Factors influencing delirium nursing competency among nurses in integrated nursing care wards in South Korea: a cross-sectional study.

The diagnosis and treatment of cancer can be a psychologically traumatic experience for many patients []. The effects of ambiguity during cancer treatments, the nature of the psychiatric symptoms experienced, and the ongoing and deteriorating medical condition of cancer make it a life-threatening experience. Thus, the presence of post-traumatic stress disorder (PTSD) during a diagnosis of cancer is not unusual []. Cancer patients develop post-traumatic stress symptoms (PTSS) including intrusive trauma-related thoughts, avoidance of trauma-related reminders, hypervigilance, and heightened arousal, at any point from diagnosis through treatment, after treatment is complete, or during recurrence of the cancer [,]. Cancer patients with PTSS feel sadness, fear, anger, helplessness, or hopelessness. They feel detached or estranged from other people []. Severe emotional distress in cancer patients results in poor compliance with treatments, an unhealthy lifestyle, and increased risk of cancer progression and death []. Therefore, it is important to detect and appropriately treat individuals in need of psychosocial support []. One of the common adaptations following a traumatic event is resilience []. Resilience refers to the ability to “bounce back” after trauma. Thus, after a short fallout period following a catastrophic event, an individual returns to pre-event or baseline functioning []. Resilience is the dynamic process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of stress []. Factors contributing to resilience include the ability to maintain an optimistic outlook in life, develop a positive social support network, face one's fears, and use active coping skills []. Resilient individuals are able to regulate their emotions effectively to adapt to stressful situations, find something positive in even adverse situations, and even experience personal growth from distressing events []. On the other hand, poorly resilient individuals go through distress and confusion when they try to understand the reason that this terrible event happened to them and the meaning of the event for their world view []. Molina et al. [] described resilience in the three ways: a preexisting, baseline characteristic or trait, such as demographics and personal attributes (e.g., optimism and hope); an adaptation mechanism to promote positive outcomes, such as stress management and resilience training; and a psychosocial outcome itself. Promoting resilience is a critical element of patient psychosocial care. Nurses can facilitate resilience by recognizing and promoting certain baseline characteristics and optimizing mechanisms of adaptation []. Adjustment to cancer is a process. Successful adjustment occurs in patients who are able to regulate their emotional distress []. Emotion regulation is the process of maintaining a preferred or desired internal emotional state following an external emotion-eliciting stimulus []. Emotion regulation is performed in an automatic or controlled manner, either unconsciously or consciously [].