The association between hospital medical teams' exposure to illness and mortality and secondary traumatization, on one hand, and personal growth and life satisfaction, on the other – The moderating role of self differentiation and social support.

The hospital work environment is complicated for the medical teams both as it requires providing optimal care for a large number of patients under stressful, uncertain conditions and time constraints, and because of the multifaceted health conditions of patients, the need to deal with death and dying patients, and engage in ethical dilemmas. The daily encounter with pain and emotional distress that such work entails has deep, long-term implications on medical professionals, and may be expressed as secondary traumatization. Professional literature in recent years, though, has also acknowledged the positive effects of traumatic events, including emotional well-being, satisfaction in life and even personal growth.

The current study aims to examine the association between prolonged exposure to illness and death and secondary traumatization, on the one hand, and personal growth as well as satisfaction in life, on the other, while comparing medical teams in different hospital departments differing in the level of exposure to illness and death. The role of social support and self-differentiation in personal growth and satisfaction in life will also be examined.

The sample composed of 149 medical and nursing health professionals working in several hospitals in Israel. All study participants completed a series of self-report questionnaires. The sample included three study groups with different levels of exposure to illness and death (high exposure to illness and death, moderate-low exposure to illness and death, and high exposure to life).  

The main hypotheses were that there will be differences between the three study groups, so that the group with high exposure to illness and death will have higher levels of secondary traumatization, lower satisfaction in life and more personal growth than the other two groups.  Additionally, higher levels of social support and self-differentiation will be associated with lower secondary traumatization, higher life satisfaction and higher personal growth. Furthermore, we examined the role of social support and self-differentiation not only as barriers to negative outcomes but also as moderators facilitating positive outcomes such as personal growth and satisfaction in life. A research question was also asked in regard to whether the staff that is exposed to a new life experience will have  different levels of secondary traumatization, life satisfaction and personal growth relative to the other  two groups with different levels of exposure to illness and death?

Contrary to the hypotheses, the three study groups did not differ in levels of secondary traumatization and satisfaction in life. Furthermore, personal growth was higher among participants with high exposure to life as compared to those with high exposure to illness and death. As hypothesized, higher levels of social support and self-differentiation were associated with more personal growth and satisfaction in life, whereas secondary traumatization was negatively associated with satisfaction in life. Additionally, the hypothesis regarding the role of social support and self-differentiation as moderators of the association between exposure to illness and death on the one hand, and personal growth and satisfaction in life on the other, was partially confirmed; among participants who perceived higher social support, higher personal growth was reported in the group with lower level of exposure to illness and death as compared to the group with the higher exposure. No differences in personal growth were found when social support was perceived as low. In addition, among participants who perceived low levels of support, there was a positive association between secondary traumatization and personal growth. Such an association was not significant for those who perceived higher levels of social support.

These findings suggest that any exposure to illness and death may illicit secondary traumatization, irrespective of the level of exposure, and that exposure to difficulties in ccontexts that are usually regarded as positive (post-natal wards) has the potential for personal growth. These findings also highlight the fact that we are still lacking in-depth understanding of the relative contribution of other variables that are associated with these outcomes.

This study has several important implications for both research and practice. First, the study suggests that daily exposure to illness and death may result in positive outcomes. This broadens our knowledge of the positive effects of direct exposure to traumatic events. Second, the study emphasizes the importance of social support as a coping resource that moderates the negative implications of such work. Thus, the support of management and allocation of resources to develop support (such as organizational and personal training programs) can promote the creation of a safety net that will protect the teams and contribute to their well-being. Finally, the findings highlight the importance of considering the emotional experiences of medical teams in all departments, not only those that are regarded as difficult in terms of their exposure to illness and death.