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Wu Y, Dai Z, Jing S, Liu X, Zhang L, Liu X, Ren T, Fu J, Chen X, Xiao W, Wang H, Huang Y, Wang W, Gu X, Ma L, Zhang S, Yu Y, Li L, Han Z, Su X, Qiao Y. Prevalence and influencing factors of PTSD symptoms among healthcare workers: A multicenter cross-sectional study during the surge period of the COVID-19 pandemic since December 2022 in the Chinese mainland. J Affect Disord 2024; 348:70-77. [PMID: 38065482 DOI: 10.1016/j.jad.2023.12.008] [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: 05/27/2023] [Revised: 10/28/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND China has experienced a surge period of COVID-19 pandemic since December 2022. Healthcare workers (HCWs) were exposed to huge workload under high risk of being infected, and significant levels of trauma, which might cause Post-traumatic Stress Disorders (PTSD) symptoms in HCWs. OBJECTIVES To identify the prevalence of PTSD symptoms among HCWs in the Chinese mainland during the surge period of the COVID-19 pandemic; to explore their psycho-social factors of PTSD symptoms. METHODS A multicenter cross-sectional study was conducted among HCWs in Chinese mainland from January 5 to February 9, 2023, covering seven geographical regions. 6552 participants were recruited by convenience sampling. Data were collected on demographic characteristics, work-related factors, and psychological factors by online questionnaires. Univariate analysis and binary logistic regression were used to determine the influencing factors of PTSD symptoms. RESULTS The prevalence of PTSD symptoms among HCWs was 37.49 %. A higher level of mindfulness, resilience, and perceived social support were protective factors. Female gender, nurses, higher educational attainment, married status, more working years, higher perceived risk of contracting COVID-19 due to work, and higher perceived work intensity were risk factors. CONCLUSION High prevalence of PTSD symptoms among HCWs necessitates psychological interventions. Tailored interventions, designed by professional psychiatrists, should be tailored to address the stressors. A comprehensive approach, incorporating mindfulness, resilience-building, and perceived social support enhancement, is vital to bolster the mental well-being of HCWs exposed to traumatic events, thus mitigating the impact of PTSD effectively. Additionally, it is essential to provide support to HCWs with other potential risk factors.
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Affiliation(s)
- Yijin Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shu Jing
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ling Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyang Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tianrui Ren
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wenjun Wang
- School of Nursing, Jining Medical University, Jining, Shandong, China
| | - Xiaofen Gu
- Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Shaokai Zhang
- Henan Cancer Hospital, Affiliate Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanqin Yu
- The First Affiliated Hospital of Baotou Medical College, Inner Mongolia, China
| | - Li Li
- Department of Clinical Research, the First Affiliated Hospital of Jinan University, Guangdong, China
| | - Zhili Han
- China Foreign Affairs University, Beijing, China.
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Gelaw A, Parker S, Johnson A, Nguyen H, Jolly A, Forner V, Deng C, Collie A. Determinants of psychological injury among health and social care workers in community settings: A systematic review. Work 2024; 78:3-27. [PMID: 38578915 DOI: 10.3233/wor-230426] [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] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Health and Social Care (HSC) workers face psychological health risks in the workplace. While many studies have described psychological injuries in HSC workers, few have examined the determinants. Previous research has primarily focused on hospitals, lacking systematic reviews of community-based settings. OBJECTIVE To systematically identify and appraise current evidence on the determinants of psychological injuries among HSC workers in community settings. METHODS Searches were conducted in three bibliographic databases, supplemented by citation searches. Included studies focused on community-based HSC workers, reporting statistical associations between psychological injury and personal, health, occupational, or organizational factors. Quantitative studies published in English between January 1, 2000 and August 15, 2023 were included. Quality appraisal was undertaken using the JBI critical appraisal checklist. RESULTS Sixty-six studies were included. Study quality was highly variable, and all studies were cross-sectional. Twenty-three studies linked psychological injury with occupational factors (e.g. low job control, high job demands and low job satisfaction). Thirteen studies observed an association between work environment and psychological injury, and a further eleven between workplace social support and psychological injury. Fewer studies have examined the relationship between psychological injury and personal/individual factors. CONCLUSION Occupational and organisational factors are significantly associated with psychological health among HSA workers, in community settings. These aspects of job design, work environment and workplace relationships are modifiable, suggesting an opportunity for work design interventions to improve workers' psychological health and reduce the prevalence of psychological injury in this sector.
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Affiliation(s)
- Asmare Gelaw
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sharon Parker
- Future of Work Institute, Curtin University, Perth, WA, Australia
| | - Anya Johnson
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Helena Nguyen
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Anu Jolly
- Future of Work Institute, Curtin University, Perth, WA, Australia
| | - Vivien Forner
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Connie Deng
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Braule Pinto ALDC, Serpa ALDO, Guatimosim RF, Costa DS, de Paula JJ, da Silva AG, Diaz AP, de Miranda DM, Malloy-Diniz LF. Longitudinal profile of post-traumatic symptoms in HealthCare Workers during COVID-19 pandemic: A latent transition model. J Psychiatr Res 2023; 168:230-239. [PMID: 37922597 DOI: 10.1016/j.jpsychires.2023.10.031] [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: 01/09/2023] [Revised: 08/03/2023] [Accepted: 10/14/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Pandemics have the potential to be considered traumatic event, increasing the risk of developing post-traumatic stress symptoms (PTSS) in HealthCare Workers (HCW). However, few longitudinal studies have evaluated the impact of prolonged exposure to the risk imposed by COVID-19. Our aim was to identify subgroups of HCW with profiles of PTSS, how this profile changed during the pandemic and which variables were related to these changes. METHODS We evaluated the levels of PTSS and psychological distress in a Brazilian HealthCare Workers' sample (n = 1398) in three waves of assessment: from May to June 2020 (Wave 1), December 2020 to February 2021 (Wave 2) and May to August 2021 (Wave 3), using Latent Profile Analysis (LPA) to identify subgroups with different profiles of symptms, and then, Latent Transition Analysis (LTA) was applied to examine changes in symptom profiles over time, including gender, psychiatric diagnosis history, and pandemic-related fears as covariates. RESULTS two profiles were identified: high-PTSS profile (Wave 1-23%; Wave 2-64% and Wave 3-73%) and a low-PTSS (Wave 1-77%; Wave 2-36% and Wave 3-27%). Being female, fear of contamination, and fearing financial problems were strong predictors of changes in the profile. In addition, the participants had a high probability of being in the high-PTSS in the long run. CONCLUSION These results suggests that targeted interventions can mitigate the impact of pandemic. Providing financial support, and psychological support can be beneficial for those with psychiatric diagnoses and experiencing bereavement.
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Affiliation(s)
- André Luiz de Carvalho Braule Pinto
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Ensino e Pesquisa (DENPE), Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Alexandre Luiz de Oliveira Serpa
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; SCNLab, Centro de Ciências Biológicas e da Saúde e do Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, Brazil.
| | - Rafaela Ferreira Guatimosim
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Danielle Souza Costa
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Jonas Jardim de Paula
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Antônio Geraldo da Silva
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Associação Brasileira de Psiquiatria (ABP), Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Faculdade de Medicina da Universidade do Porto, Portugal.
| | - Alexandre Paim Diaz
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Associação Brasileira de Psiquiatria (ABP), Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester, New York, USA.
| | - Débora Marques de Miranda
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Leandro Fernandes Malloy-Diniz
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Boucher VG, Haight BL, Hives BA, Zumbo BD, Merali-Dewji A, Hutton S, Liu Y, Nguyen S, Beauchamp MR, Black AT, Puterman E. Effects of 12 Weeks of At-Home, Application-Based Exercise on Health Care Workers' Depressive Symptoms, Burnout, and Absenteeism: A Randomized Clinical Trial. JAMA Psychiatry 2023; 80:1101-1109. [PMID: 37556150 PMCID: PMC10413218 DOI: 10.1001/jamapsychiatry.2023.2706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/28/2023] [Indexed: 08/10/2023]
Abstract
Importance During the COVID-19 pandemic, health care workers (HCWs) reported a significant decline in their mental health. One potential health behavior intervention that has been shown to be effective for improving mental health is exercise, which may be facilitated by taking advantage of mobile application (app) technologies. Objective To determine the extent to which a 12-week app-based exercise intervention can reduce depressive symptoms, burnout, and absenteeism in HCWs, compared with a wait list control condition. Design, Setting, and Participants A 2-group randomized clinical trial was conducted, with participants screened from April 6 to July 4, 2022. Participants were recruited from an urban health care organization in British Columbia, Canada. Participants completed measures before randomization and every 2 weeks thereafter. Interventions Exercise condition participants were asked to complete four 20-minute sessions per week using a suite of body weight interval training, yoga, barre, and running apps. Wait-listed control participants received the apps at the end of the trial. Main Outcomes and Measures The primary outcome consisted of the between-group difference in depressive symptoms measured with the 10-item Center for Epidemiological Studies Depression Scale. The secondary outcomes corresponded to 3 subfacets of burnout (cynicism, emotional exhaustion, and professional efficacy) and absenteeism. Intention-to-treat analyses were completed with multilevel structural equation modeling, and Feingold effect sizes (ES) were estimated every 2 weeks. Results A total of 288 participants (mean [SD] age, 41.0 [10.8] years; 246 [85.4%] women) were randomized to either exercise (n = 142) or wait list control (n = 146) conditions. Results revealed that ESs for depressive symptoms were in the small to medium range by trial's end (week 12, -0.41 [95% CI, -0.69 to -0.13]). Significant and consistent treatment effects were revealed for 2 facets of burnout, namely cynicism (week 12 ES, -0.33 [95% CI, -0.53 to -0.13]) and emotional exhaustion (week 12 ES, -0.39 [95% CI, -0.64 to -0.14]), as well as absenteeism (r = 0.15 [95% CI, 0.03-0.26]). Adherence to the 80 minutes per week of exercise decreased from 78 (54.9%) to 33 (23.2%) participants between weeks 2 and 12. Conclusions and Relevance Although exercise was able to reduce depressive symptoms among HCWs, adherence was low toward the end of the trial. Optimizing adherence to exercise programming represents an important challenge to help maintain improvements in mental health among HCWs. Trial Registration ClinicalTrials.gov Identifier: NCT05271006.
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Affiliation(s)
| | - Brook L. Haight
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Benjamin A. Hives
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruno D. Zumbo
- Department of Educational and Counselling Psychology and Special Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aaliya Merali-Dewji
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stacey Hutton
- Canadian Sport Institute Pacific, Victoria, British Columbia, Canada
| | - Yan Liu
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Suzanne Nguyen
- Providence Health Care, Vancouver, British Columbia, Canada
| | - Mark R. Beauchamp
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Agnes T. Black
- Providence Health Care, Vancouver, British Columbia, Canada
| | - Eli Puterman
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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Dong Q, Yang Y, Ma M, Ou W, Lv G, Huang M, Li Y, Lu Y, Fan A, Ju Y, Zhang Y. Posttraumatic stress symptoms in healthcare workers during the COVID-19 pandemic: A four-wave longitudinal study. Psychiatry Res 2023; 327:115406. [PMID: 37591109 DOI: 10.1016/j.psychres.2023.115406] [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: 04/29/2023] [Revised: 07/30/2023] [Accepted: 08/05/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Posttraumatic stress symptoms of healthcare workers have become a significant public concern in the healthcare system that have long COVID-19. It is less known how the pandemic impacts the HCWs' PTSS longitudinally and long-term risk factors for it. METHODS Four consecutive surveys were conducted among healthcare workers in China from 2019 to 2023 COVID-19 outbreaks. Multilevel mixed-effect models were used to examine longitudinal changes and risk factors. Network analysis was utilized to explore network centrality changes in PTSS symptoms. RESULTS HCWs' PTSS symptoms were increased over time during the COVID-19 pandemic. Being female, being nurse, working in the emergency department, working longer hours, less frequently going back home and having COVID-19 infection are risk factors of PTSS for HCWs; unmarried is the protective factor. Significant interaction between symptom changes and profession exists. PTSS networks showed that Avoidance of thoughts, Emotional-cue activity, Exaggerated startle response and Hypervigilance were the central symptoms during four waves. The global strength of the PTSS network grows over time, and nodal strength of Avoidance of thoughts, Loss of interest and Negative beliefs increased by COVID-19. CONCLUSION The pandemic's impacts on healthcare workers vary by professions. PTSS symptoms exacerbate, reinforce each other, and persists with recurring waves.
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Affiliation(s)
- Qiangli Dong
- Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou, China
| | - Yumeng Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Mohan Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Wenwen Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Guanyi Lv
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Mei Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Yunjing Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Yimei Lu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Ajiao Fan
- Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou, China
| | - Yumeng Ju
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China.
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China.
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Yule AM, Basaraba C, Mail V, Bereznicka A, Cates-Wessel K, Levin FR. A cross sectional survey of provider experiences with patient drug overdose death. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 148:209008. [PMID: 36921768 PMCID: PMC10423649 DOI: 10.1016/j.josat.2023.209008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/13/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION A record number of drug overdose (OD) deaths occurred in the United States in 2021. We know little regarding the impact of patient drug OD deaths on providers within health care settings. The aim of this study was to assess provider preparedness and experience with patient drug OD death. METHODS The study distributed an email invitation to individuals in the Provider Clinical Support System database in December 2020 to complete an anonymous web-based survey. We used multiple choice questions to assess provider demographics, preparedness to cope with patient OD death, and experience with patient OD death. The study evaluated stress associated with patient OD death using the Impact of Event Scale-Revised. We summarized responses using descriptive statistics. Associations between high stress after patient OD death and the impact of the death on clinical practice and the helpfulness of individuals and processes were assessed using Chi-square and Fisher's Exact tests. RESULTS Among the 12,204 individuals who read the email invitation, 1064 opened the survey link, and 523 completed the survey. Participants were predominantly physicians (40.2 %) and counselors (25 %), 70 % female, 78.4 % white, with a mean age of 52 years. Among the participants 26.4 % felt at least very well prepared to cope with an OD death, and 27.7 % felt at least very well prepared to support a colleague with a patient OD death. Most respondents (55.1 %) had a history of a patient OD death. Many patient OD deaths were not discussed by providers with other colleagues, but when providers did discuss these deaths providers identified colleagues as being very helpful. Compared to providers with low stress after patient OD death, those with high levels of stress were more likely to refer patients to a higher level of care (p = 0.035). CONCLUSIONS Many providers did not feel prepared themselves to cope with a patient OD death or support a colleague following this type of event. Patient OD deaths were a common experience, and providers did not frequently discuss their patient's deaths with others. A patient OD death can change clinical decision-making for providers experiencing high levels of stress related to the OD death.
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Affiliation(s)
- Amy M Yule
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Boston, MA 02118, USA; Department of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Boston, MA 02118, USA.
| | - Cale Basaraba
- Department of Psychiatry, Columbia University, 1051 Riverside Dr, New York, NY 10032, USA; Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - Victoria Mail
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Boston, MA 02118, USA
| | - Agata Bereznicka
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Boston, MA 02118, USA; Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Kathryn Cates-Wessel
- American Academy of Addiction Psychiatry, 400 Massasoit Ave #307, East Providence, RI 02914, USA
| | - Frances R Levin
- Department of Psychiatry, Columbia University, 1051 Riverside Dr, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
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Qualitative Analysis of a Roundtable Exercise "Reflecting on the COVID-19 Experience of Public Health Professionals". JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:E128-E136. [PMID: 36727794 DOI: 10.1097/phh.0000000000001703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
CONTEXT Public health professionals around the country faced significant challenges responding to the COVID-19 pandemic. Reflecting on their experience is an essential element in making sense of their experience and learning from it. OBJECTIVE The objective of this qualitative study was to (1) describe the lived experiences of public health professionals working during the COVID-19 pandemic, (2) discuss the effectiveness of a guided reflection exercise to help public health professionals process these experiences, and (3) provide lessons learned and best practices to inform preparation for a future infectious disease pandemic. DESIGN Qualitative focus group study design. SETTING This activity was conducted at a Midwestern state public health professional meeting. PARTICIPANTS Forty-eight public health professionals self-selected to participate in this study. RESULTS Five themes were elicited in this analysis, including Communication, Leadership and Collaboration, Data Management, Community Relationships, and Resources and Planning. In addition, public health professionals reported numerous lessons learned, including the need for more leadership from the state government, the conflicted response of their communities, and the benefits of community solidarity where it was present. CONCLUSIONS This article provides a detailed account of public health workers' experiences during the COVID-19 pandemic. It also provides lessons learned that will help public health workers lead more effectively in the future. Guided reflection on a traumatic professional experience can assist participating individuals in making sense of their experience and learning important lessons from it.
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Marques da Rocha MC, Malloy-Diniz LF, Romano-Silva MA, Joaquim RM, Serpa ALDO, Paim Diaz A, de Paula JJ, Costa DS, da Silva AG, Pinto ALDCB, de Miranda DM. Decision-making styles during stressful scenarios: The role of anxiety in COVID-19 pandemic. Front Psychiatry 2023; 14:1105662. [PMID: 37091714 PMCID: PMC10115220 DOI: 10.3389/fpsyt.2023.1105662] [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: 11/22/2022] [Accepted: 02/23/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Decision-making is not purely rational but highlighted by the influence of intuitive and emotional processes. Recently, researchers have focused more attention on understanding which environmental and personal features influence decision-making processes, and how. Objective and methods On this study, we investigate whether Trait Anxiety moderates the impact of Post-Traumatic Stress (PTS) symptoms reported during COVID-19 pandemic on decision-making styles. Results The study included 1,358 Brazilian participants (80% women) aged between 20 and 74 (M = 41.11; SD = 11.23) who responded to an online survey between May and August of the year 2021 of COVID-19 pandemic to The State-Trait Anxiety Inventory, The Decisions Styles Scale, The Impact of Event Scale - Revised and questions related to COVID-19. Through moderation analysis, we observed that experiencing PTS is associated with a higher tendency to biased/heuristic decision-making processes. Discussion Trait Anxiety seems to influence how people respond to PTS symptoms on decision-making related processes. Subjects with higher Trait Anxiety reported lower tendency to appeal to rationality, especially under higher reported levels of PTS. Meanwhile, lower Trait Anxiety subjects exhibited more reason-based decision-making under higher rates of PTS. This work contributes to a deeper understanding of the interplay among environmental and individual differences on decision-making styles and helps to identify factors of vulnerability for poorer cognitive functioning on stressful scenarios.
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Affiliation(s)
- Mariana Castro Marques da Rocha
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro Fernandes Malloy-Diniz
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Department of Psychiatry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Rui Mateus Joaquim
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
| | | | - Alexandre Paim Diaz
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
| | - Jonas Jardim de Paula
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Department of Psychiatry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Antônio Geraldo da Silva
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - André Luiz de Carvalho Braule Pinto
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Marques de Miranda
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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9
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Mullins RJ, Meeker TJ, Vinch PM, Tulloch IK, Saffer MI, Chien JH, Bienvenu OJ, Lenz FA. A Cross-Sectional Time Course of COVID-19 Related Worry, Perceived Stress, and General Anxiety in the Context of Post-Traumatic Stress Disorder-like Symptomatology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7178. [PMID: 35742432 PMCID: PMC9222603 DOI: 10.3390/ijerph19127178] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/26/2022] [Accepted: 06/08/2022] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic within the United States of America resulted in over 800,000 deaths as of February 2022 and has been addressed by social distancing or stay-at-home measures. Collective prolonged multimodal trauma on this scale is likely to elicit symptomatology in the general population consistent with post-traumatic stress disorder (PTSD), somatization, anxiety, and stress. The psychological component of this response contributes substantially to the burden of this disease worldwide. This cross-sectional study examines the relationship between COVID-19-related concern, anxiety, and perceived stress on PTSD-like symptomatology over the course of the COVID-19 pandemic. Participants were recruited via social media within the United States of America between 8th May 2020 and 11th August 2021 to complete an internet questionnaire including mood, personality, and COVID-19-specific scales. General anxiety and PTSD-like symptomatology were above the screening cutoffs for most respondents. These measures increased in severity over the pandemic, with the change point of our Concern scale preceding that of the other significant measures. Measures of COVID-19-related concern, generalized anxiety, and PTSD-like symptomatology were strongly correlated with each other. Anxiety, perceived stress, and PTSD-like symptomatology are strongly interrelated, increase with pandemic length, and are linked to reported levels of concern over COVID-19. These observations may aid future research and policy as the pandemic continues.
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Affiliation(s)
- Roger J. Mullins
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287, USA; (R.J.M.); (P.M.V.); (M.I.S.); (J.-H.C.); (F.A.L.)
| | - Timothy J. Meeker
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287, USA; (R.J.M.); (P.M.V.); (M.I.S.); (J.-H.C.); (F.A.L.)
| | - Paige M. Vinch
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287, USA; (R.J.M.); (P.M.V.); (M.I.S.); (J.-H.C.); (F.A.L.)
| | - Ingrid K. Tulloch
- Department of Psychology, Morgan State University, Baltimore, MD 21251, USA;
| | - Mark I. Saffer
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287, USA; (R.J.M.); (P.M.V.); (M.I.S.); (J.-H.C.); (F.A.L.)
| | - Jui-Hong Chien
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287, USA; (R.J.M.); (P.M.V.); (M.I.S.); (J.-H.C.); (F.A.L.)
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21287, USA;
| | - Frederick A. Lenz
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287, USA; (R.J.M.); (P.M.V.); (M.I.S.); (J.-H.C.); (F.A.L.)
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