The Moderating Role of Demographics on Secondary Traumatic Stress and Impostor Phenomenon among Nurses in Metro Manila: A Mixed-Methods Study

Abstract

Filipino nurses caring for trauma patients in under-resourced tertiary government hospitals of Metro Manila face potential risks of Secondary Traumatic Stress (STS) and Imposter Phenomenon (IP). This study investigates STS and IP experiences among nurses, explores their relationship, the moderating role of demographics, and the challenges they face in caring for trauma patients. The study utilized a mixed-methods explanatory sequential design involving 138 trauma nurses from a tertiary government hospital in Metro Manila. Quantitative measures included the Secondary Traumatic Stress Scale and Clance Impostor Phenomenon Scale, while qualitative data was collected through individual interviews with 10 nurses. Sample sizes were justified: SEM requires a minimum of 10 cases per variable for quantitative and data saturation for qualitative data. Data gathering occurred in July-September 2023 (quantitative) and late September 2023 (qualitative). Results showed that nurses experienced mild STS (mean = 35.01) and moderate IP (mean = 36.12). Path analysis-structural equation modeling yielded a good model fit (SRMR= 0.052) and a significant positive relationship between STS and IP (ß=0.346, p<0.001), indicating elevated STS predicted heightened IP, with stronger impact for females (β=-0.148, p=0.037), while weaker for married (ß=-0.165, p=0.023). Qualitative themes highlighted the ‘Psychological Burdens of Trauma Care’, ‘Healthcare System Constraints’, and the ‘Demands of Trauma Care Settings’. Given the results of the study, collaboration between hospitals and mental health professionals is crucial, considering that the former is best equipped to provide preventive and tailored psychological interventions for at-risk nurses to mitigate the development of more serious mental health concerns.