{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:07:19Z","timestamp":1783836439857,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n This study aimed to investigate whether psychological distress mediates the relationship between secondary traumatic stress (STS) and post\u2010traumatic stress symptoms (PTSS) among clinical nurses, and whether perceived emotional support moderates this mediating effect.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A cross\u2010sectional study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A total of 205 clinical nurses who had direct patient contact and trauma\u2010related experience were included. Data were collected using validated instruments: the Secondary Traumatic Stress Scale (STSS), Depression Anxiety Stress Scale\u201012 (DASS\u201012), Impact of Event Scale\u2010Revised (IES\u2010R), and the Multidimensional Scale of Perceived Social Support (MSPSS). All scales demonstrated high internal consistency (Cronbach's\n \u03b1<\/jats:italic>\n \u2009=\u20090.88\u20130.97).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Psychological distress significantly mediated the relationship between STS and PTSS. Perceived emotional support moderated the path from STS to psychological distress, such that higher emotional support amplified the association. However, emotional support did not significantly moderate the relationship between psychological distress and PTSS.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Psychological distress plays a central role in translating STS into PTSS among clinical nurses. Although emotional support may buffer early psychological distress, it does not attenuate PTSS development once distress is established.<\/jats:p>\n <\/jats:sec>\n \n Implications for the Profession and\/or Patient Care<\/jats:title>\n Early detection and management of psychological distress can prevent STS from progressing to PTSS. Nurses frequently exposed to trauma require timely psychological support. We recommend implementing routine screening and early interventions focused on distress, along with peer\u2010support programmes and supervisory encouragement to enhance resilience. Trauma\u2010informed care training and organisational awareness should also be strengthened to foster a supportive environment.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n This study shows that managing early emotional symptoms is critical in preventing PTSS among nurses exposed to secondary trauma. Findings can inform global policies, peer\u2010support initiatives, and early screening systems to enhance resilience and safeguard patient care.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n The study adhered to the STROBE checklist for cross\u2010sectional studies.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n No patient or public contribution.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jan.70390","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T11:57:36Z","timestamp":1763121456000},"page":"7827-7835","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary Traumatic Stress and Post\u2010Traumatic Stress Symptoms in Nurses: Mediating Role of Psychological Distress and Moderating Role of Emotional Support"],"prefix":"10.1111","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1342-2769","authenticated-orcid":false,"given":"Soo\u2010Hyun","family":"Nam","sequence":"first","affiliation":[{"name":"School of Nursing Science Gyeongkuk National University Andong South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4916-5485","authenticated-orcid":false,"given":"Jungmin","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Nursing Hallym University Chuncheon Gangwon\u2010do South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010024\u201002018\u20104"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00298"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049731503254106"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2003.07.010"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.3912\/OJIN.Vol28No01Man01"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43045\u2010022\u201000208\u2010x"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/10172-033"},{"issue":"2","key":"e_1_2_16_9_1","first-page":"1","article-title":"Trauma\u2010Informed Nursing Practice","volume":"24","author":"Fleishman J.","year":"2019","journal-title":"Online Journal of Issues in Nursing"},{"key":"e_1_2_16_10_1","volume-title":"Principles and Practice of Structural Equation Modeling","author":"Kline R. B.","year":"2015"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anr.2018.11.006"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2016.10.006"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/cps0000159"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTN.0000000000000274"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/trm0000122"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969733019851548"},{"key":"e_1_2_16_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049731516662916"},{"key":"e_1_2_16_18_1","unstructured":"Nam A. andB.Lee.2025.\u201cValidity and Reliability of the Korean Version of the Secondary Trauma Stress Scale for Healthcare Professionals.\u201d"},{"key":"e_1_2_16_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1358"},{"key":"e_1_2_16_20_1","doi-asserted-by":"publisher","DOI":"10.70256\/607490pbruec"},{"key":"e_1_2_16_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0247596"},{"key":"e_1_2_16_22_1","unstructured":"Owen C. 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