarajasingam, S.G.; Meyer, E. Exploring the barriers and facilitators of psychological safety in primary care teams: A qualitative study. BMC Health Serv. Res. 2021, 21, 269. [Google Scholar] [CrossRef]
- Sánchez-Muñoz, F.; Fernández-Medina, I.M.; Granero-Molina, J.; Suazo-Galdames, I.C.; Nunez-Nagy, S.; Ventura-Miranda, M.I.; Ruíz-Fernández, M.D. Experiences in the training of specialist family and community nurses: A qualitative study. Front. Public Health 2023, 11, 1154084. [Google Scholar] [CrossRef]
- Siffleet, J.; Williams, A.M.; Rapley, P.; Slatyer, S. Delivering best care and maintaining emotional wellbeing in the intensive care unit: The perspective of experienced nurses. Appl. Nurs. Res. 2015, 28, 305–310. [Google Scholar] [CrossRef] [PubMed]
- Smith, S.; Hanna, S. Does helping hurt the helper?—An investigation into the impacts of vicarious traumatisation on social work practitioners in Hawke’s Bay, Aotearoa New Zealand. Aotearoa N. Z. Soc. Work 2021, 33, 48–60. [Google Scholar] [CrossRef]
- Sobekwa, Z.C.; Arunachallam, S. Experiences of nurses caring for mental health care users in an acute admission unit at a psychiatric hospital in the Western Cape Province. Curationis 2015, 38, 1–9. [Google Scholar] [CrossRef]
- Sun, N.; Wei, L.; Shi, S.; Jiao, D.; Song, R.; Ma, L.; Wang, H.; Wang, C.; Wang, Z.; You, Y.; et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am. J. Infect. Control 2020, 48, 592–598. [Google Scholar] [CrossRef]
- Thude, B.R.; Primdahl, J.; Jensen, H.I.; Elkjær, M.; Hoffmann, E.; Boye, L.K.; Specht, K. How did nurses cope with the fast, comprehensive organisational changes at Danish hospital wards during the COVID-19 pandemic? An interview study based on nurses’ experiences. BMJ Open 2021, 11, e049668. [Google Scholar] [CrossRef]
- O’Toole, J.; Zaeh, S.; Eakin, M.N.; Adelman, M.H.; Ashton, R.W.; Biddison, L.D.; Bosslet, G.T.; Burkart, K.M.; Doyle, S.T.; Khan, M.M.; et al. Balancing Demands: Determinants of Burnout Reported by Fellows in Pulmonary and Critical Care Medicine. ATS Sch. 2021, 2, 108–123. [Google Scholar] [CrossRef]
- Voogt, J.J.; Kars, M.C.; van Rensen, E.L.J.; Schneider, M.M.E.; Noordegraaf, M.; van der Schaaf, M.F. Why Medical Residents Do (and Don’t) Speak Up About Organizational Barriers and Opportunities to Improve the Quality of Care. Acad. Med. 2020, 95, 574–581. [Google Scholar] [CrossRef] [PubMed]
- Walker, H.R.; Evans, E.; Nirula, R.; Hyngstrom, J.; Matsen, C.; Nelson, E.; Pickron, B.; Zurbuchen, E.; Morrow, E.H. “I need to have a fulfilling job”: A qualitative study of surgeon well-being and professional fulfillment. Am. J. Surg. 2022, 223, 6–11. [Google Scholar] [CrossRef]
- Warren, J.; Plunkett, E.; Rudge, J.; Stamoulis, C.; Torlinski, T.; Tarrant, C.; Mullhi, R. Trainee doctors’ experiences of learning and well-being while working in intensive care during the COVID-19 pandemic: A qualitative study using appreciative inquiry. BMJ Open 2021, 11, e049437. [Google Scholar] [CrossRef]
- Welsh, M.; Chimowitz, H.; Nanavati, J.D.; Huff, N.R.; Isbell, L.M. A qualitative investigation of the impact of coronavirus disease 2019 (COVID-19) on emergency physicians’ emotional experiences and coping strategies. J. Am. Coll. Emerg. Physicians Open 2021, 2, e12578. [Google Scholar] [CrossRef]
- Xu, L.; Masters, G.A.; Moore Simas, T.A.; Bergman, A.L.; Byatt, N. Labor and delivery clinician perspectives on impact of traumatic clinical experiences and need for systemic supports. Matern. Child Health J. 2023, 27, 1651–1662. [Google Scholar] [CrossRef] [PubMed]
- Zeighami, M.; Mangolian Shahrbabaki, P.; Zakeri, M.A.; Dehghan, M. Loss of Individual and Social Identity: Consequences of Sexual Harassment of Iranian Nurses in the Workplace. Front. Psychol. 2021, 12, 770859. [Google Scholar] [CrossRef]
- Hamel, C.; Michaud, A.; Thuku, M.; Skidmore, B.; Stevens, A.; Nussbaumer-Streit, B.; Garritty, C. Defining rapid reviews: A systematic scoping review and thematic analysis of definitions and defining characteristics of rapid reviews. J. Clin. Epidemiol. 2021, 129, 74–85. [Google Scholar] [CrossRef] [PubMed]
- Cogan, N.; Tse, D.; Finlayson, M.; Lawley, S.; Black, J.; Hewitson, R.; Stergiou, C.; Aziz, S.; Hamer, H.; Short, C. A journey towards a trauma informed and responsive Justice system: The perspectives and experiences of senior Justice workers. Eur. J. Psychotraumatol. 2025, 16, 2441075. [Google Scholar] [CrossRef]
- Paez, A. Gray literature: An important resource in systematic reviews. J. Evid. Based Med. 2017, 10, 233–240. [Google Scholar] [CrossRef]
SPIDER Tool | Search Terms |
---|---|
S | “health care worker*” OR “social care worker” OR “welfare worker” OR “physician*” OR Nurs* OR doctor* OR “Medic” OR “social worker*” OR “care worker*” OR “support worker*” OR “occupational therapist*” OR “psychologist*” OR “health and social care” OR “midwi*” |
P of I | “psychological safety” or “interpersonal risk*” OR “team*” OR “polyvagal theory” OR “occupational wellbeing” OR “workplace wellbeing” OR “workplace mental health” OR “occupational mental health” OR “trauma*” OR “work culture” OR “workplace culture” OR “physical pain” OR “workplace safety” OR “moral distress” |
D | “interview* OR “focus group*” OR obser* OR ethnography OR “thematic analysis” |
E | “experience*” OR “opinion*” OR outcome*” OR “satisfaction” |
R | “qualitative*” OR “mixed methods” |
Author | Year | Aim | Occupation | Number of Participants | Sample Demographics | Data Collection Method | Method of Data Analysis |
---|---|---|---|---|---|---|---|
Addo et al. [64] | 2020 | To explore and understand moral distress from the perspective of and as experienced by midwives. | Midwives | 8 | 35–45 years old. Experience ranging from 5 to 15+ years. Christian and Islamic faith. | Interviews | IPA |
Alilu et al. [65] | 2016 | To identify and describe the challenges and reasons why Iranian nurses leave their profession. | Nurses | 16 | 14 women, 2 men. Age range 24–47, 14 with a baccalaureate degree, 2 with a master’s degree, 2–15 years of nursing experience. | Interviews | Content Analysis |
Alwesmi et al. [66] | 2022 | To explore the experiences of nurses whose patients were diagnosed with and died of COVID-19 and how this affected their wellbeing. | Nurses | 7 | All female, aged 25, 31, 33, 38, 44, 47, and 58. Filipino, African, Indian and Saudi. Three had less than 10 years experience; the rest had more than 15 years. | Interviews | Thematic Analysis |
Appleton et al. [67] | 2023 | To explore how psychological well-being is maintained by healthcare professionals (HCPs) employed in a cancer setting during the COVID-19 pandemic. | Nurses; Consultants; Radiographers; AHPs (Non-Radiographers) and Support Staff (Cancer Support Workers, Healthcare Assistants) | 102 | 83% Female, 73% full time, age range: 21–60. | Diaries and interviews | IPA |
Beattie et al. [68] | 2018 | To examine the neurobiological response experienced by healthcare workers when exposed to workplace violence perpetrated by consumers, to inform future training and self-care strategies for staff wellbeing. | Healthcare Providers | 99 | Managers (n = 45, 45.5%), departmental directors (n = 21, 21.2%), OHS staff (n = 26, 26.3%), registered nurses (n = 4, 4.1%) and educators (n = 3, 3.1%). The RNs worked in the ED and the urgent care centres of two different medium regional hospitals. The majority were female (n = 69, 69.7%) | Interviews | Thematic Analysis |
Beng et al. [69] | 2015 | Exploring the experiences of stress in palliative care providers of University Malaya Medical Centre in Malaysia. | Palliative Care Providers | 20 | Male (n = 2), Females (n = 18); 7 younger than 30, 8 aged 30–39, and 5 older than 40; 7 single and 13 married; 10 participants were Malay, 7 were Chinese, and 3 were Indian. | Interviews | Thematic Analysis |
Blanco et al. [70] | 2023 | The purpose of this study was to understand the struggles and growth opportunities of NGNs entering the field of nursing during the COVID-19. | New Graduate Nurses (NGN) | 40 | The majority of participants were female (n = 11, 84.6%), single (n = 9, 69.2%), and nonparents (n = 9, 69.2%). Over half of the sample identified as Hispanic (n = 7, 53.8%); the remaining participants identified as non-Hispanic White (n = 5, 38.5%) and non-Hispanic Black (n = 1, 7.7%). | Focus Groups | Content Analysis |
Cankaya et al. [71] | 2021 | To investigate in detail the traumatic birth experiences of midwives in the delivery rooms and their attitudes, reactions, and coping strategies. | Midwives | 29 | The mean age of the midwives (n = 29) who participated in the study was 35.37 years, and the mean number of children they had was 1.24. | Interviews | Content and Thematic Analysis |
Catalan et al. [72] | 2022 | The study’s aims were to identify traumatic events experienced by the participants and describe ways used to cope with them, as well as to explore longer-term implications within the stories, including any indications of positive change and growth. | Healthcare Workers and Charity Volunteers | 22 | 14 white males, 5 white females, 1 African/Afro- Caribbean female, and 2 Southeast Asian/Indian females. | Interviews | Thematic Analysis |
Chen et al. [73] | 2023 | To explore the enablers and barriers of career satisfaction among Australian OHTs and the reasons for pursuing career changes. | Oral Health Therapists | 21 | Sex: Females: 15 Males: 6 Status: Currently practising: 20 Formerly registered: 1 Practice settings: Private clinical practice: 14 Public clinical practice: 7 Educational background: bachelor’s degree in OHT: 19 Diploma/Certificate in OHT: 2 Additional qualifications at bachelor’s level or below: 9 | Interviews | Thematic Analysis |
Cramond et al. [74] | 2019 | To explore the experiences of clinical psychologists working in palliative care with adults with cancer and gain an understanding of the impact of this work and how they manage it. | Clinical Psychologists | 12 | 3 men, 9 women. Minimum 12 months experience, qualified for 3 to 26 years. | Interviews | IPA |
Craw et al. [75] | 2022 | To investigate how nurses coped with stress while treating COVID-19 patients during the pandemic. | Nurses | 15 | 15 females aged 26 to 62. | Interviews | Inductive Thematic Analysis |
Dennis et al. [76] | 2023 | To elicit the nature and sources of workplace emotional distress in an international sample of intensivists. | Doctors | 19 | Australia (n = 13) and Israel (n = 6). The majority of respondents were male (n = 15). | Interview | Thematic Analysis |
Emmarco et al. [77] | 2023 | To evaluate the experiences of COVID-19 in the nursing cohort. | Nurses | 14 | The median age of participants was 28 and ranged from 22 to 46. The median number of years working as an RN was 4.25. | Interviews. | |
Ezeobele et al. [78] | 2021 | To explore mental health staff perspectives on assaults by psychiatric patients. | Mental Health Staff: Nurses, Physicians, Physical Therapists, and Social Service Staff | 120 | 22–63 years old, mean age = 32.4, 46 males, 74 females, college credits to doctorate level training. | Qualitative Survey | Transcendental Phenomenology Data Analysis |
Fairman et al. [79] | 2014 | To examine the personal and professional impact of patient suicides among hospice clinical staff, the coping strategies used by this group, and their recommendations for staff support after a patient suicide. | Clinical Staff: Nurses, Social Workers, Primary Providers, Social Counsellors, Licenced Vocational Nurses and Others | 186 | Participants were predominately female (78%), and the average age was 52 years (range, 28–72). Respondents included nurses (39%), social workers (20%), primary providers (physicians or nurse practitioners, 14%), spiritual counsellors (12%), licenced vocational nurses (7%), and others. On average, participants reported 21 years of clinical experience (range, 3–50) and 11 years of practice in hospice (range, 1–27). | Qualitative Survey | Coding Consensus, Co-occurrence, and Comparison |
Galuska et al. [80] | 2018 | To add to our understanding of meaning and joy in nursing. | Registered Nurses | 27 | The participants included 20 females and 7 males, ranging in age from 31 to more than 60 years, with 65% older than 50 years. Nurses’ practice experience ranged from 2 to more than 40 years. | Interviews | Thematic Analysis |
Grailey et al. [31] | 2021 | To investigate the presence of perceived stressors, psychological safety, and teamwork in healthcare professionals. | Nurses, Doctors, and Physiotherapists | 49 | Thirty-nine participants in this subgroup were critical care staff: 24 nurses, 9 doctors and 6 physiotherapists. 10 recruited from the emergency department: 2 nurses, 8 doctors. | Interviews | Thematic Analysis |
Griffiths et al. [81] | 2014 | To explore doctors, nurses, and allied health professionals’ perceptions of their preparation to care for confused older patients on general hospital wards. | Senior Specialists, Doctors, Nurses, Healthcare Assistants, Occupational Therapists, Physiotherapists | 60 | Male (n = 12), Female (n = 48); 44 participants were White British; Mean ages: specialists = 44.4, doctors = 27.6, nurses = 38.2, healthcare assistants = 40.8, occupational therapists = 28.8, physiotherapists = 29.8. | Interviews | Thematic Analysis |
Ham et al. [82] | 2021 | To explore psychiatric nurses’ and other psychiatric workers’ understanding of trauma in the context of their relationships with the people they care for and the effects on their mental health. | Psychiatric Nurses and Other Psychiatric Workers | 30 | Most were women (n = 26, 87%), aged 40 years or older (n = 22, 73%). The largest professional group was nurses (n = 14, 47%), followed by allied health professionals (n = 12, 40%), and most had more than 10 years of experience working in the mental health field (n = 20, 67%). | Qualitative Survey | Thematic Inductive Analysis |
Jakobsson Larsson et al. [83] | 2023 | To describe what registered nurses’ experience to be important to job satisfaction in nursing home settings. | Registered Nurses | 16 | Employer: Public non-profit: 8 Private for-profit: 8 Age: 25–35: 6 36–45: 4 46–55: 4 56–65: 2 | Interviews | Systematic Text Condensation, a method for thematic analysis of qualitative data |
Jeong et al. [84] | 2016 | To survey the psychological discomfort and coping processes of healthcare workers that suffered needle stick injuries. | Doctors, Nurses, Clinical Pathologists, Sanitation Workers, Medical Engineers | 15 | Males (n = 5), females (n = 10); 3 participants were doctors, 8 were nurses, 2 were clinical pathologists, 1 was a sanitation worker, and 1 was a medical engineer. Workplace experience ranges from 2 months to 17 years. | Interviews | Content Analysis |
Jiang et al. [85] | 2022 | To explore the process and influencing factors of post-traumatic growth among emergency nurses infected with COVID-19. | Nurses | 13 | 3 male, 10 female (76.92%), 84.61% single, average length of employment 3.92 years. | Interviews | Interpretative Phenomenological Approach |
Ketelaar et al. [86] | 2015 | To investigate Dutch novice nurses’ experiences and needs regarding occupational health support to prevent work-related health problems and promote wellbeing. | Nursing Students and Newly Qualified Nurses | 14 | Participating nursing students were aged 23–45 (mean = 31, SD = 8.3), while participating newly qualified nurses were aged 23–40 (mean = 29, SD = 6.1). | Interviews | Grounded Theory Approach |
Lases et al. [87] | 2018 | To investigate residents’ experiences of wellbeing in relation to their professional life. | Residents | 13 | 6 women and 7 men; ages ranged from 26 to 34 years, and their years of residency from first to fourth. | Interviews | Thematic Network Analysis |
Lewis [88] | 2017 | To investigate the affective, interactional, and meaning-related responses of NICU nurses caring for dying newborns. | Nurses | 36 | 35 of the 36 participants were all white females aged 25–65 years. One participant did not complete demographic details to maintain anonymity. | Online Survey | Reismann’s Thematic Narrative Analysis |
Lewis O’Connor et al. [89] | 2023 | The purpose of this study was to describe the experience of clinical nurses and to assess their professional quality of life after the first phase of the pandemic. | Clinical Nurses and Nurse Leaders | 278 | unknown | Surveys and Interviews | Inductive Thematic Analysis |
McNamara et al. [90] | 2018 | To explore the attitudes and responses that Irish obstetricians have following direct involvement with an intrapartum foetal death. | Obstetricians and Registrars | 10 | 5 were consultant obstetricians and 5 were registrars; 4 were exposed to intrapartum death (IPD) once, 4 were exposed twice, and 2 were exposed 3+ times. | Interviews | Interpretative Phenomenological Analysis |
Mediavilla et al. [91] | 2022 | To describe mental health problems among frontline HCWs, investigate their associations with determinants and outcomes, and consider the implications for the design and implementation of mental health programmes in Spain. | HCWs (Doctors, Nurses, Nursing Assistants, Porters, Psychologists, Administrative Staff, and Unit Managers) | 75 | Participants were above the age of 18 and balanced in age and gender. 75 participants during phase 1 and 22 participants during phase 2. | Interview | Thematic Analysis |
Michael & Jenkins [92] | 2001 | To describe the range and experience of traumatic events reported by perioperative nurses. | Nurses | 233 | 96.6% female, mean age = 38 for males, 41 for females. | Qualitative Survey | Qualitative Content Analysis |
Pavithra et al. [93] | 2022 | To develop an understanding of hospital staff experiences of unprofessional behaviours and their impact on staff and patients. | Doctors, Nurses, Midwives, Social and Welfare Workers, Management, Support Service Workers | 1636 | 77.9% female, 19.7% male, and 2.4% other/non specified. | Qualitative Survey | Directed Content Analysis |
Peng et al. [94] | 2021 | To explore the experiences of frontline nurses who had been fighting against the COVID-19 infection since the outbreak. | Nurses | 20 | Twenty nurses, 5 of whom are supervisor nurses, aged 24 to 43 years old. 3 with diploma degrees, 16 with bachelor’s degrees, and 1 with a postgraduate degree. | Interviews | Thematic Analysis |
Powell et al. [95] | 2022 | To investigate the experience of the emergency nurses assaulted by a patient or visitors. | Emergency Nurses | 11 | Eleven experienced emergency registered nurses from 3 mid-Atlantic hospitals participated in the study. | Interviews | Thematic Analysis |
Ramalisa et al. [96] | 2018 | To identify the specific barriers and facilitators of psychological safety in primary care teams. | General Practitioners, Practice Managers, Partners, Healthcare Assistants and Nurses | 20 | Anonymised. | Interviews | Thematic Analysis |
Remtulla et al. [97] | 2021 | To investigate and discuss methods to improve nurses’ resilience in a work environment with involuntary mental healthcare users. | Nurses | 24 | Psychiatric nurses, the majority of whom were female. | Written Narrative | Deductive Thematic Analysis |
Sanchez-Munoz et al. [98] | 2023 | to describe and understand the experiences of nurses during their training process in the specialty of Family and Community Nursing in Spain. | Family and Community Nurses | 16 | Female, mean age: 29.88 years (SD = 6.2). | Interviews and a focus group | Thematic Analysis |
Siffleet et al. [99] | 2015 | To explore the perspective of experienced intensive care nurses regarding the maintenance of their emotional wellbeing. | Nurses | 15 | Fifteen registered nurses, with a mean age of 39.4 (26–50) years, were interviewed. The length of time working in ICU ranged from 3 to 25 years, with a mean of 13 years, and most (n = 12) were female. All 15 nurses indicated their intention to remain in ICU. | Interviews | Thematic Analysis |
Smith & Hanna [100] | 2021 | To investigate the impacts of VT on the wellbeing of social workers and what, if any, self-care strategies social workers utilised. | Social Workers | 4 | Participant experience ranged from 5 to 18 years. 2 participants were New Zealand European, 1 was New Zealand with Maori heritage and 1 was Southeast Asian. | Interviews | Thematic Analysis |
Sobekwa & Arunachallam [101] | 2015 | To explore and describe the lived experiences of nurses who care for mental healthcare users in an acute admission unit at a psychiatric hospital. | Nurses | 12 | 3 men, 9 women, average length of qualification: 12.9 years (3–26). | Interviews | Interpretative Phenomenological Analysis |
Sun et al. [102] | 2020 | To explore the psychology of nurses caring for COVID-19 patients. | Nurses | 20 | Males (n = 3), females (n = 17); age range of 25–49 years, with an average age of 30.60 ± 6.12. Working experience ranged from 1 to 28 years, with an average of 5.85 ± 6.43. All nurses possessed a bachelor’s degree. There were 17 general nurses and 3 head nurses. | Interviews | Phenomenological Analysis |
Thude et al. [103] | 2021 | To understand how Danish nurses coped with the fast, comprehensive organisational changes in their workplace in order to identify barriers to and facilitators for organisations ensuring the best possible conditions for nurses to meet these challenges. | Nurses | 23 | All 23 interviewed nurses were female, with a mean age of 41 (26–54 years old) and a mean of 13 years of experience as a nurse (0.5–27). | Naive Reading of the Text | Thematic Analysis |
O’Toole et al. [104] | 2021 | To assess factors related to training and practice that posed a threat to physician wellbeing or increased burnout and to describe suggestions from fellows on how training programmes can improve physician wellbeing. | Doctors | 427 | 60% men, 59% white, 76% married, and 41% had caregiver responsibilities. 33% screened positive for burnout, and 41% screened positive for depressive symptoms. | Qualitative Survey | Inductive Qualitative Content Analysis |
Voogt et al. [105] | 2020 | To explore what helps residents speak up about organisational barriers and opportunities to improve the quality of their work and what hinders them from doing so. | Medical Residents | 27 | 19 (70%) female, mean age was 31 years (SD = 4, range 26–48), mean postgraduate year was 2.8 (SD = 1, range 1–6). | Interviews | QUAGOL |
Walker et al. [106] | 2022 | To examine protective factors that promote wellbeing and professional fulfilment in surgeons. | Surgeons | 32 | Males (n = 20), females (n = 12); clinical full-time equivalent (FTE) ranged from 0% to 90% (median = 65%). Age ranged from 41 to 72 years. 84.3% (n = 27) were Caucasian. | Interviews | Abductive Exploratory Analysis |
Warren et al. [107] | 2021 | To understand the experiences of trainees working in a large intensive care unit during the first wave of COVID-19 from an educational and operational perspective in order to highlight what worked and what could be improved. | Trainees in Anaesthesia and Intensive Care | 40 | Not specified | Interviews | Thematic Analysis |
Welsh et al. [108] | 2021 | To investigate the impact of COVID-19 on emergency physicians’ emotional experiences and the specific coping strategies that physicians employed throughout the pandemic. | Physicians | 26 | Metro Boston Region—10 males, 5 females; 13 white, 1 black, 1 Asian, 1 Hispanic, 14 not Hispanic; 6 hold a leadership position. New York City—4 male, 7 females; 6 white, 1 black, 3 Asian, other (middle eastern) 1, 2 Hispanic, 9 not Hispanic; 4 hold a leadership position. | Interviews | Comparative Analysis |
Xu et al. [109] | 2023 | to elicit labour and delivery clinician perspectives on the impact of exposure to traumatic births on their professional quality of life. | L&D Clinicians, Including Attending or Resident Physicians, Advanced Practice Nurses, Including Certified Nurse Midwives, and Nurses | 165 | The majority of respondents were female, White physicians, with 13.2 mean years of L&D experience. | Anonymous online questionnaire and phone interviews | Grounded Theory |
Zheigami et al. [110] | 2021 | To investigate the effects of sexual harassment in the workplace on nurses. | Nurses | 22 | 18 female, 4 male. 25–51 years old, work experience ranging from 2 to 28 years. | Interviews | Content Analysis |
Study Reference | Q1 | Q2 | Q3 | Q4 | Q5 | Q6 | Q7 | Q8 | Q9 | Q10 |
---|---|---|---|---|---|---|---|---|---|---|
Addo at al. [64] | Y | Y | Y | Y | Y | N | N | Y | Y | Y |
Alilu et al. [65] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Alwesmi et al. [66] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Appleton et al. [67] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Beattie et al. [68] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Beng et al. [69] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Blanco et al. [70] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Cankaya et al. [71] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Catalan et al. [72] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Chen et al. [73] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Cramond et al. [74] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Craw et al. [75] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Dennis et al. [76] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Emmarco et al. [77] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Ezeobele et al. [78] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Fairman et al. [79] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Galuska et al. [80] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Grailey et al. [31] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Griffiths et al. [81] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Ham et al. [82] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Jakobsson Larsson et al. [83] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Jeong et al. [84] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Jiang et al. [85] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Ketelaar et al. [86] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Lases et al. [87] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Lewis & Ahern [88] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Lewis O’Connor et al. [89] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
McNamara et al. [90] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Mediavilla et al. [91] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Michael & Jenkins [92] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
O’Toole et al. [104] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Pavithra et al. [93] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Peng et al. [94] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Powell et al. [95] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Ramalisa et al. [96] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Remtulla et al. [97] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Sanchez-Munoz et al. [98] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Siffleet et al. [99] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Smith & Hanna [100] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Sobekwa & Arunchallam [101] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Sun et al. [102] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Thude et al. [103] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Voogt et al. [105] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Walker et al. [106] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Warren at al. [107] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Welsh et al. [108] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Xu et al. [109] | Y | Y | Y | Y | Y | N | Y | Y | Y | Y |
Zeighami et al. [110] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Analytical Theme | Subtheme | Quote |
---|---|---|
Personal Factors | Skills and Experience | “I think that is something that comes with the knowledge and experience of being in that scenario…Experience definitely has a lot to do with it and I think seeing how other people handle situations. I haven’t just got seven years of experience myself; I’ve got seven years of observing other people, which definitely contributes” (Siffleet et al., 2015; p. 309) [99] “I felt like it was a good growing experience because even though growth is hard, I feel like I was able to become a lot more independent and a lot more confident in my practice and learned to appreciate how much easier the rest of our life is” (Emmarco et al., 2023; p. 270) [77]. |
Social Support and Self-Care | “You must put your own needs first because you cannot care for anyone if you are not taking care of yourself first. I can only help my clients if I take care of myself first” (Smith & Hanna, 2021; p. 55) [100] | |
Feeling Safe Within the Team | “We don’t discuss it but each one of us sort of understand how we are suffering from the death of our patients and from the whole pandemic situation. We all feel the exhaustion, frustration, so we silently help each other do the daily work in our unit, our team work became stronger and we learned to be more sensitive to each other” (Alwesmi et al., 2022; p. 5) [66] “What teamwork means for me is looking out for everybody else that is round about me and if I see anybody struggling I will go in, I will ask them…if they needassistance…if you help them out when you are in the same situation one day it is normally reciprocated” (Siffleet et al., 2015; p. 308) [99]. “It is a pleasant feeling when there is an accessible atmosphere in residency training. This makes me more inclined to ask questions, discuss things and encourages me to reflect on former situations. It is nice to notice that the supervisors also appreciate this” (Lases et al., 2018; p. 985) [87]. | |
Normalisation of Traumatic Incidents | “I felt shocked because my patient was doing well and then all of a sudden she’s gone” (Alwesmi et al., 2022; p. 5) [66] “Our superiors always blame us for any injury we sustained from a patient assault, label us as “unfit” for the job and the perpetrator of the assault. This dampens our spirit, causes demotivation, low morale... and for many of us, the work becomes, “a mere job” and this behavior makes us want to quit” (Ezeobele et al., 2021; p. 247) [78] “the most harmful intervention would be to ignore the situation or keep it ‘‘hush hush’’ and make it seem as if it never happened” (Fairman et al., 2014; p. 834) [79] | |
Unsupportive Team and Management | Team Culture | “Some of the nurses, they just don’t care. If I talk to them, they just walk away. I complain to the nurse manager, but I think they won’t change. I think that’s how they are trained, that’s how their attitude is” (Beng et al., 2015; p. 17) [69] “I feel when an event happens there is no support” (Ham et al., 2021; p. 1485) [82] “I’ve seen people bullied and confidence squashed to the point they resign as an anxious mess” (Pavithra et al., 2022; p. 7) [93] |
Hierarchical Structure | “My boss has left now—she used to hang up on me if I called in sick…Scream at me if I asked for a day off, refused to give me long service leave. I was scared of her; I wasn’t the only one. Reporting would not have worked” (Pavithra et al., 2022; p. 8–9) [93] “Many of us are very sad for the fact that physicians have such high status in the hospital, especially male doctors and we [nurse] are treated as worthless” (Alilu et al., 2016; p. 537) [65] “Sometimes we can feel the kind of separation like you feel like your input is slightly valued less than a doctor’s would be” (Remtulla et al., 2021; p. 7) [97] | |
Organisational Factors | “The existing protocols are not adequate or sometimes not relevant to control the spread of the infection” (Alwesmi et al., 2022; p. 5) [66] “There was just not enough of us. We wanted to make sure we were taking care of ourselves, but it was difficult because you couldn’t just leave the room” (Emmarco et al., 2023; p. 269) [77] “Here we have four staff per shift, but we are taking care of twenty patients. Sometimes the patients are very ill. Sometimes they want more attention, but we can’t help” (Beng et al., 2015; p. 19) [69]. “Almost every day we are assigned to more patients than we can care for” (Alilu et al., 2016; p. 539) [65] | |
Lack of Knowledge and Training | “I think employers need to be more supportive in terms of practitioner professional development. This is what I am missing. I want the training but there doesn’t seem to be much available” (Smith & Hanna, 2021; p. 56) [100]. “Some of my colleagues have years of experience and near retirement, but they are still working as staff nurses instead of being promoted to mentor our new graduates and when I see them, I can picture my own professional future without recognition or promotion” (Alilu et al., 2016; p. 538) [65] |
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Peddie, N.; Hoegh, J.; Rice, G.; Shetty, S.; Ure, A.; Cogan, N. Health and Social Care Professionals’ Experience of Psychological Safety Within Their Occupational Setting: A Thematic Synthesis Review. Nurs. Rep. 2025, 15, 131. https://doi.org/10.3390/nursrep15040131
Peddie N, Hoegh J, Rice G, Shetty S, Ure A, Cogan N. Health and Social Care Professionals’ Experience of Psychological Safety Within Their Occupational Setting: A Thematic Synthesis Review. Nursing Reports. 2025; 15(4):131. https://doi.org/10.3390/nursrep15040131
Chicago/Turabian StylePeddie, Nicola, Josephine Hoegh, Gemma Rice, Shruti Shetty, Aoife Ure, and Nicola Cogan. 2025. "Health and Social Care Professionals’ Experience of Psychological Safety Within Their Occupational Setting: A Thematic Synthesis Review" Nursing Reports 15, no. 4: 131. https://doi.org/10.3390/nursrep15040131
APA StylePeddie, N., Hoegh, J., Rice, G., Shetty, S., Ure, A., & Cogan, N. (2025). Health and Social Care Professionals’ Experience of Psychological Safety Within Their Occupational Setting: A Thematic Synthesis Review. Nursing Reports, 15(4), 131. https://doi.org/10.3390/nursrep15040131