The NICU environment is unique in that the patient population consists of critically ill neonates. Research has revealed that there are increased levels of depression, secondary traumatic stress, and burnout in nurses. Problem solving and support seeking coping strategies have been shown to be associated with lower levels of burnout and increased patient and job satisfaction in general staff nurses. Multiple linear regression and a hierarchical stepwise technique was used to conduct moderator analyses assessing whether the use of problem solving or support seeking strategies moderated the relationship between secondary traumatic stress levels and burnout as well as between depressive symptomology and burnout in NICU nurses. Of the 62 participants, the majority identified as White (64.5%) and female (98.4%) with a mean age of 41.65 years (SD = 13.05). Support seeking coping skills significantly moderated the relationship between secondary traumatic stress symptoms and burnout symptoms in NICU nurses. Post-hoc analysis indicated that NICU nurses who reported higher levels of secondary traumatic stress symptoms and engaged in higher levels of support seeking coping skills, also reported higher levels of burnout when compared with nurses who reported lower levels of support seeking coping skills. Problem solving coping did not moderate the relationship between depressive symptoms and burnout. These results indicate the need to better understand the risk and protective factors related to stress and burnout in NICU nurses. These findings can be used to inform the development of programs that could promote the well-being and coping of nurses experiencing mental health difficulties or burnout and foster a healthy work environment for all NICU nurses so that they can provide the best possible intervention to the vulnerable infants they work with.

LLU Discipline

Clinical Psychology


Clinical Psychology


School of Behavioral Health

First Advisor

Schellinger, Kriston

Second Advisor

Neece, Cameron L.

Third Advisor

Vermeersch, David A.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Intensive Care Units; Neonatal; Nurses; Adaptation; Psychological; Stress Disorders; Secondary-Traumatic; Stress; Psychological;

Subject - Local

Coping Strategies; Problem solving; Burnout; Depression



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives