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Vicarious trauma is prevalent among nurses in paediatric intensive care units (PICUs), which induces adverse physiological, psychological and cognitive alterations. These alterations not only impair nurses' well-being but also compromise patient safety, necessitating more research in this understudied area.
To explore the cognitive and emotional experience of vicarious trauma undergone by PICU nurses.
This study employed a qualitative descriptive design.
The research team conducted semi-structured individual interviews among 12 critical care nurses in a tertiary children's hospital. Participants were recruited by means of purposive sampling in October 2025. Data were analysed following a thematic analysis method in ATLAS.ti version 25.
The experience of vicarious trauma among PICU nurses was summarized into four major themes and 11 sub-themes. The major themes included traumatic scenario, double-edged sword effects, coping strategies and multi-level support needs.
The experience of vicarious trauma among PICU nurses involved various triggers and led to negative holistic impacts. In response, the nurses predominantly adopted emotion-focused coping strategies, highlighting a need for enhanced support structures to promote post-traumatic growth. The findings lay a foundation for targeted interventions aimed at mitigating vicarious trauma among PICU nurses, ultimately improving nurses' well-being and patient safety.
Following the EQUATOR guidelines, reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ).
No patient or public contribution.
PICU nurses should pay attention to vicarious trauma and actively adopt corresponding strategies to mitigate its negative impacts, thereby facilitating its transition toward posttraumatic growth. Clinical administrators should establish comprehensive, multi-level support systems to assist nurses in managing vicarious trauma and to promote their overall psychological well-being and occupational health.
Nurse-led interventions have demonstrated effectiveness in managing emergence delirium (ED), but there is a lack of evidence in pediatric studies.
To systematically synthesize the evidence on the effectiveness of the nurse-led interventions on ED in pediatric patients.
A comprehensive literature search was conducted in PubMed, CINAHL, EMBASE, MEDLINE, Web of Science, Cochrane Library, and APA PsycINFO from the inception to January 13, 2025. Risk of bias was assessed by using the revised Cochrane risk-of bias tool (ROB2) and the Cochrane risk of bias in non-randomized studies-of interventions (ROBINS-I). The meta-analysis was performed using Stata16.0. The forest plots showed the overall effect of the included study.
A total of 20 studies were included, involving 2369 children, comprising 17 RCTs, 1 quasi-experimental study and 2 cohort studies. Compared with usual care, nurse-led interventions significantly reduced the incidence of ED (risk ratio [RR]: 0.50, 95% confidence interval [CI]: 0.33 to 0.77, p = 0.002, I 2 = 77.2%), m-YPAS scores (weighted mean difference [WMD]: −7.67, 95% CI: −10.96 to −4.39, p = 0.000, I 2 = 91.7%), PAED scores (WMD: −1.47, 95% CI: −2.35 to −0.60, p = 0.000, I 2 = 91.3%), and FLACC scores (WMD: −0.97, 95% CI: −1.59 to −0.35, p = 0.000, I 2 = 92.9%). However, no significant effect was observed on the length of PACU stay or the anesthesia induction compliance.
Nurse-led interventions can reduce the incidence and severity of ED in children, as well as in alleviating preoperative anxiety and postoperative pain. However, more research is needed on influencing PACU length of stay and induction compliance.
Nurse-led interventions can be integrated into the perioperative management of children to reduce the incidence of ED. However, in clinical practice, these interventions should be flexibly adapted based on the individual differences of pediatric patients.
This study protocol was registered on PROSPERO with the registration number CRD42024601191
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