EFFECTIVENESS OF TRAUMA RECOVERY PROGRAMS IN NURSES WITH MENTAL ILLNESS WORKING IN THE TRAUMA UNIT

Abstract

Background: Nurses working in trauma units are routinely exposed to critical incidents, secondary traumatic stress, and intense emotional demands. This occupational exposure places them at increased risk of depression, anxiety, stress, and post-traumatic stress disorder. In low- and middle-income countries such as Pakistan, limited access to structured mental health support and occupational wellbeing programs further compounds this vulnerability. Evidence evaluating the effectiveness of structured trauma recovery interventions for nurses in trauma settings remains scarce. Objective: To assess the efficacy of a structured trauma recovery program in reducing psychological distress and improving professional quality of life among nurses with mental illness working in a trauma unit. Study Design: Prospective two-arm controlled trial. Settings: Trauma unit of a tertiary care hospital in Pakistan. Duration of Study: January to July 2025. Methods: A total of 90 trauma-unit nurses with clinically relevant symptoms of mental illness were enrolled and allocated to either an intervention group (n = 45) or a control group (n = 45). The intervention group received an eight-week structured trauma recovery program in addition to usual care, while the control group received usual care alone. Primary outcomes included changes in depression, anxiety, and stress assessed using the Depression Anxiety Stress Scale (DASS-21), and trauma-related symptoms assessed using the Post-Traumatic Stress Disorder Checklist (PCL-5). Secondary outcomes included professional quality of life, measured by the Professional Quality of Life Scale; resilience, assessed using the Connor-Davidson Resilience Scale; and selected work-related indicators. Outcomes were measured at baseline and at eight weeks. Adjusted repeated-measures analyses were used for between-group comparisons. Results: Baseline demographic and clinical characteristics were comparable between the two groups. At eight weeks, nurses in the intervention group demonstrated significantly greater reductions in depression, anxiety, stress, and PTSD symptom severity compared with the control group (all p < 0.001). Significant improvements were also observed in secondary outcomes, including increased compassion satisfaction and resilience, along with reduced burnout and secondary traumatic stress. Clinically meaningful response rates were substantially higher in the intervention group, with approximately a threefold increase in the likelihood of significant stress reduction and PTSD symptom improvement. No intervention-related safety concerns were reported. Conclusion: The structured trauma recovery program was effective in significantly improving psychological wellbeing and professional quality of life among trauma-unit nurses with mental illness. Incorporating trauma-informed recovery interventions into routine occupational health services may enhance workforce resilience and support sustainable healthcare delivery in high-stress trauma settings.