Estimating the associations between personal, health, lifestyle, and social factors on depressive symptoms from adolescence to adulthood: a fixed effect approach using panel data.

Intensive care units (ICUs) are highly digitalized clinical environments in which high-acuity care is organized around continuous physiological monitoring and complex sociotechnical work systems [,]. Bedside monitors, ventilators, infusion pumps, and other connected devices generate streams of physiological data, waveforms, device alerts, and audible or visual alarms that nurses must interpret, prioritize, and act on in real time [,]. These technologies are central to patient safety because they support the early detection of deterioration but also create a demanding digital work environment in which nurses’ attention is repeatedly redirected by screens, sounds, and alerts. ICUs are alarm-dense settings, and alarm rates vary by patient and clinical characteristics, while many alarms are clinically nonactionable [,]. Frequent nonactionable alarms can disrupt nursing work, increase cognitive burden, and reduce confidence in alarm systems [,]. Alarm-related risks cannot be addressed through individual vigilance alone. Existing guidance emphasizes alarm policy, parameter configuration, staff education, workflow redesign, and unit-specific implementation [-]. Research on ICU nurses’ cognitive ergonomics shows that alarm management is embedded in everyday work, requiring nurses to recognize, interpret, prioritize, reset, or silence alarms while managing competing tasks []. Scholarship on the digital nursing gaze and nursing surveillance likewise conceptualizes monitoring as more than measurement: it organizes interpretation, anticipation, continuous visibility, and responsibility-bearing work [-]. By making certain physiological changes visible, audible, and urgent, monitoring interfaces and alarm signals shape how nurses allocate attention, interpret patient risk, and coordinate responses [,]. They can also become shared reference points for interpreting patient status and organizing action []. Continuously visible parameters may heighten nurses’ perceived accountability when deterioration is difficult to reverse [-]. These features are therefore not merely operational; they are health system design choices with consequences for both patient safety and nurses’ work. Within this alarm-intensive and digitally mediated work environment, ICU nurses are repeatedly exposed to patient suffering, rapid deterioration, death, family distress, and emotionally charged clinical encounters. Such experiences have been discussed in relation to compassion fatigue, secondary traumatic stress, and other forms of occupational distress [,]. Vicarious trauma is a useful interpretive lens for this study because it concerns enduring changes in helpers’ assumptions about safety, trust, control, and meaning that may arise through empathic engagement with others’ trauma [,]. In nursing, vicarious trauma–related effects may arise not only through direct exposure to patient injury and death but also through repeated encounters with family grief, interpersonal conflict, and threats or hostility toward staff [,]. In this study, we use vicarious trauma as an interpretive lens for understanding the distress and psychological residue that may accumulate through repeated witnessing of suffering, deterioration, or death during care. Rather than treating monitoring technologies as independent causes of vicarious trauma, this framing directs attention to how they may shape the conditions under which distressing clinical events are witnessed, anticipated, and remembered.