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Maloney LM, Robitsek RJ, McKenzie K, Peralta E, Valenzuela JY. Evaluation of Posttraumatic Stress Disorder Screening Measures of Emergency Medical Services Clinicians in Urban and Suburban New York During the Coronavirus Disease 2019 Pandemic. Air Med J 2024; 43:340-344. [PMID: 38897698 DOI: 10.1016/j.amj.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/27/2024] [Accepted: 03/11/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE The objective of this study was to assess the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on the self-reported rates of posttraumatic stress disorder (PTSD) among emergency medical services (EMS) clinicians in urban and suburban settings that were one of the primary epicenters during the first wave of the COVID-19 pandemic. METHODS Anonymous surveys containing the PTSD Checklist-Specific (PCL-S) were sent electronically between November 2020 and April 2021 to EMS clinicians working in 2 EMS agencies. A threshold score ≥ 36 was considered a positive screen for PTSD symptomology; a score ≥ 44 was considered a presumptive PTSD diagnosis. RESULTS Of the 214 surveys sent, 107 responses were returned. The total PCL-S scores suggested PTSD symptoms were present in 33% of responding EMS clinicians (95% confidence interval [CI], 24.1%-42.5%), and 25% (95% CI, 17.6%-34.7%) met the criteria for a presumptive diagnosis of PTSD. Regression revealed increasing PCL-S scores were associated with thoughts of job resignation (+3.8; 95% CI, 1.1-6.4; P = .006), whereas lower PCL-S scores were related to the degree that respondents believed emotional support was available at their institution (-3.6; 95% CI, -6.8 to -0.4; P = .03). CONCLUSION Sixth months after the first wave of the COVID-19 pandemic, one third of participating EMS clinicians screened positive for PTSD symptoms. Pandemic planning must address the mental health of EMS clinicians to reduce subsequent burnout and maintain a healthy workforce.
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Affiliation(s)
- Lauren M Maloney
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY.
| | | | | | - Edder Peralta
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Julie Y Valenzuela
- Department of Surgery, Jamaica Hospital Medical Center, Jamaica, NY; University of Miami Miller School of Medicine, Miami, FL
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Knobloch LK, Owens JL. The REBOOT First Responders Program: Insights of U.S. Graduates. JOURNAL OF RELIGION AND HEALTH 2023; 62:4088-4111. [PMID: 37747663 DOI: 10.1007/s10943-023-01887-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/26/2023]
Abstract
The REBOOT First Responders program offers spiritual care for occupational stress. Although prior work suggests benefits to the program, no research has considered attendees' experiences in an open-ended way. The aim of this study was to document first responders' thoughts about the effectiveness, evaluation, and effects of the course in their own words. Interviews with 36 graduates living in the U.S. indicated favorable perceptions of the course. Reasons for success included the program's tangible benefits, community atmosphere, and faith-based approach (RQ1). Strengths involved helping first responders realize they are not alone and educating them about trauma; recommended upgrades involved customizing to specific occupations and offering ongoing support (RQ2). Effects included more self-acceptance, enhanced spirituality, better relationships, a more constructive view of trauma, and greater optimism about the future (RQ3). These results have implications for improving spiritual care for first responders.
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Affiliation(s)
- Leanne K Knobloch
- Department of Communication, University of Illinois Urbana-Champaign, 3001 Lincoln Hall, 702 South Wright Street, Urbana, IL, 61801, USA.
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Breindahl N, Strange KF, Østergaard D, Collatz Christensen H. Evaluation of a critical incident management system on mental health in lifeguard organisations: a retrospective study. BMJ Open Sport Exerc Med 2023; 9:e001499. [PMID: 36704713 PMCID: PMC9872474 DOI: 10.1136/bmjsem-2022-001499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 01/25/2023] Open
Abstract
Background Lifeguards may face many life-threatening situations during their careers and may be at increased risk of post-traumatic stress disorder (PTSD). Minimal evidence concerning critical incident management systems in lifeguard organisations exists. Objectives To develop, implement and evaluate an operational system for critical incident management in lifeguard organisations. Methods This retrospective study included data on occupational injury reports from 2013 to 2022 in TrygFonden Surf Lifesaving Denmark. All active lifeguards were invited to evaluate the system and the individual steps using an online questionnaire with three questions rated on a 5-point Likert scale. Primary outcome was a change in the frequency of psychological injury reports after system implementation in 2020. The secondary outcome was the lifeguards' satisfaction with the system. Results After implementation, the average annual number of psychological injury reports increased 6.5-fold from 2 (2013-2019) to 13 (2020-2022), without changes to the number of critical incidents attended by the lifeguards. Sixty-six (33.8%) active lifeguards answered the questionnaire and agreed that follow-up after critical incidents was very important (mean score 4.7/5). Satisfaction with steps 1-2 and 3 of critical incident management among involved lifeguards was high (mean score 4.4/5 and 4.6/5, respectively). The system included an operational workflow diagram and incident report template presented in this study. Conclusions The operational system for critical incident management may improve early recognition of symptoms for the prevention of PTSD. It may be used as a screening and decision tool for referral to a mental health professional.
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Affiliation(s)
- Niklas Breindahl
- Prehospital Center Region Zealand, Naestved Hospital, Naestved, Denmark,Department of Neonatal and Pediatric Intensive Care, Rigshospitalet, Copenhagen, Denmark,International Life Saving Federation, Leuven, Belgium,TrygFonden Surf Lifesaving Denmark, Hvidovre, Denmark
| | - Kirstine Friderichsen Strange
- TrygFonden Surf Lifesaving Denmark, Hvidovre, Denmark,Hammel Neurorehabilitation and Research Centre, Regional Hospital Hammel Neurocenter, Hammel, Denmark
| | - Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation, Herlev Hospital, Herlev, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Helle Collatz Christensen
- Prehospital Center Region Zealand, Naestved Hospital, Naestved, Denmark,Copenhagen Emergency Medical Services, Region Hovedstaden, Ballerup, Denmark,Danish Clinical Quality Program (RKKP), National Clinical Registries, Denmark, Copenhagen, Denmark
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Patel H, Easterbrook B, D'Alessandro-Lowe AM, Andrews K, Ritchie K, Hosseiny F, Rodrigues S, Malain A, O'Connor C, Schielke H, McCabe RE, Nicholson AA, Lanius R, McKinnon MC. Associations between trauma and substance use among healthcare workers and public safety personnel during the SARS-CoV-2 (COVID-19) pandemic: the mediating roles of dissociation and emotion dysregulation. Eur J Psychotraumatol 2023; 14:2180706. [PMID: 36930578 PMCID: PMC10026820 DOI: 10.1080/20008066.2023.2180706] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Given the highly stressful environment surrounding the SARS-CoV-2 pandemic, healthcare workers (HCW) and public safety personnel (PSP) are at an elevated risk for adverse psychological outcomes, including posttraumatic stress disorder (PTSD) and alcohol/substance use problems. As such, the study aimed to identify associations between PTSD severity, related dissociation and emotion dysregulation symptoms, and alcohol/substance use problems among HCWs and PSP. METHODS A subset of data (N = 498; HCWs = 299; PSP = 199) was extracted from a larger study examining psychological variables among Canadian HCWs and PSP during the pandemic. Structural equation modelling assessed associations between PTSD symptoms and alcohol/substance use-related problems with dissociation and emotion dysregulation as mediators. RESULTS Among HCWs, dissociation fully mediated the relation between PTSD and alcohol-related problems (indirect effect β = .133, p = .03) and emotion dysregulation partially mediated the relation between PTSD and substance-related problems (indirect effect β = .151, p = .046). In PSP, emotion dysregulation fully mediated the relation between PTSD and alcohol-related problems (indirect effects β = .184, p = .005). For substance-related problems among PSP, neither emotion dysregulation nor dissociation (ps >.05) had any effects. CONCLUSION To our knowledge, this is the first study examining associations between PTSD severity and alcohol/substance use-related problems via mediating impacts of emotion dysregulation and dissociation among HCWs and PSP during the SARS-CoV-2 pandemic. These findings highlight dissociation and emotion dysregulation as important therapeutic targets for structured interventions aimed at reducing the burden of PTSD and/or SUD among Canadian HCWs or PSP suffering from the adverse mental health impacts of the SARS-CoV-2 pandemic.
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Affiliation(s)
- Herry Patel
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Bethany Easterbrook
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
| | | | - Krysta Andrews
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Kimberly Ritchie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
| | | | - Sara Rodrigues
- The Atlas Institute for Veterans and Families, Ottawa, Canada
| | | | | | | | - Randi E McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
- Mental Health and Addictions Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Andrew A Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
| | - Ruth Lanius
- Department of Psychiatry, Western University, London, Canada
- Homewood Research Institute, Guelph, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
- Mental Health and Addictions Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada
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