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Carta MG, Karam EG, Cossu G. Stress, Dysregulation of Rhythms, and Bipolar Disorder: A Challenging Field of Research. J Clin Med 2024; 13:3014. [PMID: 38792554 PMCID: PMC11122454 DOI: 10.3390/jcm13103014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Clarifying the mechanisms by which circadian rhythms regulate biology is a central issue in directing life choices in the immediate future and presents an interesting challenge for current scientific research [...].
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy;
| | - Elie Georges Karam
- St. George Hospital University Medical Center, University of Balamand, Beirut 11002807, Lebanon;
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy;
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Ferrera D, Galán D, Peláez I, Carpio A, Martín-Buro MC, Mercado F. Long-term findings on working memory neural dynamics in healthcare workers after mild COVID-19. Clin Neurophysiol 2024; 161:40-51. [PMID: 38447493 DOI: 10.1016/j.clinph.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/27/2023] [Accepted: 01/19/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Understanding the long-term impact of Coronavirus Disease 2019 (COVID-19) on cognitive function, even in mild cases, is critical to the well-being of individuals, especially for healthcare workers who are at increased risk of exposure to the virus. To the best of our knowledge, the electrophysiological activity underlying cognitive functioning has not yet been explored. METHODS Seventy-seven healthcare workers took part in the study (43 with mild infection about one year before the study and 34 uninfected). To assess cognitive status, event-related potentials (ERPs) and behavioural responses were recorded while participants performed a working memory task. RESULTS COVID-19 participants exhibited a distinct neural pattern with lower parieto-occipital N1 amplitudes and higher frontal P2 amplitudes as compared to non-infected healthcare workers. We found no behavioural differences (reaction times and error rates) in working memory functioning between groups. CONCLUSIONS This neural pattern suggests the presence of a decrement of processing resources linked to the encoding of sensory information (N1), followed by the enhanced of the P2 response which could be interpreted as the activation of compensation mechanism in COVID-19 participants. SIGNIFICANCE The current findings point out that ERPs could serve as valuable neural indices for detecting distinctive patterns in working memory functioning of COVID-19 participants, even in mild cases. However, further research is required to precisely ascertain the long-term cognitive effects of COVID-19 beyond one-year post-infection.
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Affiliation(s)
- David Ferrera
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Diego Galán
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Irene Peláez
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Alberto Carpio
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - María Carmen Martín-Buro
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Francisco Mercado
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
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Carta MG, Fornaro M, Primavera D, Nardi AE, Karam E. Dysregulation of mood, energy, and social rhythms syndrome (DYMERS): A working hypothesis. J Public Health Res 2024; 13:22799036241248022. [PMID: 38680762 PMCID: PMC11047225 DOI: 10.1177/22799036241248022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/02/2024] [Indexed: 05/01/2024] Open
Abstract
A syndrome centered on the dysregulation of behavioral rhythms (DBR) is discussed. Recent pandemic brought to observe: (1) Having a DBR affecting sleep patterns, eating habits, and social interactions, before the lockdown period, was a determinant for depressive episodes during the lockdown; (2) In tighter lockdowns, DBR triggered depressive episodes in bipolar patients; (3) DBR in healthcare workers under pressure was a determinant of burnout; (4) DBR influenced the course of chronic diseases by altering immune responses. In addition, it was found that scoring positive on the Mood Disorder Questionnaire (MDQ) was closely associated with the dysregulation of sleep rhythms. MDQ is a screening tool for bipolar disorder (BD), criticized for detecting too many false positives. Studies showed that positivity to the MDQ implied a severe impairment of quality of life even in people without psychiatric diagnoses. According to this evidence, three different hyperactivation levels could be proposed (from normality to pathology): firstly, an adaptive increase in energy (e.g. athletes performing well); secondly, a DBR determined from the continuous stimulation of stress hormones, with possible positive scores on the MDQ without a diagnosis of bipolar disorder, like in burnout syndromes and, thirdly, hyperactivity during manic episodes. The Dysregulation of Mood, Energy, and Social Rhythms Syndrome (DYMERS), the second level of the scale, is proposed as a working hypothesis. DYMERS is also seen as a vulnerable condition that may evolve in other disorders (including BD) according to the individual susceptibility (including genetic predisposition) and the specific nature/level of the stressor.
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Affiliation(s)
| | - Michele Fornaro
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Antonio Egidio Nardi
- Laboratory Panic and Respiration, Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Elie Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon and Department of Psychiatry and Clinical Psychology, St Georges University of Beirut, Beirut, Lebanon
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Muysewinkel E, Stene LE, Van Deynse H, Vesentini L, Bilsen J, Van Overmeire R. Post-what stress? A review of methods of research on posttraumatic stress during COVID-19. J Anxiety Disord 2024; 102:102829. [PMID: 38219397 DOI: 10.1016/j.janxdis.2024.102829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/17/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Post-traumatic stress (PTS) was extensively investigated during the COVID-19 pandemic. However, numerous researchers have raised concerns regarding the adherence of many of these studies to the diagnostic criteria for PTSD as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). This review aimed to provide insight into the methodology of research on PTS during the COVID-19 pandemic. METHODS Two independent reviewers examined a total of 1129 studies published between 1/01/2020 and 1/07/2023. The investigation focused on the scales employed to assess PTS, the diagnostic framework used (DSM or ICD), whether there was referral to an index-event in the PTS measurement and country where data collection took place. RESULTS Among the 1129 studies, 70.0% did not provide any indication of an index-event to which PTS symptoms were attributed. Only 11.3% of the studies explicitly indicated an index-event associated with the PTS symptoms. Furthermore, 54.1% of the studies utilized scales based on DSM-IV criteria. Finally, the majority of PTS-studies had data collections in China, United States and Italy. CONCLUSION A limited number of studies conducted during the COVID-19 pandemic reported use of an index-event in their PTS measurement. Furthermore, most studies used scales based on a previous iteration of the most used diagnostical system, namely the DSM. This delay in the implementation of new diagnostic criteria, may impair the clinical relevance of scientific studies.
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Affiliation(s)
- Emilie Muysewinkel
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugveien 1, 0484 Oslo, Norway
| | - Helena Van Deynse
- Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Lara Vesentini
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Roel Van Overmeire
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugveien 1, 0484 Oslo, Norway.
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Abdelbaky AM, Eldelpshany MS. Intensive Care Unit (ICU)-Related Post-traumatic Stress Disorder: A Literature Review. Cureus 2024; 16:e57049. [PMID: 38681363 PMCID: PMC11046361 DOI: 10.7759/cureus.57049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
An intensive care unit (ICU) is a challenging environment characterized by frequent incidences of stressors and traumatic situations. Therefore, both patients and caregivers are at high risk of developing psychological disorders such as post-traumatic stress disorder (PTSD), anxiety, and depression. ICU-related PTSD is a significant concern that remains under-recognized. This literature review examines the current state of knowledge regarding ICU-related PTSD, including its prevalence, risk factors, clinical manifestations, and potential interventions. Key findings suggest that a considerable proportion of ICU survivors develop PTSD symptoms, which can significantly impact their quality of life and recovery. The most common predictors investigated for PTSD in ICU survivors are age, gender, pre-illness psychopathy, length of stay in the ICU, delirium, and sedative agents. The treatment and prevention strategies of ICU-related PTSD include psychological therapies and pharmacological and non-pharmacological treatments. Psychological interventions, including cognitive-behavioral therapy and pharmacotherapy, have shown promise in mitigating PTSD symptoms in ICU survivors. However, further research is needed to better understand the mechanisms underlying ICU-related PTSD and to develop targeted interventions to prevent and manage this debilitating condition.
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Rapisarda F, Guay S, Ouellet-Morin I, Bond S, Geoffrion S. Longitudinal assessment of psychological distress and its determinants in a sample of firefighters based in Montreal, Canada. Front Psychol 2024; 15:1303063. [PMID: 38425559 PMCID: PMC10902061 DOI: 10.3389/fpsyg.2024.1303063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Firefighters face elevated risks of common mental health issues, with distress rates estimated at around 30%, surpassing those of many other occupational groups. While exposure to potentially traumatic events (PTEs) is a well-recognized risk factor, existing research acknowledges the need for a broader perspective encompassing multidimensional factors within the realm of occupational stress. Furthermore, this body of evidence heavily relies on cross-sectional studies. This study adopts an intensive longitudinal approach to assess psychological distress and its determinants among firefighters. Methods Participants were recruited from 67 fire stations in Montreal, Canada, meeting specific criteria: full-time employment, smartphone ownership, and recent exposure to at least one PTE, or first responder status. Subjects underwent a telephone interview and were directed to use an app to report depressive, post-traumatic, and generalized anxiety symptoms every 2 weeks, along with work-related stressors, social support, and coping styles. Analyses involved 274 participants, distinguishing between those exceeding clinical thresholds in at least one distress measure (the "distressed" subgroup) and those deemed "resilient." The duration and onset of distress were computed for the distressed group, and linear mixed models were employed to evaluate determinants for each psychological distress variable. Results Clinical psychological distress was observed in 20.7% of participants, marked by depressive, post-traumatic, and anxiety symptoms, often within the first 4-week reference period. Contextual factors (operational climate, social support, solitude) and individual factors (coping style, solitude and lifetime traumatic events in private life) exhibited more significant impacts on psychological distress than professional pressures within the firefighters' work environment. Discussion This study reports lower rates of psychological distress than previous research, possibly attributable to sample differences. It highlights that reported symptoms often represent a combined and transient layer of distress rather than diagnosable mental disorders. Additionally, determinants analysis underscores the importance of interpersonal relationships and coping mechanisms for mental health prevention interventions within this worker group. The findings carry implications for the development of prevention and support programs for firefighters and similar emergency workers.
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Affiliation(s)
- Filippo Rapisarda
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
| | - Stéphane Guay
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- Département de Psychiatrie et d’Addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- École de Criminologie, Faculté des Arts et des Sciences, Université de Montréal, Montreal, ON, Canada
| | - Isabelle Ouellet-Morin
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- École de Criminologie, Faculté des Arts et des Sciences, Université de Montréal, Montreal, ON, Canada
| | - Suzie Bond
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- Département de Sciences Humaines, Lettres et Communications, Université TÉLUQ, Quebec City, QC, Canada
| | - Steve Geoffrion
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- École de Psychoéducation, Faculté des Arts et des Sciences, Université de Montréal, Montreal, QC, Canada
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Carmassi C, Bertelloni CA, Dell'Oste V, Pedrinelli V, Fantasia S, Atti AR, Goracci A, Nanni MG, Massimetti E, Dell'Osso L, Bui E. The relationship between peritraumatic distress, mental health symptoms, and functioning impairment in healthcare workers during the COVID-19 emergency. CNS Spectr 2024:1-7. [PMID: 38327004 DOI: 10.1017/s1092852923006338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Healthcare workers (HCWs) were considered a population at risk for developing psychiatric symptoms during the COVID-19 pandemic, such as anxiety, depression, and post-traumatic stress disorder (PTSD). Peritraumatic distress is associated with post-traumatic psychopathological symptoms; however, little is known about how it may affect functioning. The study aimed at evaluating the level of peritraumatic distress in a sample of HCWs during the first wave of the COVID-19 pandemic and at examining the relationship between peritraumatic distress, mental health symptoms, and functioning impairment. METHODS A sample of 554 frontline HCWs were consecutively enrolled in major university hospitals and community services in Italy. The PDI, IES-R, PHQ-9, and GAD-7 were used to assess peritraumatic distress, symptoms of PTSD, depression, and anxiety, respectively, and the WSAS to investigate functioning impairment. PDI scores were higher among females, community services, physicians, and nurses. Furthermore, the PDI correlated significantly with the GAD-7, PHQ-9, IES-R, and WSAS. RESULTS In a mediation analysis, the direct effect of PDI on WSAS and the indirect effects through the PHQ-9 and IES-R were statistically significant (P < .001). CONCLUSION Peritraumatic distress reported by HCWs was associated with symptoms of PTSD, depression, and anxiety, but the association with reduced functioning may be only partially mediated through symptoms of depression and PTSD.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Anna-Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Enrico Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lilliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eric Bui
- Department of Psychiatry Caen University of Caen, Normandy & Caen University Hospital, Caen, France
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Carnesten H, von Heideken Wågert P, Gustin LW, Toivanen S, Skoglund K, Jaarsma T, Andreae C. Struggling in the dehumanized world of COVID-An exploratory mixed-methods study of frontline healthcare workers' experiences. J Adv Nurs 2024. [PMID: 38305070 DOI: 10.1111/jan.16083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 12/19/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024]
Abstract
AIM To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden. DESIGN An online fully mixed-methods design. METHODS A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting. RESULTS Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy. CONCLUSIONS Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. SUMMARY The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder. IMPLICATIONS FOR PRACTICE/POLICY This study might guide how to prepare for resilience in future emergencies.
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Affiliation(s)
- Hillewi Carnesten
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | | | - Lena Wiklund Gustin
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
- Department of Health and Care Sciences, UiT/The Arctic University of Norway, Narvik, Norway
| | - Susanna Toivanen
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Karin Skoglund
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Julius Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Christina Andreae
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
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Mejia CR, Serna-Alarcón V, Vilela-Estrada MA, Armada J, Ubillus M, Beraún-Barrantes J, Álvarez-Risco A, Del-Aguila-Arcentales S, Davies NM, Yáñez JA. Prevalence of post-traumatic stress disorder risk post-COVID-19 in 12 countries in Latin America: a cross-sectional survey. Front Public Health 2024; 11:1302694. [PMID: 38264243 PMCID: PMC10804613 DOI: 10.3389/fpubh.2023.1302694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/06/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Latin America was the region most affected by COVID-19 in the second quarter of 2020, and consequently, the impact on mental health requires evaluation. The aim of this study was to assess the risk of post-traumatic stress disorder (PTSD) caused by bereavement due to COVID-19 in 12 countries in Latin America. Methods The current study was an analytical cross-sectional study. Validated tests were applied for PTSD, depression, anxiety, and stress (DASS-21), questions about the respondent's condition or their environment, and demographic questions, as well as the length of the mourning period of suffering. Results The outcomes demonstrated that the PTSD risk increased for women (p < 0.001), when a friend or acquaintance had COVID-19 (p = 0.002), when a close relative died from COVID-19 (p = 0.010), having severe depression (p <0.001), severe anxiety (p <0.001), severe stress (p <0.001), residing in Chile (p <0.001), Paraguay (p <0.001), Bolivia (p <0.001), Costa Rica (p <0.001) or El Salvador (p = 0.005). On the other hand, there was less risk of PTSD at an older age (p <0.001) or if respondents had a sentimental partner (p = 0.025). In the case of severe PTSD, there was a greater gender risk for women (p <0.001), a close relative dying from COVID-19 (p = 0.017), having severe depression (p <0.001), severe anxiety (p <0.001), severe stress (p <0.001), residing in Chile (p <0.001), Paraguay (p <0.001), Bolivia (p <0.001) and Costa Rica (p = 0.002). It was also observed that there was less risk of severe PTSD at an older age demographic (p <0.001). Discussion It can be concluded that the percentages of PTSD are high in its clinical presentation as severe, especially among Latin American women.
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Affiliation(s)
| | - Víctor Serna-Alarcón
- Universidad Privada Antenor Orrego, Piura, Peru
- Hospital Regional José Cayetano Heredia, EsSalud, Piura, Peru
| | - Martín A. Vilela-Estrada
- Universidad Privada Antenor Orrego, Piura, Peru
- Hospital Regional José Cayetano Heredia, EsSalud, Piura, Peru
| | | | | | | | | | | | - Neal M. Davies
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
- Asociación Médica de Investigación y Servicios en Salud, Lima, Peru
| | - Jaime A. Yáñez
- Universidad Peruana de Ciencias Aplicadas, Facultad de Educación, Carrera de Educación y Gestión del Aprendizaje, Lima, Peru
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Hovland IS, Skogstad L, Stafseth S, Hem E, Diep LM, Ræder J, Ekeberg Ø, Lie I. Prevalence of psychological distress in nurses, physicians and leaders working in intensive care units during the COVID-19 pandemic: a national one-year follow-up study. BMJ Open 2023; 13:e075190. [PMID: 38135308 PMCID: PMC10897841 DOI: 10.1136/bmjopen-2023-075190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE To report and compare psychological distress as symptoms of anxiety, depression and post-traumatic stress among intensive care units' (ICU) nurses, physicians and leaders at 12 months after the baseline survey (spring 2020), during the COVID-19 pandemic in Norway. Furthermore, to analyse which baseline demographic and COVID ICU-related factors have a significant impact on psychological distress at 12 months. DESIGN Prospective, longitudinal, observational cohort study. SETTING Nationwide, 27 of 28 hospitals with COVID ICUs in Norway. PARTICIPANTS Nurses, physicians and their leaders. At 12 month follow-up 287 (59.3%) of 484 baseline participants responded. PRIMARY AND SECONDARY OUTCOME MEASURES Symptoms of anxiety and depression using the Hopkins Symptoms Checklist-10 (HSCL-10). Symptoms of post-traumatic stress using the post-traumatic stress disease checklist for the Diagnostic and Statistical Manual of Mental Disorders 5 (PCL-5).Demographics (included previous symptoms of anxiety and depression) and COVID ICU-related factors (professional preparations, emotional experience and support) impacting distress at 12 months. RESULTS Psychological distress, defined as caseness on either or both HSCL-10 and PCL-5, did not change significantly and was present for 13.6% of the participants at baseline and 13.2% at 12 month follow-up. Nurses reported significantly higher levels of psychological distress than physicians and leaders. Adjusted for demographics and the COVID ICU-related factors at baseline, previous symptoms of depression and fear of infection were significantly associated with higher levels of anxiety and depression at 12 months. Previous symptoms of depression, fear of infection and feeling of loneliness was significantly associated with more symptoms of post-traumatic stress. CONCLUSION One year into the COVID-19 pandemic 13.2% of the ICUs professionals reported psychological distress, more frequently among the nurses. Fear of infection, loneliness and previous symptoms of depression reported at baseline were associated with higher levels of distress. Protective equipment and peer support are recommended to mitigate distress. TRIAL REGISTRATION NUMBER ClinicalTrials.gov. Identifier: NCT04372056.
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Affiliation(s)
- Ingvild Strand Hovland
- Department of Acute Medicine, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of the Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Laila Skogstad
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - Siv Stafseth
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
- Department of MEVU, Lovisenberg Diaconal University College, Oslo, Norway
| | - Erlend Hem
- Department of the Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Institue of Studies of the Medical Profession, Oslo, Norway
| | - Lien M Diep
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Johan Ræder
- Department of Anesthesiology, Intitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway
| | - Øivind Ekeberg
- Psychosomatic and CL psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Irene Lie
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
- Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology, Gjøvik, Norway
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Deltour V, Poujol AL, Laurent A. Post-traumatic stress disorder among ICU healthcare professionals before and after the Covid-19 health crisis: a narrative review. Ann Intensive Care 2023; 13:66. [PMID: 37477706 PMCID: PMC10361923 DOI: 10.1186/s13613-023-01145-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The ICU (intensive care unit) involves potentially traumatic work for the professionals who work there. This narrative review seeks to identify the prevalence of post-traumatic stress disorder (PTSD) among ICU professionals; how PTSD has been assessed; the risk factors associated with PTSD; and the psychological support proposed. METHODS Three databases and editorial portals were used to identify full-text articles published in English between 2009 and 2022 using the PRISMA method. RESULTS Among the 914 articles obtained, 19 studies met our inclusion criteria. These were undertaken primarily during the Covid-19 period (n = 12) and focused on nurses and assistant nurses (n = 10); nurses and physicians (n = 8); or physicians only (n = 1). The presence of mild to severe PTSD among professionals ranged from 3.3 to 24% before the pandemic, to 16-73.3% after the pandemic. PTSD in ICU professionals seems specific with particularly intense intrusion symptoms. ICU professionals are confronted risk factors for PTSD: confrontation with death, unpredictability and uncertainty of care, and insecurity related to the crisis COVID-19. The studies show that improved communication, feeling protected and supported within the service, and having sufficient human and material resources seem to protect healthcare professionals from PTSD. However, they also reveal that ICU professionals find it difficult to ask for help. CONCLUSION ICU professionals are particularly at risk of developing PTSD, especially since the Covid-19 health crisis. There seems to be an urgent need to develop prevention and support policies for professionals.
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Affiliation(s)
- Victoire Deltour
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Anne-Laure Poujol
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Alexandra Laurent
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France.
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France.
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Liu Z, Hong L. Work-Family Conflict and Mental Health among Chinese Female Healthcare Workers during the COVID-19 Pandemic: The Moderating Effects of Resilience. Healthcare (Basel) 2023; 11:1696. [PMID: 37372814 DOI: 10.3390/healthcare11121696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: The mental health of female healthcare workers is at greater risk during the COVID-19 pandemic due to increased psychological stress and heightened work-family conflict. This study investigated whether resilience, as a protective factor for mental health, can safeguard the well-being of female healthcare workers. This study assessed the mental health of female healthcare workers (n = 431) from a small inland city in Central China, explored the impact of work-family conflict on their mental health, and examined the moderating role of resilience. (2) Methods: The main variables were measured using standard tools administered via an online survey. A one-sample t-test, ANOVA, Pearson correlation analysis, and multiple regression were performed with SPSS. A simple slope test was conducted based on the multiple regression results. (3) Results: The analysis revealed that the mental health level of the surveyed female healthcare workers was significantly lower than the national norm (t = 16.36, p < 0.001). Work-family conflict had a significant negative impact on mental health (β = 0.39, p < 0.001), while the interaction effect of resilience and work-family conflict was significant (β = -0.13, p < 0.05), suggesting a moderating effect. (4) Conclusions: Female healthcare workers exhibited poor mental health during the COVID-19 pandemic, but resilience remained a protective factor, mitigating the negative impact of work-family conflict on female healthcare workers' mental health.
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Affiliation(s)
- Zixiao Liu
- School of Humanities, Tongji University, Shanghai 200092, China
| | - Liu Hong
- School of Social Development and Public Policy, Fudan University, Shanghai 200433, China
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Richez B, Cantarel C, Durrieu F, Soubeyran I, Blanchi J, Pernot S, Chakiba Brugère C, Roubaud G, Cousin S, Etienne G, Floquet A, Babre F, Rivalan J, Lalet C, Narbonne M, Belaroussi Y, Bellera C, Mathoulin-Pélissier S. One-Year Follow-Up of Seroprevalence of SARS-CoV-2 Infection and Anxiety among Health Workers of a French Cancer Center: The PRO-SERO-COV Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5949. [PMID: 37297553 PMCID: PMC10252859 DOI: 10.3390/ijerph20115949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
Infection of SARS-CoV-2 among health workers (HWs) in contact with cancer patients has been a major issue since the beginning of the pandemic. We aimed to assess the serological immune status of SARS-CoV-2 infection among these HWs. A prospective cohort study was initiated in the comprehensive cancer center of the Nouvelle-Aquitaine region (NA, France). Volunteer HWs working on March 2020 without active infection or symptoms of COVID-19 completed a self-questionnaire and had a blood test at inclusion, at 3 and 12 months. Positive serological status of SARS-CoV-2 infection was defined by anti-nucleocapsid antibodies and/or IgG anti-spike antibodies, except at 12 months due to vaccine. Half of the HWs were included (N = 517) and 89% were followed for three months (N = 500) and one year (N = 462). Seroprevalence of SARS-CoV-2 infection was 3.5% (95% CI: 1.9-5.1), 6.2% (95% CI: 4.1-8.3), and 10% (95% CI: 7.2-12.7) on June-September 2020, September 2020-January 2021, and June-October 2021, respectively. At 12 months, 93.3% had detectable antibodies with 80% vaccinated in the first three months of vaccine availability. The COVID-19-free policy of the institution, respect for barrier gestures, high and early vaccination of HWs, and low prevalence of SARS-CoV-2 in NA may explain the low rate of seropositivity among the HWs of the Institut Bergonié.
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Affiliation(s)
- Brice Richez
- Department of Anesthesia—Intensive Care, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Coralie Cantarel
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Françoise Durrieu
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Isabelle Soubeyran
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Julie Blanchi
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Simon Pernot
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Camille Chakiba Brugère
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Guilhem Roubaud
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Sophie Cousin
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Gabriel Etienne
- Hematology Department, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Anne Floquet
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Florence Babre
- Department of Anesthesia—Intensive Care, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Julie Rivalan
- Department of Anesthesia—Intensive Care, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Caroline Lalet
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Marine Narbonne
- Department PRISME, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Yaniss Belaroussi
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Carine Bellera
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
- Epicene Team, UMR 1219, Bordeaux Population Health Research Center, University Bordeaux, Inserm, F-33000 Bordeaux, France
| | - Simone Mathoulin-Pélissier
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
- Epicene Team, UMR 1219, Bordeaux Population Health Research Center, University Bordeaux, Inserm, F-33000 Bordeaux, France
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Rapisarda F, Bergeron N, Dufour MM, Guay S, Geoffrion S. Longitudinal assessment and determinants of short-term and longer-term psychological distress in a sample of healthcare workers during the COVID-19 pandemic in Quebec, Canada. Front Psychiatry 2023; 14:1112184. [PMID: 37275978 PMCID: PMC10232907 DOI: 10.3389/fpsyt.2023.1112184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/27/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Previous research has demonstrated the negative impact of the COVID-19 pandemic emergency on the wellbeing of healthcare workers. However, few research contributions reported a longitudinal evaluation of psychological distress and examined determinants of its duration and course over time. The present study aims to explore the impact of the pandemic emergency on HCWs mental health by adopting a longitudinal design and assessing mental health as combination of overlapping clinical symptoms (post-traumatic stress disorder, depression and anxiety). Methods Data were collected weekly through a mobile application during and after the first wave of COVID-19 in the province of Quebec, Canada, in 2020. Analysis was conducted on a final sample of 382 participants. Participants were grouped into "resilient" (RES) if they did not manifest clinical-level psychological distress during monitoring, "short-term distress" (STD) if distress exceeded the clinical threshold for 1-3 weeks, and longer-term distress (LTD) if it occurred for four or more weeks, even if not consecutively. Descriptive statistics for all variables were computed for each subgroup (RES, STD and LTD), and pairwise comparisons between each group for every descriptive variable were made using chi square statistics for categorical variables and t-test for continuous variables. Predictors of distress groups (STD and LTD vs RES) were assessed running multinomial hierarchical logistic regression models. Results In our sample, almost two third (59.4%) HCWs did not manifest moderate or severe distress during the monitoring time. Short-term distress, mostly post-traumatic symptoms that lasted for less than 4 weeks, were the most common distress response, affecting almost one third of participants. Longer psychological distress occurred only in a smaller percentage (12.6%) of cases, as a combination of severe posttraumatic, depressive and anxiety symptoms. Perceived occupational stress was the most significant risk factor; moreover individual, peritraumatic work and family risk and protective factors, were likely to significantly affect the stress response. Discussion Results tend to provide a more complex and resiliency-oriented representation of psychological distress compared to previous cross-sectional studies, but are in line with stress response studies. Findings allow us to better describe the profiles of distress response in STD and LTD groups. Participants that manifest short term distress experience acute stress reaction in which the interplay between personal, family and professional life events is associated with the stress response. Conversely, longer term distress response in HCWs presents a more complex mental health condition with an higher level of impairment and support needs compared to participants with short-term distress.
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Affiliation(s)
- Filippo Rapisarda
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
| | - Nicolas Bergeron
- Département de psychiatrie et d'addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Marie-Michèle Dufour
- École de psychoéducation, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Guay
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
- Département de psychiatrie et d'addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- École de criminologie, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
| | - Steve Geoffrion
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
- École de psychoéducation, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
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Farrell D, Moran J, Zat Z, Miller PW, Knibbs L, Papanikolopoulos P, Prattos T, McGowan I, McLaughlin D, Barron I, Mattheß C, Kiernan MD. Group early intervention eye movement desensitization and reprocessing therapy as a video-conference psychotherapy with frontline/emergency workers in response to the COVID-19 pandemic in the treatment of post-traumatic stress disorder and moral injury—An RCT study. Front Psychol 2023; 14:1129912. [PMID: 37063579 PMCID: PMC10100089 DOI: 10.3389/fpsyg.2023.1129912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/22/2023] [Indexed: 04/01/2023] Open
Abstract
ObjectiveFrontline mental health, emergency, law enforcement, and social workers have faced unprecedented psychological distress in responding to the COVID-19 pandemic. The purpose of the RCT (Randomized Controls Trial) study was to investigate the effectiveness of a Group EMDR (Eye Movement Desensitization and Reprocessing) therapy (Group Traumatic Episode Protocol—GTEP) in the treatment of Post-Traumatic Stress Disorder (PTSD) and Moral Injury. The treatment focus is an early intervention, group trauma treatment, delivered remotely as video-conference psychotherapy (VCP). This early intervention used an intensive treatment delivery of 4x2h sessions over 1-week. Additionally, the group EMDR intervention utilized therapist rotation in treatment delivery.MethodsThe study’s design comprised a delayed (1-month) treatment intervention (control) versus an active group. Measurements included the International Trauma Questionnaire (ITQ), Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire (PHQ-9), Moral Injury Events Scale (MIES), and a Quality-of-Life psychometric (EQ-5D), tested at T0, T1: pre—treatment, T2: post-treatment, T3: 1-month follow-up (FU), T4: 3-month FU, and T5: 6-month FU. The Adverse Childhood Experiences – International version (ACEs), Benevolent Childhood Experience (BCEs) was ascertained at pre-treatment only. N = 85 completed the study.ResultsResults highlight a significant treatment effect within both active and control groups. Post Hoc comparisons of the ITQ demonstrated a significant difference between T1 pre (mean 36.8, SD 14.8) and T2 post (21.2, 15.1) (t11.58) = 15.68, p < 0.001). Further changes were also seen related to co-morbid factors. Post Hoc comparisons of the GAD-7 demonstrated significant difference between T1 pre (11.2, 4.91) and T2 post (6.49, 4.73) (t = 6.22) = 4.41, p < 0.001; with significant difference also with the PHQ-9 between T1 pre (11.7, 5.68) and T2 post (6.64, 5.79) (t = 6.30) = 3.95, p < 0.001, d = 0.71. The treatment effect occurred irrespective of either ACEs/BCEs during childhood. However, regarding Moral Injury, the MIES demonstrated no treatment effect between T1 pre and T5 6-month FU. The study’s findings discuss the impact of Group EMDR therapy delivered remotely as video-conference psychotherapy (VCP) and the benefits of including a therapist/rotation model as a means of treatment delivery. However, despite promising results suggesting a large treatment effect in the treatment of trauma and adverse memories, including co-morbid symptoms, research results yielded no treatment effect in frontline/emergency workers in addressing moral injury related to the COVID-19 pandemic.ConclusionThe NICE (2018) guidance on PTSD highlighted the paucity of EMDR therapy research used as an early intervention. The primary rationale for this study was to address this critical issue. In summary, treatment results for group EMDR, delivered virtually, intensively, using therapist rotation are tentatively promising, however, the moral dimensions of trauma need consideration for future research, intervention development, and potential for further scalability. The data contributes to the emerging literature on early trauma interventions.Clinical Trial Registration:Clinicaltrials.gov, ISRCTN16933691.
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Affiliation(s)
- Derek Farrell
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
- *Correspondence: Derek Farrell,
| | - Johnny Moran
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Zeynep Zat
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Paul W. Miller
- School of Nursing, Magee Campus, Ulster University, Northern Ireland, United Kingdom
| | - Lorraine Knibbs
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Penny Papanikolopoulos
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Tessa Prattos
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Iain McGowan
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
| | - Derek McLaughlin
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
| | - Ian Barron
- Centre for International Education, College of Education, University of Massachusetts, Amherst, MA, United States
| | - Cordula Mattheß
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Matthew D. Kiernan
- Northern Hub for Veteran and Military Families’ Research, Northumbria University, Newcastle upon Tyne, United Kingdom
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Pilot Study on the Impact of Gratitude Journaling or Cognitive Strategies on Health Care Workers. J Pediatr Health Care 2023:S0891-5245(23)00029-9. [PMID: 36882351 PMCID: PMC9985770 DOI: 10.1016/j.pedhc.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has significantly impacted the mental well-being of health care workers (HCWs). This study assessed the feasibility, acceptability, and preliminary efficacy of two psychological interventions, gratitude journaling or cognitive strategies, on pediatric HCWs. METHOD A pilot randomized parallel repeated measures design was used, with a convenience sample of 59 HCWs. Data were collected before and after the intervention period, 2 weeks after, and again 6 months later. Outcomes included depression, anxiety, meaning and purpose, feasibility, and acceptability. RESULTS Thirty-seven participants completed the study. The majority were nurses (registered nurses and advanced practice registered nurses) and physicians. In both groups, depression and anxiety scores diminished, but changes were not statistically significant. The study was feasible to conduct, and subjects reported high acceptability. DISCUSSION Gratitude journaling and cognitive strategies may help mental well-being in HCWs; however, future studies with larger samples are needed.
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Gesi C, Cirnigliaro G, Achilli F, Cerioli M, Cafaro R, Boscacci M, Dell’Osso B. The Impact of COVID-19 Pandemic First Wave on Healthcare Workers: A New Perspective from Qualifying PTSD Criterion A to Assessing Post-Traumatic Growth. J Clin Med 2023; 12:jcm12051862. [PMID: 36902649 PMCID: PMC10003652 DOI: 10.3390/jcm12051862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
Post-traumatic growth (PTG) and specific traumatic events have been poorly explored in the literature focusing on post-traumatic stress disorder (PTSD) among healthcare workers (HWs) tackling the COVID-19 pandemic. In a large sample of Italian HWs, we investigated the kinds of traumatic events and whether PTG affects the risk of PTSD, along with its prevalence and features, during the first COVID-19 wave. COVID-19-related stressful events, Impact of Event Scale-Revised (IES-R) and PTG Inventory-Short Form (PTGI-SF) scores were collected through an online survey. Out of 930 HWs included in the final sample, 257 (27.6%) received a provisional PTSD diagnosis based on IES-R scores. Events referring to the overall pandemic (40%) and to a threat to a family member (31%) were reported as the most stressful events. Female sex, previous mental disorders, job seniority, unusual exposure to sufferance and experiencing a threat to one's family significantly increased the provisional PTSD diagnosis' risk, while being a physician, the availability of personal protective equipment and moderate/greater scores on the PTGI-SF spiritual change domain were found to be protective factors.
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Affiliation(s)
- Camilla Gesi
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Giovanna Cirnigliaro
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
- Correspondence: ; Tel.: +39-0239042904
| | - Francesco Achilli
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Matteo Cerioli
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Rita Cafaro
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Maria Boscacci
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Bernardo Dell’Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, Stanford, CA 94305, USA
- CRC “Aldo Ravelli” for Neurotechnology & Experimental Brain Therapeutics, University of Milan, 20122 Milan, Italy
- Centro per lo Studio dei Meccanismi Molecolari alla Base delle Patologie Neuro-Psico-Geriatriche, University of Milan, 20122 Milan, Italy
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18
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Carnesten H, Wiklund Gustin L, Skoglund K, von Heideken Wågert P. Caring through barriers-Newly graduated registered nurses' lived experiences in emergency departments during the COVID-19 pandemic. J Adv Nurs 2023; 79:2269-2279. [PMID: 36749551 DOI: 10.1111/jan.15585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/02/2023] [Accepted: 01/20/2023] [Indexed: 02/08/2023]
Abstract
AIM To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID-19 pandemic. DESIGN A phenomenological hermeneutical study guided by Lindseth and Norberg. METHODS In-depth one-on-one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline. RESULTS The findings comprise one main theme Caring through barriers and three themes with sub-themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be. CONCLUSION Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care. IMPACT The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions. PUBLIC CONTRIBUTION This study involved new nurses in semi-structured interviews.
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Affiliation(s)
- Hillewi Carnesten
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Lena Wiklund Gustin
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden.,Department of Health and Care Sciences, UiT/The Arctic University of Norway, Narvik, Norway
| | - Karin Skoglund
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
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Oksanen A, Oksa R, Celuch M, Cvetkovic A, Savolainen I. COVID-19 Anxiety and Wellbeing at Work in Finland during 2020-2022: A 5-Wave Longitudinal Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:680. [PMID: 36612998 PMCID: PMC9819787 DOI: 10.3390/ijerph20010680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic impacted workers globally during 2020-2022 and it has had major psychological implications for workers' wellbeing. This longitudinal study analyzed risk and protective factors predicting COVID-19 anxiety among workers in Finland. Longitudinal national sample of Finnish workers (n = 685) participated in a five-wave study conducted in 2020-2022, covering multiple waves of the COVID-19 pandemic and its aftermath. Our outcome measure was COVID-19 anxiety. Predictors were psychological distress, work exhaustion, technostress, and loneliness. Models also controlled for self-regulation; social support at work and remote working; and socio-demographic background factors. Both within-person and between-person effects were analyzed using multilevel hybrid regression models. COVID-19 anxiety varied between time points which is explained by changes in circumstances during the pandemic. Highest anxiety was expressed in the middle of the Delta variant surge and lockdown in spring 2021. Within-person changes in psychological distress, work exhaustion, technostress, self-regulation, and perceived loneliness were all associated with COVID-19 anxiety. Between-person results showed that distressed, exhausted, technostressed, and lonely workers expressed more anxiety than others. Remote workers reported higher anxiety over time than others. Those who had reported high self-regulation reported lower anxiety than others. Female gender and younger age were associated with higher anxiety. COVID-19 anxiety continues to be an important phenomenon with a magnitude of consequences on people and numerous industries. This study showed that general mental health and work stressors predict COVID-19 anxiety. Promoting social support and workers' self-regulation skills can be beneficial for overcoming anxiety during and after the pandemic.
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20
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Coronavirus disease 2019 aftermath: psychological trauma in ICU healthcare workers. Curr Opin Crit Care 2022; 28:686-694. [PMID: 36302198 DOI: 10.1097/mcc.0000000000000994] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW We aim to describe the extent of psychological trauma and moral distress in healthcare workers (HCW) working in the intensive care unit (ICU) during the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we review reports on prevalence of mental health symptoms, highlight vulnerable populations and summarize modifiable risk factors associated with mental health symptoms in ICU HCW. RECENT FINDINGS The pandemic has resulted in a multitude of closely intertwined professional and personal challenges for ICU HCW. High rates of posttraumatic stress disorder (14-47%), burnout (45-85%), anxiety (31-60%), and depression (16-65%) have been reported, and these mental health symptoms are often interrelated. Most studies suggest that nurses and female HCW are at highest risk for developing mental health symptoms. The main personal concerns associated with reporting mental health symptoms among ICU HCW were worries about transmitting COVID-19 to their families, worries about their own health, witnessing colleagues contract the disease, and experiencing stigma from their communities. Major modifiable work-related risk factors were experiencing poor communication from supervisors, perceived lack of support from administrative leadership, and concerns about insufficient access to personal protective equipment, inability to rest, witnessing hasty end-of-life decisions, and restriction of family visitation policies. SUMMARY The COVID-19 pandemic has severely impacted ICU HCW worldwide. The psychological trauma, manifesting as posttraumatic stress disorder, burnout, anxiety, and depression, is substantial and concerning. Urgent action by lawmakers and healthcare administrators is required to protect ICU HCW and sustain a healthy workforce.
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21
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Andhavarapu S, Yardi I, Bzhilyanskaya V, Lurie T, Bhinder M, Patel P, Pourmand A, Tran QK. Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114890. [PMID: 36260970 PMCID: PMC9573911 DOI: 10.1016/j.psychres.2022.114890] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/02/2022] [Accepted: 10/06/2022] [Indexed: 01/05/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I2 >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I2 >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.
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Affiliation(s)
- Sanketh Andhavarapu
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Isha Yardi
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Vera Bzhilyanskaya
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Tucker Lurie
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mujtaba Bhinder
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Priya Patel
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, 22 South Greene Street, Suite T3N45, Baltimore, MD 21043, United States; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States.
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22
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Cogan N, Kennedy C, Beck Z, McInnes L, MacIntyre G, Morton L, Tanner G, Kolacz J. ENACT study: What has helped health and social care workers maintain their mental well-being during the COVID-19 pandemic? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6656-e6673. [PMID: 36068667 PMCID: PMC9539329 DOI: 10.1111/hsc.13992] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 07/07/2022] [Accepted: 08/20/2022] [Indexed: 06/01/2023]
Abstract
A growing body of research has highlighted the adverse impact of COVID-19 stressors on health and social care workers' (HSCWs) mental health. Complementing this work, we report on the psychosocial factors that have had both a positive and negative impact on the mental well-being of HSCWs during the third lockdown period in Scotland. Using a cross-sectional design, participants (n = 1364) completed an online survey providing quantitative data and free open-text responses. A multi-method approach to analysis was used. The majority of HSCWs were found to have low well-being scores, high levels of COVID-19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut-off for acute stress (indicative of PTSD). HSCWs with higher scores on adaptive coping strategies and team resilience reported higher scores on mental well-being. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems compared to formal supports. Barriers to formal help-seeking were identified including stigma and fear of the consequences of disclosure. HSCWs mostly valued peer support, workplace supports, visible leadership and teamwork in maintaining their mental well-being. Our findings illuminate the complexity of the effects of the COVID-19 pandemic on HSCWs' well-being and will inform future intervention development seeking to increase positive adaptation and improve staff well-being. Addressing barriers to mental health help-seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics.
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Affiliation(s)
- Nicola Cogan
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Chloe Kennedy
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Zoe Beck
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Lisa McInnes
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Gillian MacIntyre
- School of Social Work & Social PolicyUniversity of StrathclydeGlasgowUK
| | - Liza Morton
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Gary Tanner
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Jacek Kolacz
- Traumatic Stress Research Consortium (TSRC)Kinsey Institute, Indiana UniversityBloomingtonIndianaUSA
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23
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Mazzetti G, Sciolino L, Guglielmi D, Mongardi M, Nielsen K, Dawson J. Organizational citizenship behaviour as a protective factor against the occurrence of adverse nursing-sensitive outcomes: A multilevel investigation. J Nurs Manag 2022; 30:4294-4303. [PMID: 36190738 PMCID: PMC10092892 DOI: 10.1111/jonm.13827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/19/2022] [Accepted: 09/29/2022] [Indexed: 12/30/2022]
Abstract
AIMS This study aimed to investigate the association between organizational citizenship behaviour enacted by nurses and the occurrence of adverse nursing-sensitive patient outcomes. BACKGROUND Managing psychosocial factors (i.e., aspects concerning the work environment) is key to ensure patient safety, to prevent exacerbation of case complexity and to cope with critical shortages in human and financial resources. METHODS Self-report measures of nurses' organizational citizenship behaviour were combined with objective data on the incidence of adverse nursing-sensitive outcomes (i.e., pressure ulcers and restraint use) collected through patients' medical records. Participants were 11,345 patients and 1346 nurses across 52 teams working in 14 Italian hospitals. Data were analysed using multilevel binary logistic regression models. RESULTS A negative relationship between nurses' organizational citizenship behaviour and restraint use was identified, with an odds ratio of 0.11. Thus, for a one-unit higher organizational citizenship behaviour score, the odds of using restraints shrink to about one eighth of the previous level. CONCLUSIONS Intervention strategies to foster the implementation of organizational citizenship behaviour among nurses may inhibit the occurrence of critical outcomes affecting patients' health and well-being (i.e., using restraint devices). IMPLICATIONS FOR NURSING MANAGEMENT In health care organizations, shaping a psychosocial environment encouraging organizational citizenship behaviour can mitigate the occurrence of adverse nursing-sensitive outcomes such as restraint use on patients.
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Affiliation(s)
- Greta Mazzetti
- Department of Education Studies, University of Bologna, Bologna, Italy
| | - Lorenzo Sciolino
- Hospital Care Service, General Direction for People Care, Health and Welfare, Emilia-Romagna Region, Bologna, Italy
| | - Dina Guglielmi
- Department of Education Studies, University of Bologna, Bologna, Italy
| | - Maria Mongardi
- Infectious Diseases Division, Diagnostics and Public Health Department, University of Verona, Verona, Italy
| | - Karina Nielsen
- Sheffield University Management School, The University of Sheffield, Sheffield, UK
| | - Jeremy Dawson
- Sheffield University Management School, The University of Sheffield, Sheffield, UK.,School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
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Gustafson DR, Yucel R, Apple SJ, Cirrone G, Gao H, Huang AJ, Ma X, Saad A, Wilson J, Kabariti S, Motov S. Mental Health of Emergency Department Healthcare Workers During COVID-19 in Brooklyn, New York. MEDICAL RESEARCH ARCHIVES 2022; 10:2903. [PMID: 36465877 PMCID: PMC9718537 DOI: 10.18103/mra.v10i7.2903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Maintaining good mental health among Emergency Department healthcare workers (ED HCW) is paramount to well-functioning healthcare. We measured mental health and COVID-19 symptoms in ED HCW at a COVID-19 epicenter. METHODS A cross-sectional, convenience sample of adult (≥18 years) ED HCW in Brooklyn, New York, USA, who were employed at ≥50% of a full-time effort, was surveyed September-December, 2020 with reference period March-May 2020. An anonymous email-distributed survey assessed gender, age, race, healthcare worker status (clinical versus non-clinical), SARS-CoV-2 testing, number of people to talk to, COVID-19-related home problems, mental health care interruption during COVID-19, loneliness, and survey date. Outcomes included symptoms of depression, psychological distress, perceived stress, post-traumatic stress disorder (PTSD), anxiety, and resilience measured using validated scales. RESULTS Of 774 HCW, 247 (31.9%) responded (mean age 38.2±10.8 years; 59.4% White; 52.5% men; 80.1% clinical; 61.6% SARS-CoV-2 tested). Average mental health scores were significantly higher among clinical vs non-clinical HCW (P's<0.0001-0.019). The proportion reporting a clinically-relevant psychological distress symptom burden was higher among clinical vs non-clinical HCW (35.8% vs 13.8%, p=0.019); and suggested for depression (53.9% clinical vs 35.7% non-clinical, p=0.072); perceived stress (63.6% clinical vs 44.8% non-clinical, p=0.053); and PTSD (18.2% clinical vs 3.6% non-clinical, p=0.064). Compared to non-clinical staff, Medical Doctors and Doctors of Osteopathy reported 4.8-fold higher multivariable-adjusted odds of clinically-relevant perceived stress (95%CI 1.8-12.9, p=0.002); Emergency Medical Technicians reported 15.5-fold higher multivariable-adjusted odds of clinically-relevant PTSD (95%CI 1.6-150.4, p=0.018). Increasing age, number of COVID-19-related home problems and people to talk to, loneliness and mental health care interruption were adversely associated with mental health; being male and SARS-CoV-2 testing were beneficial. CONCLUSIONS COVID-19-related mental health burden was high among ED HCW in Brooklyn. Mental health support services are essential for ED HCW.
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Affiliation(s)
- Deborah R Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Recai Yucel
- Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
| | - Samuel J Apple
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Gianna Cirrone
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Haoyuan Gao
- Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
| | - Aaron J Huang
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Xinrui Ma
- Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
| | - Ayesha Saad
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Jeremy Wilson
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Sarah Kabariti
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York
- Department of Emergency Medicine, State University of New York Downstate Health Sciences University, Brooklyn New York
| | - Sergey Motov
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York
- Department of Emergency Medicine, State University of New York Downstate Health Sciences University, Brooklyn New York
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25
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Noda Y, Asano K, Shimizu E, Hirano Y. The mediating effect of symptoms of posttraumatic stress disorder and depression on the relationship between personality traits and quality of life in emergency service workers. Compr Psychiatry 2022; 116:152327. [PMID: 35643052 DOI: 10.1016/j.comppsych.2022.152327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Emergency service workers are often exposed to fatalities during accidents or disasters. Therefore, they may be more prone to experiencing posttraumatic stress disorder (PTSD) and depression. It has been shown that these comorbid disorders are related to personality traits and quality of life (QOL). METHODS We hypothesized that mental disorders, such as symptoms of PTSD and depression, mediate the relationship between personality traits, as measured on the 10-Item Personality Inventory (TIPI), and QOL, as measured on the MOS 36-item Short-Form Health Survey (SF-36). RESULTS Participants were aged 23-61 years. Questionnaires were sent to 373 participants, 220 of whom returned responses. A direct effect was found between two subscales of the TIPI (Extraversion and Emotional stability) and mental component summary scores of the SF-36 (Extraversion: β = 0.154, p < .001; Emotional stability: β = 0.179, p < .001), which indicated partial mediation. A significant indirect effect was revealed between two personality traits and mental health summary scores (Extraversion: β = 0.058, p < .001; Emotional stability: β = 0.087, p < .001). We also found a direct effect of extraversion scores of the TIPI on role/social component summary scores of the SF-36 (β = 0.084, p < .05). However, none of the 95% confidential intervals was significant, which indicated full mediation, and the indirect effect was significant (β = 0.023, p < .01). Sensitivity analysis indicated that a direct effect between extraversion scores of the TIPI and role/social component summary scores of the SF-36 was significant, which indicated partial mediation. CONCLUSIONS The findings of direct and indirect effects highlight the importance of identifying effective methods for protecting individuals from developing symptoms of PTSD and depression; moreover, they may help improve QOL. The capacity of dealing with incidents among emergency service workers may vary depending on their personality traits. Therefore, the screening of mental health states that includes a personality trait inventory may be valuable.
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Affiliation(s)
- Yoshikazu Noda
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; Department of Nursing, Teikyo University of Science, 34-1 Senjumotomachi, Adachi-ku, Tokyo 120-0041, Japan.
| | - Kenichi Asano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan
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26
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"It's All COVID's Fault!": Symptoms of Distress among Workers in an Italian General Hospital during the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127313. [PMID: 35742555 PMCID: PMC9223842 DOI: 10.3390/ijerph19127313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic, healthcare workers (HCWs) have been faced with specific stressors endangering their physical and mental health and their functioning. This study aimed to assess the short-term psychological health of a sample of Italian HCWs and the related influencing factors. In particular, the study focused on the differences related to HCWs' gender and to having been directly in charge of COVID-19 patients or not. METHODS An online survey was administered to the whole staff of the Modena General University Hospital three months after the onset of the pandemic, in 2020. Demographic data and changes in working and living conditions related to COVID-19 were collected; mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale-Revised (IES-R). RESULTS 1172 out of 4788 members returned the survey (response rate = 24.5%), the male/female ratio was 30/70%. Clinically significant symptoms assessed according to the DASS-21 emerged among 21.0% of the respondents for depression, 22.5% for anxiety and 27.0% for stress. Symptoms suggestive of a traumatic reaction were reported by 19.0% of the sample. Symptoms of psychological distress were statistically associated with female gender, job role, ward, changes in lifestyle, whereas first-line work with COVID-19 patients was statistically associated with more stress symptoms. HCWs reported a significant level of psychological distress that could reach severe clinical significance and impact dramatically their quality of life and functioning. CONCLUSIONS Considering the persistence of the international emergency, effective strategies to anticipate, recognize and address distress in HCWs are essential, also because they may impact the organization and effectiveness of healthcare systems.
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Łaskawiec D, Grajek M, Szlacheta P, Korzonek-Szlacheta I. Post-Pandemic Stress Disorder as an Effect of the Epidemiological Situation Related to the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:healthcare10060975. [PMID: 35742026 PMCID: PMC9222801 DOI: 10.3390/healthcare10060975] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/05/2022] [Accepted: 05/23/2022] [Indexed: 12/18/2022] Open
Abstract
According to many experts in the fields of psychology and psychiatry, the destabilization resulting from the coronavirus pandemic may not be as noticeable now as it will be after the pandemic period is over. Undoubtedly, the fact that the surrounding reality is standardized and normalized by many at present contributes to this. In the opinion of many researchers, the scale and degree of trauma experienced by society will only be noticed by many once the pandemic is over. Many also suggest that we will experience post-pandemic stress disorder. This literature review aims to bring together in one place the information that speaks to the nature of the problem, which is post-pandemic stress disorder. The main sections of the paper deal with exposure to the disorder in the general population and a review of the current literature on the subject. The second section deals with a group of medical personnel who are on the direct frontline in the fight against the COVID-19 pandemic; it is assumed here that they are those who are at much higher risk of developing post-pandemic stress disorder.
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Affiliation(s)
- Daria Łaskawiec
- Department of Prevention of Metabolic Diseases, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41902 Katowice, Poland; (D.Ł.); (I.K.-S.)
| | - Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41902 Katowice, Poland
- Correspondence: ; Tel.: +48-794-250-724
| | - Patryk Szlacheta
- Department of Toxicology and Health Protection, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41902 Katowice, Poland;
| | - Ilona Korzonek-Szlacheta
- Department of Prevention of Metabolic Diseases, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41902 Katowice, Poland; (D.Ł.); (I.K.-S.)
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28
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Paterlini M, Neri E, Nicoli A, Genova F, Villani MT, Santi S, Agostini F. Emotions, Stress and Coping among Healthcare Workers in a Reproductive Medicine Unit during the First and Second COVID-19 Lockdowns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105899. [PMID: 35627436 PMCID: PMC9141561 DOI: 10.3390/ijerph19105899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 02/01/2023]
Abstract
The impact of the COVID-19 pandemic on global healthcare workers’ (HCWs) mental health has been well documented in the last two years; however, little is known regarding HCWs working in specific healthcare fields. During two subsequent periods of national lockdown in Italy (June–July 2020, T1, and November–December 2020, T2), a total sample of 47 HCWs working in a reproductive medicine hospital unit completed an ad hoc questionnaire for assessing emotional reactions to the pandemic, stress symptoms, and ways of coping. Moderate–high levels of anger and sadness were experienced by 65.9% and 68.1% of the HCWs, respectively, while moderate–high levels of anxiety and fear were experienced by 51.1% and 56.8%, respectively. Higher stress symptoms experienced by HCWs were hypervigilance, avoidance of thoughts and memories, and tiredness/low energy. At T2, levels of hypervigilance, irritability, intrusive thoughts, and detachment were higher than at T1, while avoidance of external triggers decreased. Moderate–high levels of anxiety resulted significantly associated with several symptoms of stress: irritability/fearfulness, depression/hopelessness, tiredness/low energy, problems with concentration, and intrusive thoughts. Regarding coping strategies, HCWs tended to adopt more problem-focused coping (e.g., contributing to improving a situation) and this tendency was higher at T2. Overall findings suggest a risk for the persistence of stress symptoms and, therefore, a risk for a chronic course, which might interfere with the global quality of mental health at work and the care provided to patients. Clinical implications highlight the relevance of implementing support programs for this category of HCWs focused on the elaboration of negative emotions and on fostering adaptive coping strategies.
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Affiliation(s)
- Marcella Paterlini
- Department of Obstetrics and Pediatrics, AUSL-IRCCS, 42123 Reggio Emilia, Italy;
| | - Erica Neri
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (E.N.); (F.G.)
| | - Alessia Nicoli
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, AUSL-IRCCS, 42123 Reggio Emilia, Italy; (A.N.); (M.T.V.); (S.S.)
| | - Federica Genova
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (E.N.); (F.G.)
| | - Maria Teresa Villani
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, AUSL-IRCCS, 42123 Reggio Emilia, Italy; (A.N.); (M.T.V.); (S.S.)
| | - Sara Santi
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, AUSL-IRCCS, 42123 Reggio Emilia, Italy; (A.N.); (M.T.V.); (S.S.)
| | - Francesca Agostini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (E.N.); (F.G.)
- Correspondence:
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Soto-Cámara R, Navalpotro-Pascual S, Jiménez-Alegre JJ, García-Santa-Basilia N, Onrubia-Baticón H, Navalpotro-Pascual JM, Thuissard IJ, Fernández-Domínguez JJ, Matellán-Hernández MP, Pastor-Benito E, Polo-Portes CE, Cárdaba-García RM. Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals. J Clin Med 2022; 11:jcm11082227. [PMID: 35456319 PMCID: PMC9027086 DOI: 10.3390/jcm11082227] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023] Open
Abstract
This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID-19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (G-SES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.
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Affiliation(s)
- Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (R.S.-C.); (N.G.-S.-B.); (H.O.-B.); (M.P.M.-H.)
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
| | - Susana Navalpotro-Pascual
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain
- Nursing Department, Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Correspondence: (S.N.-P.); (R.M.C.-G.)
| | - José Julio Jiménez-Alegre
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain
- Faculty of Medicine, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Noemí García-Santa-Basilia
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
| | - Henar Onrubia-Baticón
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
| | - José M. Navalpotro-Pascual
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain
| | - Israel John Thuissard
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Juan José Fernández-Domínguez
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
- Emergency Service, HLA Moncloa University Hospital, 28008 Madrid, Spain
| | - María Paz Matellán-Hernández
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
| | - Elena Pastor-Benito
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain
| | - Carlos Eduardo Polo-Portes
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Rosa M. Cárdaba-García
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain; (J.J.J.-A.); (J.M.N.-P.); (I.J.T.); (J.J.F.-D.); (E.P.-B.); (C.E.P.-P.)
- Nursing Department, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
- Correspondence: (S.N.-P.); (R.M.C.-G.)
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Carmassi C, Dell’Oste V, Barberi FM, Bertelloni CA, Pedrinelli V, Dell’Osso L. Mental Health Symptoms among General Practitioners Facing the Acute Phase of the COVID-19 Pandemic: Detecting Different Reaction Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074007. [PMID: 35409690 PMCID: PMC8998411 DOI: 10.3390/ijerph19074007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/13/2022] [Accepted: 03/24/2022] [Indexed: 01/13/2023]
Abstract
During the 2020 first wave of the COVID-19 pandemic, general practitioners (GPs) represented the first line of primary care and were highly exposed to the pandemic risks, with a consequent risk of developing a wide range of mental health symptoms. However, scant data are still available on factors associated with a worse outcome. The aim of the present study was to investigate mental health symptoms in 139 GPs in the aftermath of the first COVID-19 national lockdown in Italy, detecting groups of subjects with different depressive, anxiety, and post-traumatic stress symptom severity. The impact of the mental health symptoms on quality of life and individual functioning were also evaluated. A cluster analysis identified three groups with mild (44.6%), moderate (35.3%), and severe psychopathological burden (20.1%). Higher symptom severity was related to younger age, fewer years in service as GPs, working in a high incidence area for the pandemic, having a relative at risk of medical complications due to COVID-19, besides more severe global functioning impairment, burnout, and secondary traumatic stress. The present findings showed that GPs, forced to perform their professional activity in extremely stressful conditions during the COVID-19 pandemic, were at high risk of developing mental health problems and a worse quality of life.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Valerio Dell’Oste
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- Correspondence: ; Tel.: +39-050-2219760; Fax: +39-050-2219787
| | - Filippo Maria Barberi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Carlo Antonio Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
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Guttormson JL, Calkins K, McAndrew N, Fitzgerald J, Losurdo H, Loonsfoot D. Critical Care Nurse Burnout, Moral Distress, and Mental Health During the COVID-19 Pandemic: A United States Survey. Heart Lung 2022; 55:127-133. [PMID: 35561589 PMCID: PMC9050623 DOI: 10.1016/j.hrtlng.2022.04.015] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND The COVID-19 pandemic has and will continue to have a tremendous influence on intensive care unit (ICU) nurses' mental health. OBJECTIVES The purpose of this study was to describe the impact of COVID-19 on nurse moral distress, burnout, and mental health. METHODS Between October 2020 and January 2021 this descriptive study recruited a national sample of nurses who worked in the ICU during the COVID-19 pandemic through American Association of Critical Care Nurses newsletters and social media. RESULTS A total of 488 survey responses were received from critical care nurses working in the U.S. during the COVID pandemic. Over two thirds of respondents experienced a shortage of personal protective equipment (PPE). Nurse respondents reported moderate/high levels of moral distress and burnout. Symptoms of moderate to severe depression and anxiety were reported by 44.6% and 31.1% of respondents, respectively. Forty-seven percent of respondents were at risk for having posttraumatic stress disorder (PTSD). Lack of perceived support from administration and shortage of PPE were associated with higher levels of burnout, moral distress, and PTSD symptoms. CONCLUSIONS Respondents had higher anxiety and depression than the general population and higher risk for having PTSD than recent veterans or patients after traumatic injury. High levels of reported burnout and moral distress increase the risk of nurses leaving ICU practice or the profession. This study offers important insights about the mental health of nurses during a global pandemic that can guide the development of customized interventions for ICU nurses related to this health care crisis.
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Affiliation(s)
- Jill L Guttormson
- Associate Professor, Marquette University College of Nursing,Corresponding Author. Jill Guttormson, Marquette University College of Nursing PO Box 1881, Milwaukee, WI 53201; Phone (office): 414-288-3819
| | - Kelly Calkins
- Assistant Professor, Marquette University College of Nursing
| | - Natalie McAndrew
- Assistant Professor, University of Wisconsin-Milwaukee College of Nursing
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