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Tacchini-Jacquier N, Monnay S, Bonvin E, Dubuis J, Verloo H. Relatives' experiences of visiting restrictions during the COVID-19 pandemic's first wave: a PREMs study in Valais Hospital, Switzerland. BMC Health Serv Res 2023; 23:1008. [PMID: 37726727 PMCID: PMC10510254 DOI: 10.1186/s12913-023-10013-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, most countries introduced temporary visiting restrictions on the relatives of acute care hospital patients, whether or not they were infected with SARS-CoV-2. This affected relatives' psychological and emotional states and how closely they could be involved in their loved one's hospitalization. STUDY AIMS Investigate relatives' experiences of visiting restrictions during the COVID-19 pandemic's first wave and the support offered by Valais Hospital's healthcare staff. METHODS Relatives and patients who had been discharged between February 28 and May 13, 2020, were asked to complete a patient-reported experience measures (PREMs) questionnaire, whether or not they had been infected by SARS-CoV-2. Relatives were asked about how visiting restrictions had affected them, their perceptions of the severity of the COVID-19 pandemic, the quality of communication concerning their loved ones' health status during their hospitalization, and the information received from healthcare staff. Descriptive and inferential statistics were computed. RESULTS Of 866 PREMs questionnaires returned, 818 were analyzable, and 543 relatives had experienced visiting restrictions to their loved ones: 92 relatives (87%) of COVID-19 patients and 451 relatives (66%) of non-infected patients, with heterogenous effects on their psychological and affective status. Overall, whether or not relatives were subjected to visiting restrictions, they perceived themselves to be well treated, well informed, and that communication with hospital healthcare staff was satisfactory. However, relatives subjected to visiting restrictions reported significantly lower scores on the quality of communication than other relatives. The relatives of patients in gynecology/obstetrics and internal medicine wards were significantly more affected by visiting restrictions than were the relatives of patients in other wards. Numerous relatives subjected to visiting restrictions reported regular communication with their loved ones or with healthcare staff, at least once a day (n = 179), either via videoconferences using FaceTime®, WhatsApp®, Zoom®, or Skype® or via mobile phone text messages. CONCLUSION Visiting restrictions affected relatives differently depending on the wards their loved ones were hospitalized. Healthcare institutions should investigate the utility of visiting restrictions on patients, how they affect relatives, and how to improve personalized patient-relative communications. Future research should attempt to develop reliable, validated measurement instruments of relatives' experiences of acute-care visiting restrictions during pandemics.
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Affiliation(s)
- N Tacchini-Jacquier
- Development of Nursing Practices Unit, Valais Hospital, 86, Avenue du Grand-Champsec, CH-1951, Sion, Switzerland
| | - S Monnay
- Social Affairs and Human Resources Specialist, Valais Hospital, 86, Avenue du Grand-Champsec, CH-1951, Sion, Switzerland
| | - E Bonvin
- Valais Hospital, 86, Avenue Grand-Champsec, CH-1951, Sion, Switzerland
| | - J Dubuis
- Valais Family Caregivers' Association, 19, Avenue de Tourbillon, CH-1950, Sion, Switzerland
| | - H Verloo
- Valais Hospital, HES-SO Valais/Wallis, 5, Chemin de L'Agasse, CH-1950, Sion, Valais, Switzerland.
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Monti L, Marconi E, Bocci MG, Kotzalidis GD, Mazza M, Galliani C, Tranquilli S, Vento G, Conti G, Sani G, Antonelli M, Chieffo DPR. COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review. World J Psychiatry 2023; 13:191-217. [PMID: 37123099 PMCID: PMC10130962 DOI: 10.5498/wjp.v13.i4.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.
AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.
METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.
RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.
CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.
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Affiliation(s)
- Laura Monti
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Elisa Marconi
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Maria Grazia Bocci
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Georgios Demetrios Kotzalidis
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- NESMOS Department, Facoltà di Medicina e Psicologia, Sant’Andrea University Hospital, Rome 00189, Italy
| | - Marianna Mazza
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Carolina Galliani
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Sara Tranquilli
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giovanni Vento
- UOC Neonatologia, Dipartimento di Scienze Della Salute Della Donna, Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Neonatologia, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giorgio Conti
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Massimo Antonelli
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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COVID-19-related consultation-liaison (CL) mental health services in general hospitals: A perspective from Europe and beyond. J Psychosom Res 2023; 167:111183. [PMID: 36801662 PMCID: PMC9912022 DOI: 10.1016/j.jpsychores.2023.111183] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE The COVID-19 pandemic posed new challenges for integrated health care worldwide. Our study aimed to describe newly implemented structures and procedures of psychosocial consultation and liaison (CL) services in Europe and beyond, and to highlight emerging needs for co-operation. METHODS Cross-sectional online survey from June to October 2021, using a self-developed 25-item questionnaire in four language versions (English, French, Italian, German). Dissemination was via national professional societies, working groups, and heads of CL services. RESULTS Of the participating 259 CL services from Europe, Iran, and parts of Canada, 222 reported COVID-19 related psychosocial care (COVID-psyCare) in their hospital. Among these, 86.5% indicated that specific COVID-psyCare co-operation structures had been established. 50.8% provided specific COVID-psyCare for patients, 38.2% for relatives, and 77.0% for staff. Over half of the time resources were invested for patients. About a quarter of the time was used for staff, and these interventions, typically associated with the liaison function of CL services, were reported as most useful. Concerning emerging needs, 58.1% of the CL services providing COVID-psyCare expressed wishes for mutual information exchange and support, and 64.0% suggested specific changes or improvements that they considered essential for the future. CONCLUSION Over 80% of participating CL services established specific structures to provide COVID-psyCare for patients, their relatives, or staff. Mostly, resources were committed to patient care and specific interventions were largely implemented for staff support. Future development of COVID-psyCare warrants intensified intra- and inter-institutional exchange and co-operation.
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Kowalski E, Graf J, Schneider A, Zipfel S, Stengel A. [Resilience and General Self-Efficacy are Related to Perception of COVID-19 Symptomatology, Mental Health, and Coping with Acute COVID-19 Infection]. Psychother Psychosom Med Psychol 2023; 73:139-147. [PMID: 36070761 DOI: 10.1055/a-1876-2777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The COVID-19 pandemic may be associated with massive impacts on mental health. For example, people with pre-existing mental illness were particularly vulnerable to mental health deterioration. It is known that resilience and general self-efficacy can be protective factors for mental health in the face of stress and challenge such as the COVID-19 pandemic. This study is the first to examine the associations of resilience and general self-efficacy on mental health coping with acute COVID-19 infection in home isolation. METHODS This study is a cross-sectional online survey of people with acute, PCR-diagnosed COVID-19 infection during their home isolation. Recruitment was conducted by telephone via the Freudenstadt health department (Germany). After informed consent, study participants received a link for an online questionnaire. The questionnaire assessed sociodemographic aspects, resilience, general self-efficacy, COVID-19 somatic health, psychological burden (depressiveness, anxiety, somatic symptom disorder), stress experience, and coping strategies. Descriptive statistics, correlational analyses, and multiple linear regressions with resilience and general self-efficacy as independent variables were performed. RESULTS A total of 224 home-isolated people with acute COVID-19 infection were included in the study. Lower resilience and lower general self-efficacy were each related with more intense perception of COVID-19 somatic symptoms, higher psychological burden, increased stress perception, lower coping skills, and lower experienced support. DISCUSSION Resilience and general self-efficacy are essential for mental health as well as for coping with acute COVID-19 infection. They not only protect against negative effects on mental health but also enhance positive effects. Resilience is positively related to the perception and evaluation of somatic COVID-19 symptoms. More resilient people with COVID-19 infection feel physically healthier. CONCLUSION Home-isolated people with acute COVID-19 infection should be screened for support needs using standardized brief questionnaires to avoid negative psychological and somatic consequences. Demand-driven, low-threshold, digital, and individualized intervention programs should also be developed and established for the home isolation setting.
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Affiliation(s)
- Elias Kowalski
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Tübingen, Germany
- Gesundheitsamt Freudenstadt, Gesundheitsamt Freudenstadt, Freudenstadt, Germany
| | - Johanna Graf
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Axel Schneider
- Gesundheitsamt Freudenstadt, Gesundheitsamt Freudenstadt, Freudenstadt, Germany
| | - Stephan Zipfel
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Tübingen, Germany
- Corporate Member Freie Universität Berlin, Humboldt-Universität zu Berlin und Berliner Institut für Gesundheit, CharitéCentrum für Innere Medizin und Dermatologie, Abteilung für Psychosomatik, Charité Universitätsmedizin Berlin, Berlin, Germany
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Fenton A, Stevens S, Cost Z, Bickford J, Kohut M, Jacobs EA, Hutchinson RN. Patients' and caregivers' experiences of hospitalization under COVID-19 visitation restrictions. J Hosp Med 2022; 17:819-826. [PMID: 35920080 PMCID: PMC9538139 DOI: 10.1002/jhm.12924] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, hospitals did not allow caregiver visitation. Little is known about how caregivers' absence affected patients' care. OBJECTIVE This study aimed to describe visitation restrictions' impact on patients and their caregivers experiences. DESIGN We used a sequential explanatory mixed-methods study design. First, we randomly selected 200 adult patients with cancer or heart failure hospitalized before (n = 100) and during visitor restrictions (n = 100) and abstracted data from the electronic medical record on communication between medical teams and caregivers and the topics discussed. Results from the quantitative analysis guided our thematic analysis of semi-structured interviews conducted with a subsample of patients hospitalized during visitor restrictions and their caregivers to understand the impact of visitor restrictions on their experiences. RESULTS Compared to prerestrictions, caregivers under visitation restrictions communicated less frequently with the medical team (29% vs. 37% of hospitalized days; p = .04), fewer received discharge counseling (37% vs. 52%; p = .04), and disproportionately more had no contact with the medical team (36% vs. 17%; p < .01). Video conferencing was documented for caregivers of only five patients. Qualitative analysis revealed that both caregivers and patients experienced emotional distress, increased conflict, and decreased perception of quality of care because of visitation restrictions. CONCLUSIONS Hospital visitor restrictions significantly reduced caregivers' communication with patients' medical team, causing caregivers and patients emotional distress. Protocols that facilitate communication between caregivers and care teams may benefit caregivers who cannot be physically present at care facilities, including distance caregivers.
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Affiliation(s)
- Anny Fenton
- Division of Population SciencesDana Farber Cancer InstituteBostonMassachusettsUSA
| | - Sandra Stevens
- Maine Medical CenterDivision of Palliative MedicinePortlandMaineUSA
| | - Zachary Cost
- Tufts University School of MedicineBostonMassachusettsUSA
| | - Jaime Bickford
- Maine Medical CenterDivision of Palliative MedicinePortlandMaineUSA
| | - Michael Kohut
- MaineHealth Center for Interdisciplinary Population Health ResearchPortlandMaineUSA
| | - Elizabeth A. Jacobs
- Tufts University School of MedicineBostonMassachusettsUSA
- MaineHealth Center for Interdisciplinary Population Health ResearchPortlandMaineUSA
| | - Rebecca N. Hutchinson
- Maine Medical CenterDivision of Palliative MedicinePortlandMaineUSA
- Tufts University School of MedicineBostonMassachusettsUSA
- MaineHealth Center for Interdisciplinary Population Health ResearchPortlandMaineUSA
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Yang T, Yan MZ, Li X, Lau EHY. Sequelae of COVID-19 among previously hospitalized patients up to 1 year after discharge: a systematic review and meta-analysis. Infection 2022; 50:1067-1109. [PMID: 35750943 PMCID: PMC9244338 DOI: 10.1007/s15010-022-01862-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 05/21/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Although complications and clinical symptoms of COVID-19 have been elucidated, the prevalence of long-term sequelae of COVID-19 is less clear in previously hospitalized COVID-19 patients. This review and meta-analysis present the occurrence of different symptoms up to 1 year of follow-up for previously hospitalized patients. METHODS We performed a systematic review from PubMed and Web of Science using keywords such as "COVID-19", "SARS-CoV-2", "sequelae", "long-term effect" and included studies with at least 3-month of follow-up. Meta-analyses using random-effects models were performed to estimate the pooled prevalence for different sequelae. Subgroup analyses were conducted by different follow-up time, regions, age and ICU admission. RESULTS 72 articles were included in the meta-analyses after screening 11,620 articles, identifying a total of 167 sequelae related to COVID-19 from 88,769 patients. Commonly reported sequelae included fatigue (27.5%, 95% CI 22.4-33.3%, range 1.5-84.9%), somnipathy (20.1%, 95% CI 14.7-26.9%, range 1.2-64.8%), anxiety (18.0%, 95% CI 13.8-23.1%, range 0.6-47.8%), dyspnea (15.5%, 95% CI 11.3-20.9%, range 0.8-58.4%), PTSD (14.6%, 95% CI 11.3-18.7%, range 1.2-32.0%), hypomnesia (13.4%, 95% CI 8.4-20.7%, range 0.6-53.8%), arthralgia (12.9%, 95% CI 8.4-19.2%, range 0.0-47.8%), depression (12.7%, 95% CI 9.3-17.2%, range 0.6-37.5%), alopecia (11.2%, 95% CI 6.9-17.6%, range 0.0-47.0%) over 3-13.2 months of follow-up. The prevalence of most symptoms reduced after > 9 months of follow-up, but fatigue and somnipathy persisted in 26.2% and 15.1%, respectively, of the patients over a year. COVID-19 patients from Asia reported a lower prevalence than those from other regions. CONCLUSIONS This review identified a wide spectrum of COVID-19 sequelae in previously hospitalized COVID-19 patients, with some symptoms persisting up to 1 year. Management and rehabilitation strategies targeting these symptoms may improve quality of life of recovered patients.
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Affiliation(s)
- Tianqi Yang
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Michael Zhipeng Yan
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xingyi Li
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Eric H Y Lau
- School of Public Health, The University of Hong Kong, Hong Kong, China.
- Laboratory of Data Discovery for Health Limited, Hong Kong Science Park, Hong Kong, China.
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Khraisat B, Toubasi A, AlZoubi L, Al-Sayegh T, Mansour A. Meta-analysis of prevalence: the psychological sequelae among COVID-19 survivors. Int J Psychiatry Clin Pract 2022; 26:234-243. [PMID: 34709105 DOI: 10.1080/13651501.2021.1993924] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This meta-analysis aims to estimate the pooled prevalence of mental disorders among COVID-19 survivors. METHODS The databases Pubmed, Google Scholar, ScienceDirect, and medRxiv have been searched up to 1 August 2021 using COVID-19, survivors, mental disorders, and their related MeSH terms. The included studies were either cross-sectional, cohort, or case-control in design. Those studies included COVID-19 survivors after 14 or more days from their COVID-19 recovery and used validated questionnaires to assess their mental health outcomes. The random-effects model was used to pool the data from the incorporated studies. The heterogeneity was assessed using Cochran's Q heterogeneity test and I2 statistic. RESULTS Twenty-seven studies were included in the data synthesis with a total sample size of 9605 COVID-19 survivors. The prevalence rates for Post-Traumatic Stress Disorder (PTSD), anxiety, psychological distress, depression, and sleeping disorders were 20% (95% CI = 16-24%), 22% (95% CI = 18-27%), 36% (95% CI = 22-51%), 21% (95% CI = 16-28%), and 35% (95% CI = 29-41%), respectively. CONCLUSIONS Although we found high heterogeneity across the included studies, our meta-analysis provides evidence that there are psychological sequelae in COVID-19 survivors that require medical assiduity as well as further research on the matter.KEY POINTSIncreased prevalence of psychological sequelae among COVID-19 survivors.The prevalence of PTSD was 20% (95% CI = 16-24%) and of anxiety was 22% (95% CI = 18-27%) among COVID-19 survivors.The prevalence of psychological distress was 36% (95% CI = 22-51%), of depression was 21% (95% CI = 16-28%), and of sleep disorders was 35% (95% CI = 29-41%) among COVID-19 survivors.Future researches are recommended to search for effective and safe methods to mitigate the psychological sequelae in COVID-19 patients.
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Affiliation(s)
- Bann Khraisat
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Ahmad Toubasi
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Lujain AlZoubi
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | | | - Ahmad Mansour
- Department of Pathology, University of Cincinnati, Cincinnati, OH, USA
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Khubchandani J, Sharma S, Webb FJ, Wiblishauser MJ, Sharma M. COVID-19 Infection among Family and Friends: The Psychological Impact on Non-Infected Persons. Brain Sci 2022; 12:1123. [PMID: 36138859 PMCID: PMC9497068 DOI: 10.3390/brainsci12091123] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
Little is known about the mental health impact of having a family member or friend infected with COVID-19. Thus, the purpose of this study was to conduct a comprehensive national assessment of the psychological impact of COVID-19 infection, hospitalization, or death among family members and friends. A multi-item valid and reliable questionnaire was deployed online to recruit adults in the U.S. A total of 2797 adult Americans without a history of COVID-19 infection participated in the study and reported that they had a family member or friend infected with (54%), hospitalized due to (48%), or die (36%) of COVID-19 infection. Symptoms of depression, anxiety, or both (i.e., psychological distress) were statistically significantly higher among those who had family members/friends infected, hospitalized, or die due to COVID-19. Also, this study found that the greater the number of family members/friends affected by COVID-19, or the more severe the COVID-19 infection outcome (i.e., hospitalization vs. death), the higher the odds of symptoms of depression, anxiety, or both. There is an urgent need to develop educational interventions and implement policy measures that address the growing mental health needs of this subgroup of the population that was not infected but indirectly affected by COVID-19 infections among social networks.
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Affiliation(s)
- Jagdish Khubchandani
- College of Health, Education & Social Transformation, New Mexico State University, Las Cruces, NM 88003, USA
| | - Sushil Sharma
- Provost Office, Texas A&M University Texarkana, Texarkana, TX 75503, USA
| | - Fern J. Webb
- College of Medicine, University of Florida, Jacksonville, FL 32209, USA
| | - Michael J. Wiblishauser
- School of Education, Health Professions & Human Development, University of Houston-Victoria, Victoria, TX 77901, USA
| | - Manoj Sharma
- School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
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Carola V, Vincenzo C, Morale C, Pelli M, Rocco M, Nicolais G. Psychological health in COVID-19 patients after discharge from an intensive care unit. Front Public Health 2022; 10:951136. [PMID: 36033791 PMCID: PMC9411785 DOI: 10.3389/fpubh.2022.951136] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/21/2022] [Indexed: 01/24/2023] Open
Abstract
Along with physical changes, psychological changes are detectable in patients with COVID-19. In these patients, the stressful experience of intensive care unit (ICU) hospitalization may aggravate psychological conditions. Our study examines the short- and long-term psychological consequences of COVID-19 in ICU patients. COVID-19 patients completed the self-rating questionnaires Kessler 10 Psychological Distress Scale (K10), Perceived Stress Scale-10 (PSS), Impact of Event Scale Revised (IES-R), and Post-traumatic Growth Inventory (PTGI) and were clinically interviewed 1 and 6 months after discharge. Altered behavioral-psychological symptoms and patients' strategies (adaptive vs. maladaptive) for coping with stress during and after hospitalization were coded during clinical interviews. Between 20 and 30% of patients showed moderate symptoms of depression or anxiety and perceived stress 1 and 6 months after discharge. Sleep problems, difficulty concentrating, confusion in placing events, and fear of reinfection were observed in many (6-17%) patients. At 6 months, only 7% of patients showed PTSD symptoms, and 50% showed post-traumatic growth in the "appreciation of life" sub-scale. Finally, 32% of subjects were classified as "maladaptive coping patients," and 68% as "adaptive coping patients." Patients who adopted "adaptive" coping strategies showed significantly lower levels of anxious-depressive symptoms and perceived stress when compared to subjects with "maladaptive" strategies at both time points. Coping strategy had no effect on PTSD symptoms or post-traumatic growth at 6 months. These findings clarify the short- and long-term psychological effects of intensive care due to COVID-19 infection and demonstrate that patient characteristics, particularly strategies for coping with stress, seem to play a critical role in psychological outcomes.
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Affiliation(s)
- Valeria Carola
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Cristina Vincenzo
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Chiara Morale
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Pelli
- Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Monica Rocco
- Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Giampaolo Nicolais
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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Fernández-de-las-Peñas C, Rodríguez-Jiménez J, Palacios-Ceña M, de-la-Llave-Rincón AI, Fuensalida-Novo S, Florencio LL, Ambite-Quesada S, Ortega-Santiago R, Arias-Buría JL, Liew BXW, Hernández-Barrera V, Cigarán-Méndez M. Psychometric Properties of the Hospital Anxiety and Depression Scale (HADS) in Previously Hospitalized COVID-19 Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9273. [PMID: 35954630 PMCID: PMC9367824 DOI: 10.3390/ijerph19159273] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is associated with psychological/emotional disturbances. This study aimed to assess internal consistency, reliability, and construct validity of the Hospital Anxiety and Depressive Scale (HADS), as a patient-reported outcome measure (PROM) for evaluating emotional consequences of SARS-CoV-2 in hospitalized COVID-19 survivors with long COVID. The LONG-COVID-EXP-CM is a multicenter cohort study including patients hospitalized by COVID-19 during the first wave of the pandemic in five hospitals in Madrid. A total of 1969 (age: 61 ± 16 years, 46.5% women) COVID-19 survivors experiencing post-COVID symptoms a mean of 8.4 ± 1.5 months after hospital discharge completed HADS. Internal consistency (Cronbach α), reliability (item-internal consistency, item-discriminant validity), construct validity (confirmatory factor analysis), and floor effect and ceiling effect were calculated. The mean time for fulfilling HADS was 65 ± 12 s. A ceiling effect ranging from 1.99% to 13.74% and a floor effect ranging from 43.05% to 77.77% was observed. Based on the item-scale correlation coefficients, the Cronbach's alpha values reflecting the internal consistency reliability were 0.890 for the anxiety scale (HADS-A) and 0.856 for the depressive scale (HADS-D) The correlation coefficient between HADS-A and HADS-D scores was excellent (r: 0.878). The confirmatory factor analysis revealed that five out of the seven fitness indexes were excellent: CFI = 0.969, NNFI = 0.963; TLI = 0.963; AGFI = 0.951; GFI = 0.972), supporting good construct validity. In conclusion, this study indicates that both anxiety and depressive symptoms scales of HADS had overall good psychometric properties to be used for assessing psychological and emotional stress in COVID-19 survivors with long COVID.
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Affiliation(s)
- César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - Jorge Rodríguez-Jiménez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - María Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - Ana I de-la-Llave-Rincón
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - Stella Fuensalida-Novo
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - Lidiane L. Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - Silvia Ambite-Quesada
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - José L. Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (J.R.-J.); (M.P.-C.); (A.I.d.-l.-L.-R.); (S.F.-N.); (L.L.F.); (S.A.-Q.); (R.O.-S.); (J.L.A.-B.)
| | - Bernard X. W. Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3SQ, UK;
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11
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Ollila H, Pihlaja R, Koskinen S, Tuulio-Henriksson A, Salmela V, Tiainen M, Hokkanen L, Hästbacka J. Long-term cognitive functioning is impaired in ICU-treated COVID-19 patients: a comprehensive controlled neuropsychological study. Crit Care 2022; 26:223. [PMID: 35858899 PMCID: PMC9297673 DOI: 10.1186/s13054-022-04092-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/02/2022] [Indexed: 12/15/2022] Open
Abstract
Background Cognitive impairment has emerged as a common post-acute sequela of coronavirus disease 2019 (COVID-19). We hypothesised that cognitive impairment exists in patients after COVID-19 and that it is most severe in patients admitted to the intensive care unit (ICU). Methods This prospective controlled cohort study of 213 participants performed at the Helsinki University Hospital and the University of Helsinki, Finland, comprised three groups of patients—ICU-treated (n = 72), ward-treated (n = 49), and home-isolated (n = 44)—with confirmed COVID-19 between March 13 and December 31, 2020, participating in a comprehensive neuropsychological evaluation six months after the acute phase. Our study included a control group with no history of COVID-19 (n = 48). Medical and demographic data were collected from electronic patient records and interviews carried out four months after the acute phase. Questionnaires filled six months after the acute phase provided information about change in cognitive functioning observed by a close informant, as well as the presence of self-reported depressive and post-traumatic symptoms. Results The groups differed (effect size η2p = 0.065, p = 0.004) in the total cognitive score, calculated from neuropsychological measures in three domains (attention, executive functions, and memory). Both ICU-treated (p = 0.011) and ward-treated patients (p = 0.005) performed worse than home-isolated patients. Among those with more than 12 years of education, ICU-treated patients performed worse in the attention domain than ward-treated patients (p = 0.021) or non-COVID controls (p = 0.045); ICU-treated male patients, in particular, were impaired in executive functions (p = 0.037). Conclusions ICU-treated COVID-19 patients, compared to patients with less severe acute COVID-19 or non-COVID controls, showed more severe long-term cognitive impairment. Among those with more than 12 years of education, impairment existed particularly in the domains of attention and for men, of executive functions. Trial registration number: ClinicalTrials.gov NCT04864938, retrospectively registered February 9, 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13054-022-04092-z.
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Affiliation(s)
- Henriikka Ollila
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Riikka Pihlaja
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Division of Neuropsychology, HUS Neurocentre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sanna Koskinen
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Annamari Tuulio-Henriksson
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Viljami Salmela
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marjaana Tiainen
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura Hokkanen
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna Hästbacka
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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12
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Van Wijk CH, Martin JH, Meintjes WAJ. A Concise Occupational Mental Health Screening Tool for South African Workplaces. Front Psychol 2022; 13:895137. [PMID: 35707644 PMCID: PMC9190782 DOI: 10.3389/fpsyg.2022.895137] [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: 03/13/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Mental health in the workplace is becoming of ever greater importance. General occupational health surveillance programmes are already in widespread use, with established referral systems for treatment and rehabilitation, and the same mechanisms could be expanded to include mental health screening and intervention. This study aimed to develop a concise composite mental health screening tool, based on analysis of existing data, for application in routine occupational health surveillance in South Africa. Data from workplace occupational health surveillance programs from 2,303 participants were analysed. Participants completed a number of questions/scaled items collated into a survey format, and partook in an interview with a psychologist. The data was analysed using frequency of positive self-reports, Chi square to calculate associations with outcomes, Receiver Operator Characteristic curve analysis to explore predictive ability, and binomial logistic regression to calculate the relative contribution of markers to outcomes. An exploratory factor analysis was further conducted on identified items. A general workplace model with 14 markers (and a maritime workplace model with 17 markers) were identified. The factor analysis suggested their organisation into five domains (similar for both models), namely neurocognitive health, common mental disorders, history of adaptation in occupational specific contexts, family-work interface, and stress overload. The study’s data-driven approach proposed a concise composite screener with less than 50 items, comprising five domains. This tool appears useful in identifying employees at risk for workplace injuries or poor mental health outcomes, and could be applied to related workplace settings in South Africa.
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Affiliation(s)
- Charles H Van Wijk
- Institute for Maritime Medicine, Simon's Town, South Africa.,Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Jarred H Martin
- Department of Psychology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - W A J Meintjes
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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13
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Devita M, Di Rosa E, Iannizzi P, Bianconi S, Contin SA, Tiriolo S, Ghisi M, Schiavo R, Bernardinello N, Cocconcelli E, Balestro E, Cattelan AM, Leoni D, Volpe B, Mapelli D. Risk and Protective Factors of Psychological Distress in Patients Who Recovered From COVID-19: The Role of Cognitive Reserve. Front Psychol 2022; 13:852218. [PMID: 35719579 PMCID: PMC9204198 DOI: 10.3389/fpsyg.2022.852218] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/05/2022] [Indexed: 01/06/2023] Open
Abstract
Recent studies reported the development of psychological distress symptoms in patients who recovered from COVID-19. However, evidence is still scarce and new data are needed to define the exact risk and protective factors that can explain the variability in symptoms manifestation. In this study, we enrolled 257 patients who recovered from COVID-19 and we evaluated the levels of psychological distress through the Symptoms Checklist-90-R scale. Data concerning illness-related variables were collected from medical records, while the presence of subjective cognitive difficulties, both before and after the illness, as well as the level of the cognitive reserve (CR), were assessed over a clinical interview. Results revealed that being female and reporting the presence of subjective cognitive difficulties after COVID-19 were associated with higher levels of psychological distress. At the same time, being admitted to the hospital and having a high CR were protective factors. Adding new information to this emerging research field, our results highlight the importance of a complete psychological and cognitive assessment in patients with COVID-19.
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Affiliation(s)
- Maria Devita
- Department of General Psychology, University of Padua, Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padua, Padua, Italy
| | - Pamela Iannizzi
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Sara Bianconi
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Sara Anastasia Contin
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Simona Tiriolo
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padua, Padua, Italy
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Rossana Schiavo
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Elisabetta Cocconcelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Elisabetta Balestro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | | | - Davide Leoni
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Biancarosa Volpe
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padua, Padua, Italy
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14
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Taurisano P, Lanciano T, Alfeo F, Bisceglie F, Monaco A, Sbordone FL, Abbatantuono C, Costadura S, Losole J, Ruggiero G, Iachini S, Vimercati L, Vacca A, De Caro MF, Curci A. The COVID-19 Stress Perceived on Social Distance and Gender-Based Implications. Front Psychol 2022; 13:846097. [PMID: 35615201 PMCID: PMC9126176 DOI: 10.3389/fpsyg.2022.846097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/17/2022] [Indexed: 01/12/2023] Open
Abstract
The COVID-19 pandemic is an unprecedented event entailing long-term consequences on population health and welfare. Those who contracted the coronavirus may have suffered from both physical and mental health issues that unfold the need for tailored intervention strategies. Hence, our study aims to investigate the psychological and social consequences of COVID-19 on a sample of 86 participants, encompassing 43 patients (clinical group; 25 women; mean age = 50.4 ± 10.1 years) recruited from Bari University Hospital, 19 of whom were hospitalized due to the disease. The remaining 43 were individuals not fallen ill with COVID-19 to date (control group; 25 women; mean age = 50.4 ± 10.1 years). The investigation yielded significant gender differences in post-traumatic stress symptoms, depression, and representation of interpersonal distance (IPD), evaluated through the IES-R, the BDI-II, and the IVAS task, respectively. This pattern of results was not replicated in the control group. In general, participants who reported having experienced the most intense post-traumatic symptoms also presented a greater mood deflection and, more specifically, within the clinical group women obtained the highest scores on both scales. Women reported higher IES-R and BDI-II scores compared to men, that could indicate that women who have contracted COVID-19 are more exposed to post-traumatic and depressive symptoms. Our results also showed a significant effect of COVID-19 on IPD with a tendency of disease-experienced individuals to increase their preferred IPD from adults, children, and elderly people. Regarding gender differences in mood and proxemic behavior, a correlation between depressive symptoms and probable PTSD and a further correlation between probable PTSD and greater IPD were found in women from both clinical and control group. Overall, these findings might contribute to a better understanding of gender-based implications of the current pandemic on mental health, also leading to the development of integrated yet personalized intervention strategies.
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Affiliation(s)
- Paolo Taurisano
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Bari, Italy
| | - Tiziana Lanciano
- Department of Education, Psychology, Communication, University of Bari "Aldo Moro," Bari, Italy
| | - Federica Alfeo
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Bari, Italy.,Department of Education, Psychology, Communication, University of Bari "Aldo Moro," Bari, Italy
| | - Francesca Bisceglie
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Bari, Italy
| | - Alessia Monaco
- Department of Education, Psychology, Communication, University of Bari "Aldo Moro," Bari, Italy
| | | | - Chiara Abbatantuono
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Bari, Italy
| | - Silvia Costadura
- Department of Education, Psychology, Communication, University of Bari "Aldo Moro," Bari, Italy
| | - Jolanda Losole
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Bari, Italy
| | - Gennaro Ruggiero
- Department of Psychology, Second University of Naples, Caserta, Italy
| | - Santa Iachini
- Department of Psychology, Second University of Naples, Caserta, Italy
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, Occupational Health Division, University of Bari "Aldo Moro," Bari, Italy
| | - Angelo Vacca
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro," Bari, Italy
| | - Maria Fara De Caro
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Bari, Italy
| | - Antonietta Curci
- Department of Education, Psychology, Communication, University of Bari "Aldo Moro," Bari, Italy
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15
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Greenberg JA, Basapur S, Quinn TV, Bulger JL, Schwartz NH, Oh SK, Shah RC, Glover CM. Challenges faced by families of critically ill patients during the first wave of the COVID-19 pandemic. PATIENT EDUCATION AND COUNSELING 2022; 105:297-303. [PMID: 34507866 PMCID: PMC8393512 DOI: 10.1016/j.pec.2021.08.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To understand how surrogates of critically ill patients adjusted to challenges that resulted from the COVID-19 pandemic. METHODS Participants (N = 62) were surrogates of critically ill adults with COVID-19 in the ICU at an urban, academic medical center from March to June 2020. Participants were recruited using convenience sampling and took part in one-time qualitative individual interviews via telephone. Qualitative data were analyzed using thematic content analysis. RESULTS Qualitative analyses yielded four types of challenges: Communication with the medical team, communication among family members, understanding and tracking medical information, and distress related to visitor restrictions. To adjust to challenges related to communication, participants developed routines for receiving updates from the medical team and providing updates to other family members. To adjust to the challenge related to comprehension, participants sought information from external sources such as family members in healthcare fields. To adjust to the challenge related to visitation, participants found some comfort in video calls with the patient. CONCLUSIONS Surrogates of critically ill patients with COVID-19 faced multiple types of challenges yet adjusted to those challenges. PRACTICAL IMPLICATIONS Future research should focus on ways to support the wellbeing of surrogates during times of restricted hospital visitation. Clinical trial registered at ClinicalTrials.gov (NCT03969810).
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Affiliation(s)
- Jared A Greenberg
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Rush University Medical Center, 1725 W. Harrison St., Suite 010, Chicago, IL, USA.
| | - Santosh Basapur
- Office of Design, Academic Support Services, Rush University Medical Center, Chicago, IL, USA
| | - Thomas V Quinn
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Rush University Medical Center, 1725 W. Harrison St., Suite 010, Chicago, IL, USA
| | - Jeffrey L Bulger
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | | | | | - Raj C Shah
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Family Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush Medical College, Chicago, IL, USA
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16
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Psychological Symptoms in COVID-19 Patients: Insights into Pathophysiology and Risk Factors of Long COVID-19. BIOLOGY 2022; 11:biology11010061. [PMID: 35053059 PMCID: PMC8773222 DOI: 10.3390/biology11010061] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 12/17/2022]
Abstract
There is growing evidence of studies associating COVID-19 survivors with increased mental health consequences. Mental health implications related to a COVID-19 infection include both acute and long-term consequences. Here we discuss COVID-19-associated psychiatric sequelae, particularly anxiety, depression, and post-traumatic stress disorder (PTSD), drawing parallels to past coronavirus outbreaks. A literature search was completed across three databases, using keywords to search for relevant articles. The cause may directly correlate to the infection through both direct and indirect mechanisms, but the underlying etiology appears more complex and multifactorial, involving environmental, psychological, and biological factors. Although most risk factors and prevalence rates vary across various studies, being of the female gender and having a history of psychiatric disorders seem consistent. Several studies will be presented, demonstrating COVID-19 survivors presenting higher rates of mental health consequences than the general population. The possible mechanisms by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the brain, affecting the central nervous system (CNS) and causing these psychiatric sequelae, will be discussed, particularly concerning the SARS-CoV-2 entry via the angiotensin-converting enzyme 2 (ACE-2) receptors and the implications of the immune inflammatory signaling on neuropsychiatric disorders. Some possible therapeutic options will also be considered.
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17
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Schaefert R, Stein B, Meinlschmidt G, Roemmel N, Huber CG, Hepp U, Saillant S, Fazekas C, Vitinius F. COVID-19-Related Psychosocial Care in General Hospitals: Results of an Online Survey of Psychosomatic, Psychiatric, and Psychological Consultation and Liaison Services in Germany, Austria, and Switzerland. Front Psychiatry 2022; 13:870984. [PMID: 35815043 PMCID: PMC9270003 DOI: 10.3389/fpsyt.2022.870984] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/27/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic was accompanied by new challenges for psychosocial health care to enable the support of affected patients, their families, and staff in general hospitals. In this study, we aimed to describe the structures and procedures put in place by psychosomatic, psychiatric, and psychological consultation and liaison (CL) services in German, Austrian, and Swiss general hospitals, and to elucidate the emerging needs for cooperation, networking, and improvement. METHODS We conducted a cross-sectional online survey between December 2020 and May 2021, using a 25-item questionnaire derived from relevant literature, professional experience, and consultation with the participating professional societies. The survey was disseminated via national professional societies, relevant working and interest groups, and heads of the above-mentioned CL services. RESULTS We included responses from 98 CL services in the analyses, with a total response rate of 55% of surveyed hospital CL services; 52 responses originated from Germany, 20 from Austria, and 26 from Switzerland. A total of 77 (79%) of the 98 responding CL services reported that "COVID-19-related psychosocial care" (COVID-psyCare) was provided in their hospital. Among these, 47 CL services (61%) indicated that specific cooperation structures for COVID-psyCare had been established within the hospital. A total of 26 CL services (34%) reported providing specific COVID-psyCare for patients, 19 (25%) for relatives, and 46 (60%) for staff, with 61, 12, and 27% of time resources invested for these target groups, respectively. Regarding emerging needs, 37 (48%) CL services expressed wishes for mutual exchange and support regarding COVID-psyCare, and 39 (51%) suggested future changes or improvements that they considered essential. CONCLUSION More than three-quarters of the participating CL services provided COVID-psyCare for patients, their relatives, or staff. The high prevalence of COVID-psyCare services targeting hospital staff emphasizes the liaison function of CL services and indicates the increased psychosocial strain on health care personnel during the COVID-19 pandemic. Future development of COVID-psyCare warrants intensified intra- and interinstitutional exchange and support. TRIAL REGISTRATION ClinicalTrials.gov NCT04753242, version 11 February 2021.
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Affiliation(s)
- Rainer Schaefert
- Department of Psychosomatic Medicine, Faculty of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
| | - Gunther Meinlschmidt
- Department of Psychosomatic Medicine, Faculty of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland.,Department of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University, Berlin, Germany
| | - Noa Roemmel
- Department of Psychosomatic Medicine, Faculty of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christian G Huber
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Urs Hepp
- Integrated Psychiatric Services Winterthur - Zurcher Unterland, Winterthur, Switzerland
| | - Stéphane Saillant
- Department of General and Liaison Psychiatry, Neuchâtel Psychiatry Center (CNP), Neuchâtel, Switzerland
| | - Christian Fazekas
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Frank Vitinius
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
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18
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Zhou T, Guan R, Rosenthal SL, Moerdler S, Guan Z, Sun L. Supporting Health-Care Workers and Patients in Quarantine Wards: Evidence From a Survey of Frontline Health-Care Workers and Inpatients With COVID-19 in Wuhan, China. Front Public Health 2021; 9:705354. [PMID: 34733814 PMCID: PMC8558351 DOI: 10.3389/fpubh.2021.705354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/13/2021] [Indexed: 11/15/2022] Open
Abstract
Objective: Frontline health-care workers and patients with COVID-19 have been identified as high-risk groups for psychological problems. Experience of working or staying in quarantine wards generated psychological stressors for health-care workers and patients with COVID-19. The present study aimed to investigate the psychological symptoms of hospitalized patients with COVID-19 and the health-care workers treating them during the outbreak period, examine the effects of psychological stressors on mental health in both populations and perceived coping resources for both sides. Methods: Three hundred and eleven health-care workers working in a COVID-19 designated hospital in Wuhan, China, and 148 hospitalized patients with COVID-19 in the same hospital participated in this cross-sectional survey conducted in February 2020. Psychological symptoms, psychological stressors, and perceived coping resources were reported by both groups. Results: Thirty-three percent of health-care workers and 35.2% of patients with COVID-19 had significant psychological symptoms that were indicative of a high risk for psychological disorders. Pandemic-related psychological stressors contributed to psychological symptoms for both populations. Concern about patients was one aspect of psychological stressors of frontline health-care workers and both groups perceived support from the opposite side as an important external coping resource. Conclusion: The results shed light on the need to provide psychological support to both frontline health-care workers and patients with COVID-19 and suggest enhancing the treatment alliance might be effective to improve mental health for both populations during the crisis.
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Affiliation(s)
- Ting Zhou
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China
| | - Ruiyuan Guan
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China
| | - Susan L Rosenthal
- Department of Pediatrics, Columbia University Irving Medical Center-Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Scott Moerdler
- Division of Pediatric Hematology Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Ziqi Guan
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Liqun Sun
- Intensive Care Unit, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Kowalski E, Schneider A, Zipfel S, Stengel A, Graf J. SARS-CoV-2 Positive and Isolated at Home: Stress and Coping Depending on Psychological Burden. Front Psychiatry 2021; 12:748244. [PMID: 34880791 PMCID: PMC8645573 DOI: 10.3389/fpsyt.2021.748244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/01/2021] [Indexed: 12/28/2022] Open
Abstract
Objective: The SARS-CoV-2 pandemic has led to pronounced health changes, especially for those infected and psychologically burdened. This cross-sectional study examined the stress experience and coping strategies during home isolation of SARS-CoV-2 infected individuals and analyzed differences regarding psychological burden. Methods: SARS-CoV-2 infected respondents were recruited by telephone and completed an online survey during their home isolation. This questionnaire assessed sociodemographic aspects, somatic factors, psychological burden (depressive symptoms, anxiety, and somatic symptom disorder), perceived stress and coping behavior during the home isolation. Results: Out of 838 SARS-CoV-2 infected individuals during the study period, 648 were contacted and 224 home-isolated respondents were included in the study. Disgrace, social restrictions, job fear, health concerns, and infectiousness could be explored as stressors during the home isolation. Fifty-four percent experienced psychological burden. SARS-CoV-2 infected and home-isolated individuals with psychological burden perceived significant stressors more strongly (p < 0.001, r = 0.5) and coped significantly less (p < 0.001, r = 0.3) with their infection and home isolation compared to SARS-CoV-2 infected individuals without psychological burden. Conclusion: SARS-CoV-2 infected individuals with psychological burden experienced higher stressors and were unable to cope adaptively with home isolation. Therefore, a general and standardized screening procedure for psychological burden should be established. SARS-CoV-2 infected individuals with psychological burden should receive targeted support with professional help in the areas of stress experience and coping skills during their home isolation and beyond to avoid long-term consequences.
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Affiliation(s)
- Elias Kowalski
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Health Department Freudenstadt, Freudenstadt, Germany
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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