The impact of 24/7 news coverage on the mental health of Israelis in the 'Iron Swords' War: A cross-sectional analysis among television audience

Emotional resilience and sense of danger among doctors in hospitals during periods of heightened tensions and warfare in Israel

BACKGROUND

The "Iron Swords" War beginning in October 2023 led to unprecedented levels of shock and trauma across Israel, significantly impacting the Israeli population and medical personnel. This study aimed to evaluate and compare the perceived personal resilience and sense of danger among physicians in hospitals located in different conflict zone proximities in Israel during this period.

METHODS

A quantitative, cross-sectional study was conducted from March to August 2024, during an active phase of the war, using a structured anonymous questionnaire. Participants were 161 physicians from three hospitals: one in southern Israel near the Gaza Strip, another in northern Israel near the borders with Lebanon, Syria, and Jordan, and a third in central Israel near Tel Aviv. The survey measured personal resilience using the Connor-Davidson Resilience Scale (CD-RISC-10) and sense of danger using the Solomon & Prager scale. Statistical analyses included Kruskal-Wallis H test, multiple linear regression, two-way analysis of variance (ANOVA), and Sobel test for mediation effects.

RESULTS

The final sample included 161 physicians (54 southern, 56 central, 51 northern). The mean resilience score was 31.14 ± 5.77, and the mean sense of danger score was 8.36 ± 4.15 (scales 0-40 and 0-20, respectively). Physicians in the southern hospital reported significantly higher sense of danger scores (p = 0.005). A trend towards lower resilience scores was noted among southern hospital physicians (p = 0.068) (p = 0.068). Two-way ANOVA revealed significant main effects of hospital location and gender on resilience (p = 0.046 and p = 0.003, respectively) and sense of danger (p = 0.005 and p = 0.062, respectively). Multiple regression analysis identified hospital location (β = -0.178, p = 0.023) and gender (β = 0.229, p = 0.004) as significant predictors of resilience. Mediation analysis indicated that personal resilience partially mediated the relationship between hospital location and sense of danger (indirect effect = 0.2896, p < 0.001).

CONCLUSIONS

Physicians working near conflict zones report higher levels of perceived danger, though their resilience is comparable to peers in less threatened regions. Enhancing personal resilience is crucial to mitigate the heightened sense of danger. This could include regular resilience training, psychological support, and specific programs for single and childless physicians to improve safety perceptions. Additionally, fostering a supportive community with clear communication and robust emergency protocols is essential for enhancing staff resilience and safety in hospitals.

Is SNOT-22 a Reliable Tool During Periods of High Stress? A Retrospective Cohort Study

OBJECTIVE

To assess the impact of a major crisis, such as the October 7, 2023, terror attack, on SNOT-22 scores, especially the extra-rhinologic subdomains.

METHODS

This retrospective cohort study was conducted at the Rhinology Clinic in a Tertiary University Hospital. Patients who visit our Rhinology Clinic routinely complete the SNOT-22, a widely employed questionnaire designed for evaluating health-related quality of life in individuals with rhinologic conditions. Patients were divided into two groups: 5 weeks before the October 7 terror attack and 5 weeks after. Primary outcomes for analyses included the Sedaghat Subdomain model of the SNOT-22. Descriptive analysis and Welch's t-test were used to compare SNOT-22 subdomain scores between groups.

RESULTS

A total of 159 patients completed the SNOT-22 questionnaire, with 60 before and 99 after October 7, 2023. A general decrease in average scores was observed across all subdomains, with a significant decrease in the Nasal subdomain (p = 0.0388). Subgroup analysis showed an increase in the Ear/Facial subdomain in Arabic and the Sleep and Function subdomains in English, though not statistically significant. In sex-based sub-analysis, female patients showed a significant decrease in the Emotions subdomain.

CONCLUSION

Our study was unable to establish a direct link between the terror attack and specific SNOT-22 subdomains. However, the observed trends suggest that SNOT-22 may display variability or unreliability when used during periods of high stress.

LEVEL OF EVIDENCE

III Laryngoscope, 2024.

Anxiety, post-traumatic symptoms, media-induced secondary trauma, post-traumatic growth, and resilience among mental health workers during the Israel-Hamas war

The ongoing Israel-Hamas war is posing additional challenges for mental health workers in an already stressful workplace. This study centres on the psychological effects of the shared traumatic reality on mental health workers, arising from the Israel-Hamas war. One month after exposure to the terrorist attack of 7 October 2023 and the outbreak of war following this event, 147 mental health workers completed questionnaires regarding a variety of variables such as demographics, anxiety symptoms, acute stress symptoms, media-induced secondary trauma, personal resilience, National resilience (NR), and post-traumatic growth (PTG). The study found that mental health workers with previous trauma displayed higher anxiety symptoms, acute stress symptoms, and media-induced secondary trauma. Additionally, acute stress and anxiety were positively correlated with media-induced secondary trauma. Religiosity, personal resilience, and NR were found associated with lower anxiety and acute stress symptoms. Religiosity was also positively correlated with personal resilience, NR, and PTG. The PTG of mental health workers working with trauma survivors and evacuees was higher compared to that of other mental health workers. Both adverse and adaptive reactions were evident among mental health workers. While traumatic stress is expected, individual, professional, and NR factors may mitigate its effects. Providing training, social support, regulated media exposure, stress management, and meaning-focused coping strategies can help safeguard workers' well-being.