Nurses during war: Profiles-based risk and protective factors

Introduction: Nurses in southern Israel's public hospitals were exposed to unusual traumatic events following the October 7, 2023, Hamas attack on Israel, and the ensuing Swords of Iron War. This study aimed to clarify the complexity of wartime nursing by identifying profiles based on risk factors (i.e., psychological distress and adjustment disorders) and protective factors (i.e., positive affect (PA), resilience, and perceived social support [PSS]). Design: This study utilizes a cross-sectional design. Method: Two hundred nurses at a major public hospital in southern Israel completed self-report questionnaires. A latent profile analysis (LPA) was conducted to identify distinct profiles based on nurses' risk and protective factors. Differences in profiles were examined alongside sociodemographic and occupational variables and traumatic event exposure. The LPA was conducted using MPlus 8.8 Structural Equation Modeling (SEM) software. Findings: Two distinct profiles were identified: “reactive” and “resilient.” The “reactive” group included nurses who had higher risk factor scores (psychological distress and adjustment disorder), whereas the “resilient” group included nurses who had higher protective factor scores (PA, resilience, and PSS). Furthermore, nurses in the “reactive” group were younger, with greater seniority, worse self-rated health, and a higher frequency of kidnapped family members compared to nurses from the “resilient” group. Conclusion: Nurses in wartime are at risk if identified as “reactive.” Identifying these profiles can assist in developing effective support practices to help nurses cope with wartime challenges and maintain their mental well-being. Clinical Relevance: Healthcare organizations should tailor interventions to prepare and support nurses of various ages and experience levels, during and after conflicts. This approach aims to reduce risk factors and promote protective factors among nurses during wartime.