Resilience and its impact on the mental health of physiotherapists during the COVID-19 pandemic in São Paulo, Brazil

The psychological impact of the COVID-19 pandemic and the role of resilience: cross cultural differences between Brazil, Italy, and the United States

OBJECTIVE

Restrictive measures consequent to the COVID-19 pandemic have had a significant psychological impact on everyday life in the general population, even though differences between countries remain poorly investigated. The present study sought to examine the different psychological impacts and resilience of the pandemic among three of the most heavily hit countries: Brazil, Italy, and the United States.

METHODS

This cross-sectional study separately involved three national community populations, namely the Brazilian, the Italian, and the American population. Participants aged 18 years or older were recruited through a shared online survey. Participants self-completed the Connor-Davidson Resilience Scale (CD-RISC-10) and the Center for Epidemiological Studies-Depression Scale (CES-D); post-traumatic stress was additionally assessed using the Impact of Event Scale-Revised (IES-R). Three separate Analyses of Covariance (ANCOVA) were performed in order to investigate differences in the levels of resilience, post-traumatic stress, and depression among the three populations.

RESULTS

The study included in total 734 participants (mean age = 27.60 ± 11.69 years; 77% of females). Results of ANCOVA comparisons showed significant differences between the three groups in the variable measuring resilience, post-traumatic stress symptoms, and depression. As for resilience, results of post-hoc tests showed significant differences between the groups from Brazil and Italy and between the groups from Brazil and USA. As for the post-traumatic stress symptoms, results showed significant differences between the USA and Brazil groups and between the USA and Italy groups. As for the depression symptoms, results showed significant differences between the USA and Brazil groups.

CONCLUSIONS

Overall, these findings may help to increase understanding of the psychological impact of COVID-19 in Brazil, Italy, and the USA. Interventions to prevent mental disorders among general populations should take into account these findings.

Comparison of Resilience, Personal Recovery, and Quality of Life Measures Pre- and Post-Discharge from Inpatient Mental Health Units in Alberta: Analysis of Control Group Data from a Randomized Trial

Background: The transition from hospital to community settings for most mental health service users is often hindered by challenges that affect community adjustment and continuity of care. The first few weeks and days after discharge from mental health inpatient units represent a critical phase for many service users. This paper aims to evaluate the changes in the resilience, personal recovery, and quality of life status of individuals with mental health challenges recently discharged from acute mental health care into the community. Methods: Data for this study were collected as part of a pragmatic stepped-wedge cluster-randomized, longitudinal approach in Alberta. A paired sample t-test and Chi-squared/Fisher test were deployed to assess changes from baseline to six weeks in the recovery assessment scale (RAS), brief resilience scale (BRS), and EuroQol-5d (EQ-5D), using an online questionnaire. Results: A total of 306 service users were recruited and 88 completed both baseline and six weeks, giving a response rate of 28.8%. There was no statistically significant change in the level of resilience, recovery and quality of life as measured with the brief resilience scale, recovery assessment scale and EQ-5D from baseline to six weeks (p > 0.05). Conclusions: The study showed that there was neither an improvement nor deterioration in resilience, recovery, or quality of life status of service users six weeks post-discharge from inpatient mental health care. The lack of further progress calls into question whether the support available in the community when patient's leave inpatient care is adequate to promote full recovery. The results justify investigations into the effectiveness of innovative and cost-effective programs such as peer and text-based supportive interventions for service users discharged from inpatient psychiatric care.

Mental health patterns of physiotherapists in South Africa during COVID-19

Background

While attention has been drawn to the impact of the coronavirus disease 2019 (COVID-19) pandemic on the mental health of healthcare workers generally, little is known regarding mental health changes over time in frontline and non-frontline physiotherapists during this period.

Objectives

Our study aimed to investigate differences in mental health trends among frontline and non-frontline physiotherapists across three time periods during the pandemic.

Method

Survey-based data were collected from 366 practising physiotherapists across three time periods during the pandemic (Time 1: n = 171; Time 2: n = 101; Time 3: n = 94). Variations in reported mental health of frontline and non-frontline respondents generally and over time were analysed using comparative statistical techniques and trend analysis.

Results

Frontline physiotherapists reported significantly lower levels of general mental well-being and resilience, and significantly higher levels of burnout and maladaptive strategy use. Only frontline physiotherapists' general mental well-being and resilience decreased over time, whereas depression decreased over time for both groups. Anxiety decreased over time for non-frontline physiotherapists but initially decreased and then increased for frontline physiotherapists. Burnout increased initially and then decreased for non-frontline physiotherapists.

Conclusion

Varying mental health trends were found between frontline and non-frontline physiotherapists over time. Nuanced mental health interventions that consider the period of the pandemic and degree of exposure are needed.

Clinical implications

Understandings of the mental health trajectories experienced by physiotherapists across the pandemic can inform long-term, targeted interventions that effectively enhance well-being, retention, and sustainability of practitioners, and thus the care delivered, in the healthcare system.

Global prevalence of low resilience among the general population and health professionals during the COVID-19 pandemic: A meta-analysis

Objective

To estimate the global prevalence of low resilience among the general population and health professionals during the COVID-19 pandemic.

Methods

Embase, Ovid-MEDLINE, PubMed, Scopus, Web of Science, CINAHL, WHO COVID-19 databases, and grey literature were searched for studies from January 1, 2020, to August 22, 2022. Hoy's assessment tool was used to assess for risk of bias. Meta-analysis and moderator analysis was performed using the Generalized Linear Mixed Model with a corresponding 95 % confidence interval (95 % CI) adopting the random-effect model in R software. Between-study heterogeneity was measured using I² and τ² statistics.

Results

Overall, 44 studies involving 51,119 participants were identified. The pooled prevalence of low resilience was 27.0 % (95 % CI: 21.0 %–33.0 %) with prevalence among the general population being 35.0 % (95 % CI: 28.0 %–42.0 %) followed by 23.0 % (95 % CI: 16.0 %–30.9 %) for health professionals. The 3-month trend analysis of the prevalence of low resilience beginning January 2020 to June 2021 revealed upward then downward patterns among overall populations. The prevalence of low resilience was higher in females, studied during the delta variant dominant period, frontline health professionals, and undergraduate degree education.

Limitations

Study outcomes showed high heterogeneity; however, sub-group and meta-regression analyses were conducted to identify potential moderating factors.

Conclusions

Globally, 1 out of 4 people among the general population and health professionals experienced low resilience due to COVID-19 adversity. The prevalence of low resilience was twice as much among the general population compared to health professionals. These findings provide information for policymakers and clinicians in the development and implementation of resilience-enhancing programs.

Relationships Between Burnout and Resilience: Experiences of Physical Therapists and Occupational Therapists During the COVID-19 Pandemic

OBJECTIVE

Research on burnout among physical therapists and occupational therapists in the context of the coronavirus disease 2019 (COVID-19) pandemic is limited. Resilience may be important for reducing burnout and promoting well-being among rehabilitation specialists, especially during periods of elevated occupational demand and stress. The purpose of this study was to investigate experiences of burnout, COVID-19 pandemic-related distress, and resilience among physical therapists and occupational therapists during the first year of the COVID-19 pandemic.

METHODS

Physical therapists and occupational therapists working in a university-affiliated health system were invited to complete an online survey assessing burnout, COVID-19 pandemic-related distress, state- and trait-like resilience, physical activity, sleep disturbance, and financial concerns. Multiple linear regressions were used to examine variables associated with burnout as well as the contribution of specific aspects of resilience to burnout.

RESULTS

Greater COVID-19 pandemic-related distress was associated with greater emotional exhaustion and depersonalization, whereas state-like resilience at work was associated with lower emotional exhaustion, greater personal accomplishment, and lower depersonalization. Analyses examining the impact of specific components of resilience at work suggested that several components are associated with less burnout, with finding one's calling being particularly relevant for all 3 domains of burnout.

CONCLUSION

Symptoms of burnout were reported by many physical therapists and occupational therapists. COVID-19-related distress and state-like resilience at work, particularly the perception of finding one's calling, emerged as consistently being associated with burnout in the context of the COVID-19 pandemic.

IMPACT

These findings can inform the development of interventions to reduce burnout among physical therapists and occupational therapists amid the continuing COVID-19 pandemic.

Effects of the COVID-19 pandemic on the mental health of rehabilitation area professionals: A systematic review

Background

The role of the physiotherapist is vital in the recovery of post-COVID-19 patients, but fear of contagion is a possible feeling among healthcare professionals. The objective of this study is to assess the mental health effects that COVID-19 has had on healthcare workers, including rehabilitation care, in times of pandemic.

Methods

A systematic review was conducted using the PRISMA format in the Pubmed, SCOPUS, and Web of Science databases between July and September 2022. Keywords included were "healthcare providers," "COVID-19," "Mental Health," and "Psychological Distress." Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools.

Results

A total of 14 studies were included in this review. The study population was healthcare professionals including the rehabilitation services. In total, 4 studies reported exclusively on anxiety and stress levels in physiotherapists providing care during the pandemic.

Conclusions

The mental health of healthcare professionals has been compromised during the pandemic. However, initially, research was only focused on physicians and nurses, so the need arises to include those professionals, such as physiotherapists, who are also in direct contact with COVID-19 patients.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=367664, identifier: CRD42022367664.

Resilience mediates the influence of hope, optimism, social support, and stress on anxiety severity among Chinese patients with cervical spondylosis

OBJECTIVE

Cervical spondylosis (CS) is a potential stressor threatening mental health among affected individuals. This study was to analyze resilience level and associated factors among cervical spondylosis (CS) patients, and to explore the underlying mechanism of anxiety based on resilience-focused psychological variables.

METHODS

Resilience Scale-14 (RS-14), Zung Self-Rating Anxiety Scale (SAS), Herth Hope Index (HHI), Revised Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale-10 (PSS-10) were used in this cross-sectional investigation among 250 CS patients.

RESULTS

The score of resilience was 65.58 ± 16.14. Hierarchical linear regression analysis revealed that hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases were the independent associates of resilience among CS patients, which explained 63.9% of the total variance. The structural equation model showed that hope, optimism, perceived social support and perceived stress affected anxiety via resilience, and hope and optimism also had direct effects on anxiety.

CONCLUSION

Chinese patients with CS had moderate level of mental resilience, which was independently related to hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases. Resilience played a mediating role between various psychological variables and anxiety. Improving the level of resilience, hope, optimism and perceived social support and reducing the level of perceived stress are important strategies to reduce anxiety level. Relevant healthcare professionals should put more focus on the mental problems of Chinese CS patients and help maintain good psychological status by improving their resilience and associated psychological variables thereof.