Secondary traumatic stress and vigor among neonatal intensive care unit personnel: The moderator role of coping flexibility

Rachel Nissanholtz Gannot, Yaira Hamama Raz, Iris Stein, Ori Hochwald

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: The demanding and highly stressful work environment of the neonatal intensive care unit (NICU) has led to the identification of a possible psychological stress reaction among NICU nurses and physicians, termed secondary traumatic stress (STS). Purpose: The current study aimed to explore the association between vigor at work (as an energy resource) and STS, while considering their association with the professional role (nurses/physicians - as a condition resource) as well as with coping flexibility (as a personal resource). Methods: In this cross-sectional study physicians and nurses working in NICUs across Israel completed a questionnaire comprising sections on demographics and professional characteristics, self-rated health, STS, coping flexibility, and vigor. Results: Of 280 physicians and nurses approached, 70% (195) completed the questionnaire. No significant differences between nurses and physicians were found in STS adjusted for gender, being in a committed relationship, and seniority in the NICU. Vigor was negatively correlated with STS - both in the entire sample and for each professional role alone. Coping flexibility was a statistically significant moderator between vigor and STS, whereas the interaction between vigor and professional role was not significant. Specifically, the negative relationship between vigor and STS was significant when coping flexibility was more than 10.10 (61% of the participants) but not significant at lower values. Implications for Practice and Research: The understanding of the relationship between vigor and STS, with coping flexibility as its moderator, encourages an intervention aimed at reducing stress by increasing these resources.

Original languageEnglish
Pages (from-to)E86-E93
JournalAdvances in Neonatal Care
Issue number3
StatePublished - 2022


  • Coping flexibility
  • Neonatal intensive care unit personnel
  • Posttraumatic stress disorder
  • Secondary traumatic stress
  • Vigor


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