1
|
Barton C, Troy L, Teoh A, Spencer L, Reeves J, Cram V, Wai M, Jones L. COVID-19 and collective trauma: Implementing a trauma-informed model of care for post-COVID patients. J Adv Nurs 2024; 80:3593-3599. [PMID: 38294136 DOI: 10.1111/jan.16076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 12/20/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
AIM To describe the implementation of a trauma-informed model of care in the Post COVID Respiratory Clinic of a large tertiary referral centre in NSW. DESIGN Discussion paper. DATA SOURCES Evidence gathered from a literature search (2008-2022) was used to develop a framework for management of patients presenting to this Post COVID Respiratory Clinic. This paper outlines the personal reflections of the clinic staff as they developed and implemented this framework. Ethical approval was obtained to report the data collected from patient reviews. DISCUSSION The literature highlights the high prevalence of trauma in patients following COVID-19 infection, as well as the larger population both during and after the pandemic. This experience of trauma was observed in patients seen within the clinic, indicating a need for specialized care. In response, a trauma-informed model of care was implemented. CONCLUSION Reconceptualizing COVID-19 as a 'collective trauma' can help healthcare workers understand the needs of post-COVID patients and enable them to respond empathetically. A trauma-informed model is complementary to this cohort as it specifically addresses vulnerable populations, many of whom have been further marginalized by the pandemic. IMPLICATIONS FOR NURSING AND PATIENT CARE Frontline healthcare workers, particularly nurses, are well positioned to implement trauma-informed care due to their high-level of patient contact. Adequate allocation of resources and investment in staff is essential to ensure such care can be provided. IMPACT The COVID-19 pandemic has led to adverse physical and mental health outcomes for many. Trauma-informed care is a way to promote reengagement with the healthcare system in this group. Post COVID patients globally may benefit from this approach, as it aims to build trust and independence. PATIENT OR PUBLIC CONTRIBUTION Feedback was sought from a patient representative to ensure this paper adequately reflected the experience of the post-COVID patient.
Collapse
Affiliation(s)
- Carly Barton
- Department of Respiratory and Sleep Science, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Lauren Troy
- Department of Respiratory and Sleep Science, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Alan Teoh
- Department of Respiratory and Sleep Science, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Lissa Spencer
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jack Reeves
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Vincent Cram
- Department of Clinical Psychology, RPA Virtual, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Michael Wai
- Department of Clinical Psychology, RPA Virtual, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Lynette Jones
- Department of Respiratory and Sleep Science, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| |
Collapse
|
2
|
Closson K, Dong E, Zulu B, Dietrich JJ, Zharima C, Jesson J, Pakhomova T, Beksinska M, Kaida A. 'Life became harder with COVID-19': exploring the experiences of the COVID-19 pandemic among youth living in eThekwini district, South Africa. BMC Public Health 2024; 24:1922. [PMID: 39020372 PMCID: PMC11256542 DOI: 10.1186/s12889-024-19238-7] [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: 11/10/2023] [Accepted: 06/24/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND In South Africa, pervasive age and gender inequities have been exacerbated by the COVID-19 pandemic and public health response. We aimed to explore experiences of the COVID-19 pandemic among youth in eThekwini district, South Africa. METHODS Between December 2021-May 2022 we explored experiences of the COVID-19 pandemic on youth aged 16-24 residing in eThekwini, South Africa. We collated responses to the open-ended question "Has the COVID-19 pandemic affected you in any other way you want to tell us about?" in an online survey focused on understanding the pandemic's multi-levelled health and social effects. We used a thematic analysis to summarise the responses. RESULTS Of 2,068 respondents, 256 (12.4%, median age = 22, 60.9% women) completed the open-ended survey question (11% in isiZulu). Results were organized into three main themes encompassing (1) COVID-19-related loss, fear, grief, and exacerbated mental and physical health concerns; (2) COVID-19-related intensified hardships, which contributed to financial, employment, food, education, and relationship insecurities for individuals and households; and (3) positive effects of the pandemic response, including the benefits of government policies and silver linings to government restrictions. CONCLUSIONS We found that South African youth experienced significant grief and multiple losses (e.g., death, income, job, and educational) during the COVID-19 pandemic. Trauma-aware interventions that provide economic and educational opportunities must be included in post-COVID recovery efforts.
Collapse
Affiliation(s)
- Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
- Center of Gender Equity and Health, University of California San Diego, La Jolla, CA, United States.
| | - Erica Dong
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Bongiwe Zulu
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Janan J Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa
- African Social Sciences Unit of Research and Evaluation (ASSURE), Wits Health Consortium, Johannesburg, South Africa
| | - Campion Zharima
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Julie Jesson
- Center for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Tatiana Pakhomova
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Mags Beksinska
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| |
Collapse
|
3
|
Alnaddaf A, Baloğlu M. The validation of the Arabic version of the Coronavirus-2019 Phobia Scale (C19P-SA) and individual differences in coronaphobia experiences among an Arabic population. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:630-639. [PMID: 34219236 PMCID: PMC8427111 DOI: 10.1002/jcop.22642] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
The current study adapted the Coronavirus 19 Phobia Scale into Arabic and tested the psychometric properties of the adapted version on 469 Arabic-speaking individuals (mean age = 29.57 years old; SD = 10.39; range = 9-71 years old). After confirmatory analysis found supporting evidence for the four-factor structure, consequent analysis on convergent and discriminant validity and reliability of the Arabic version are also supported. A 2 × 2 between-groups factorial multivariate analysis of variance was used to investigate individual differences in coronaphobia. Results show that there is no significant interaction effect between gender and marital status, λ = 0.973, F (8,460) = 1600, p = 0.121, partial η2 = 0. 014; however, the main effect for gender is statistically significant, λ = 0.925, F (4,464) = 9.367, p < 0.001, partial η2 = 0.075, power = 1.000, where women score higher than men on all coronaphobia factors. In addition, the main effect for marital status is also significant, λ = 0.923, F (4,464) = 4.701, p < 0.001, partial η2 = 0.039, power = 0.998, where singles score higher than married couples on only two coronaphobia factors: Psychological and economic. Based on the findings, we conclude that the effects of coronaphobia have similarities across nations as well as differences unique to the Arabic populations.
Collapse
Affiliation(s)
- Abdelsalam Alnaddaf
- Department of Physical Education, College of Sport SciencesMutah UniversityMut'ahJordan
| | - Mustafa Baloğlu
- Department of Special Education, College of EducationHacettepe UniversityAnkaraTurkey
| |
Collapse
|
4
|
Graham Bn Advanced Prac Cmhn N, Whitaker BSocWk Msw PhD L, Smith BSocSci Hons St Class PhD Oam G, Hurley Cmhn PhD J. Trauma-Informed Care in Acute Adult Public Mental Health Settings: A Scoping Study Examining Implementation. Issues Ment Health Nurs 2024; 45:217-231. [PMID: 38466388 DOI: 10.1080/01612840.2024.2308543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Trauma-informed care (TIC) is not a new concept. Despite TIC being at the forefront of international acute public mental health services policy, and researched since 2006, implementation has been hampered. This paper reports findings from a scoping study examining clinical and lived experience workers experience of TIC in Acute Adult Public Mental Health Services. In this scoping study five databases and grey literature were scanned in 2021 and updated in 2023, to address the question: What is known about TIC concerning the clinical and mental health lived experience workforce in the acute adult public mental health service? Forty-six papers met the inclusion criteria. Analysis revealed commitment in conceptualisation of TIC in mental health policy, requirements for incorporating TIC in acute adult mental health care, and barriers to implementation, including dissonance towards role expectations. The literature calls for investment in implementing TIC, which includes an increased workforce consisting of mental health lived experience workers, clinical staff with TIC knowledge and skills, and specialist TIC experts. Further research is needed to understand more fully the opportunities and barriers to implementing TIC in acute public mental health settings.
Collapse
|
5
|
Sabado P, Kuoch K, Sngiem S, Peong V, Chan L, Hopson C, Veng T, Colfax G, Tham L, Sen-Matthews A, Ung V, Tieng P, Siphan C, Dance J, Chang K, Doxey J, Wood J, D'Anna L. A Community-Defined Approach to Address Trauma Among Cambodian Immigrants and Refugees. Health Promot Pract 2023:15248399231184450. [PMID: 37482758 DOI: 10.1177/15248399231184450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Asian American and Pacific Islanders are one of the fastest growing and most diverse groups in the United States. Yet, they are often aggregated as a single group, masking within-group differences in rates of disease and demographic characteristics commonly associated with elevated health risk. While more than four decades have passed since the Khmer Rouge genocide, Cambodians continue to experience trauma-related psychiatric disorders, including post-traumatic stress disorder and major depression. Funded by the California Department of Public Health Office of Health Equity, the Community Wellness Program (CWP) aimed to reduce mental health disparities among Cambodians in Long Beach and Santa Ana, California, using community-defined approaches. The 6-month program comprised community outreach, educational workshops, strengths-based case management, and social and spiritual activities. Our study aimed to examine the effects of the CWP on trauma symptoms. Program evaluation followed an incomplete stepped wedge waitlist design with two study arms. A linear mixed models analysis revealed that participants reported fewer trauma symptoms as a result of participation in the CWP and that participants experienced fewer symptoms over time. This is an especially important finding, as trauma can lead to long-term individual health effects and to social and health repercussions on an entire cultural group by way of intergenerational trauma. As the number of refugees and displaced individuals continues to grow, there is an urgent need for programs such as the CWP to prevent the lasting effects of trauma.
Collapse
Affiliation(s)
| | - Kimthai Kuoch
- Cambodian Association of American, Long Beach, CA, USA
| | | | | | - Ladine Chan
- Families in Good Health, Long Beach, CA, USA
| | - Chan Hopson
- Khmer Parent Association, Long Beach, CA, USA
| | | | - Gary Colfax
- Cambodian Association of American, Long Beach, CA, USA
| | - Lavyn Tham
- United Cambodian Community, Long Beach, CA, USA
| | | | - Virak Ung
- Cambodian Association of American, Long Beach, CA, USA
| | | | | | | | - Kyle Chang
- California State University, Long Beach, CA, USA
| | | | | | - Laura D'Anna
- California State University, Long Beach, CA, USA
| |
Collapse
|
6
|
Bragesjö M, Arnberg FK, Olofsdotter Lauri K, Aspvall K, Särnholm J, Andersson E. Condensed Internet-delivered prolonged exposure provided soon after trauma: a randomised trial. Psychol Med 2023; 53:1989-1998. [PMID: 37310324 PMCID: PMC10106292 DOI: 10.1017/s0033291721003706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/06/2021] [Accepted: 08/23/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Exposure to trauma is common and can have a profoundly negative impact on mental health. Interventions based on trauma-focused cognitive behavioural therapy have shown promising results to facilitate recovery. The current trial evaluated whether a novel, scalable and digital early version of the intervention, Condensed Internet-Delivered Prolonged Exposure (CIPE), is effective in reducing post-traumatic stress symptoms. METHOD A single-site randomised controlled trial with self-referred adults (N = 102) exposed to trauma within the last 2 months. The participants were randomised to 3 weeks of CIPE or a waiting list (WL) for 7 weeks. Assessments were conducted at baseline, week 1-3 (primary endpoint), week 4-7 (secondary endpoint) and at 6-month follow-up. The primary outcome measure was PTSD Checklist for DSM-5 (PCL-5). RESULTS The main analysis according to the intention-to-treat principle indicated statistically significant reductions in symptoms of post-traumatic stress in the CIPE group as compared to the WL group. The between-group effect size was moderate at week 3 (bootstrapped d = 0.70; 95% CI 0.33-1.06) and large at week 7 (bootstrapped d = 0.83; 95% CI 0.46-1.19). Results in the intervention group were maintained at the 6-month follow-up. No severe adverse events were found. CONCLUSIONS CIPE is a scalable intervention that may confer early benefits on post-traumatic stress symptoms in survivors of trauma. The next step is to compare this intervention to an active control group and also investigate its effects when implemented in regular care.
Collapse
Affiliation(s)
- Maria Bragesjö
- Department of Clinical Neuroscience, Division of Psychology, Nobels väg 9, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Filip K. Arnberg
- Department of Neuroscience, Psychiatry, National Centre for Disaster Psychiatry, 751 24 Uppsala, Sweden
- Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden
| | - Klara Olofsdotter Lauri
- Department of Clinical Neuroscience, Division of Psychology, Nobels väg 9, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Kristina Aspvall
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, 171 77 Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Josefin Särnholm
- Department of Clinical Neuroscience, Division of Psychology, Nobels väg 9, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Erik Andersson
- Department of Clinical Neuroscience, Division of Psychology, Nobels väg 9, Karolinska Institutet, 171 77 Stockholm, Sweden
| |
Collapse
|
7
|
Wilson N, McDaid S, Wieber F, Lindert J. European public mental health responses to the COVID-19 pandemic. Eur J Public Health 2023; 33:87-92. [PMID: 36410002 PMCID: PMC9897993 DOI: 10.1093/eurpub/ckac169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic increased multiple risk factors for mental health. Evidence-based, intersectoral public mental health responses are therefore critical. The primary aim of this study was to collate public mental health responses from across Europe. METHODS We conducted a cross-sectional survey in March 2021. Participants were public and mental health professionals from across Europe. We developed an online instrument exploring five domains: changes in mental health supports during the pandemic; mental health support for vulnerable groups; multi-sectoral and service-user involvement; published mental health response plans; and perceived quality of overall country response. RESULTS Fifty-two individuals from 20 European nations responded. Reported changes in mental health supports included an increase in online mental health supports (n = 18); but no change in long-term mental health funding (n = 13); and a decrease in access to early interventions (n = 9). Responses indicated mental health support for vulnerable groups was limited, as was multi-sectoral and service-user involvement. Few national mental health response plans existed (n = 9) and 48% of respondents felt their countries mental health response had been 'poor' or 'very poor'. CONCLUSIONS Our results give insights into the changes in mental health support at a country level across Europe during the COVID-19 pandemic. They indicate countries were not prepared to respond and people with existing vulnerabilities were often neglected in response planning. To be prepared for future pandemics and environmental disasters Public Mental Health preparedness plans are highly needed. These must be developed cross-departmentally, and through the meaningful inclusion of vulnerable groups.
Collapse
Affiliation(s)
| | | | - Frank Wieber
- Zurich University of Applied Sciences, Zurich, Switzerland
| | - Jutta Lindert
- University of Applied Sciences Emden/Leer, Emden, Germany
| |
Collapse
|
8
|
Trauma-informed care for perinatal women during the COVID-19 pandemic: A survey of nurses and midwives in Turkey. Midwifery 2023; 116:103555. [PMID: 36434849 PMCID: PMC9657894 DOI: 10.1016/j.midw.2022.103555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/02/2022] [Accepted: 11/11/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES There is a paucity of evidence on the provision of trauma-informed care among nurses and midwives during the pandemic.Therefore, this online survey of Turkish nurses and midwives aimed to: describe reported maternal concerns and anxieties during the COVID-19 pandemic; and explore aspects of trauma-informed care for perinatal women during the COVID-19 pandemic (i.e., nurses' and midwives' knowledge, opinions, perceived competence, current practices, and implementation barriers). DESIGN A cross-sectional descriptive survey design. SETTING AND PARTICIPANTS A web-based survey conducted between June 2021 to December 2021. A total of 102 nurses and midwives comprised the final sample of this study. FINDINGS The safety of COVID-19 vaccine was both the most common maternal concern (73%) and the most frequently noted maternal source of anxiety (79%) reported to nurses and midwives by perinatal women. Most nurses and midwives were knowledgeable of, held favorable opinion about, and perceived moderate competence in trauma-informed care. The most frequently provided practice was encouraging mothers to make use of their own social support system (82%). Time constrains and lack of resources were perceived as somewhat to significant barriers to providing trauma-informed care during the pandemic. CONCLUSIONS Access to correct information related to COVID-19 vaccination is necessary to reduce maternal anxiety. Since perinatal nurses and midwives had favorable opinions concerning implementing trauma-informed care, successful strategies for mitigating the implementation barriers are essential to facilitate the provision of trauma-informed care during the pandemic.
Collapse
|
9
|
Chu CH, Yee AV, Stamatopoulos V. “It’s the worst thing I’ve ever been put through in my life”: the trauma experienced by essential family caregivers of loved ones in long-term care during the COVID-19 pandemic in Canada. Int J Qual Stud Health Well-being 2022; 17:2075532. [PMID: 35638169 PMCID: PMC9176373 DOI: 10.1080/17482631.2022.2075532] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background Essential family caregivers (EFCs) of relatives living in long-term care homes (LTCHs) experienced restricted access to their relatives due to COVID-19 visitation policies. Residents’ experiences of separation have been widely documented; yet, few have focused on EFCs’ traumatic experiences during the pandemic. Objective: This study aims to explore the EFCs’ trauma of being locked out of LTCHs and unable to visit their loved ones in-person during COVID-19. Methods Seven online focus groups with a total of 30 EFCs from Ontario and British Columbia, Canada were conducted as part of a larger mixed-method study. We used an inductive approach to thematic analysis to understand the lived experiences of trauma. Results Four trauma-related themes emerged: 1) trauma from prolonged separation from loved ones; 2) trauma from uncompassionate interactions with the LTCH’s staff and administrators; 3) trauma from the inability to provide care to loved ones, and 4) trauma from experiencing prolonged powerlessness and helplessness. Discussion The EFCs experienced a collective trauma that deeply impacted their relationships with their relatives as well as their perception of the LTC system. Experiences endured by EFCs highlighted policy and practice changes, including the need for trauma-centred approaches to repair relational damage and post-pandemic decision-making that collaborates with EFCs.
Collapse
Affiliation(s)
- Charlene H. Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Amanda V. Yee
- Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Vivian Stamatopoulos
- Faculty of Social Science and Humanities, Ontario Tech University, Oshawa, Ontario, Canada
| |
Collapse
|
10
|
Heris CL, Kennedy M, Graham S, Bennetts SK, Atkinson C, Mohamed J, Woods C, Chennall R, Chamberlain C. Key features of a trauma-informed public health emergency approach: A rapid review. Front Public Health 2022; 10:1006513. [PMID: 36568798 PMCID: PMC9771594 DOI: 10.3389/fpubh.2022.1006513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
Abstract
COVID-19 is a major threat to public safety, and emergency public health measures to protect lives (e.g., lockdown, social distancing) have caused widespread disruption. While these measures are necessary to prevent catastrophic trauma and grief, many people are experiencing heightened stress and fear. Public health measures, risks of COVID-19 and stress responses compound existing inequities in our community. First Nations communities are particularly at risk due to historical trauma, ongoing socio-economic deprivation, and lack of trust in government authorities as a result of colonization. The objective of this study was to review evidence for trauma-informed public health emergency responses to inform development of a culturally-responsive trauma-informed public health emergency framework for First Nations communities. We searched relevant databases from 1/1/2000 to 13/11/2020 inclusive, which identified 40 primary studies (and eight associated references) for inclusion in this review. Extracted data were subjected to framework and thematic synthesis. No studies reported evaluations of a trauma-informed public health emergency response. However, included studies highlighted key elements of a "trauma-informed lens," which may help to consider implications, reduce risks and foster a sense of security, wellbeing, self- and collective-efficacy, hope and resilience for First Nations communities during COVID-19. We identified key elements for minimizing the impact of compounding trauma on First Nations communities, including: a commitment to equity and human rights, cultural responsiveness, good communication, and positive leadership. The six principles guiding trauma-informed culturally-responsive public health emergency frameworks included: (i) safety, (ii) empowerment, (iii) holistic support, (iv) connectedness and collaboration, (v) compassion and caring, and (vi) trust and transparency in multi-level responses, well-functioning social systems, and provision of basic services. These findings will be discussed with First Nations public health experts, together with data on the experiences of First Nations families and communities during COVID-19, to develop a trauma-integrated public health emergency response framework or "lens" to minimize compounding trauma for First Nations communities.
Collapse
Affiliation(s)
- Christina L. Heris
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Murdoch Children's Research Institute, Parkville, VIC, Australia
| | | | | | - Cindy Woods
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Richard Chennall
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Lowitja Institute, Collingwood, VIC, Australia,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia,Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA, Australia,*Correspondence: Catherine Chamberlain
| |
Collapse
|
11
|
Macedo DM, Reilly JA, Pettit S, Negoita C, Ruth L, Cox E, Staugas R, Procter N. Trauma-informed mental health practice during COVID-19: Reflections from a Community of Practice initiative. Int J Ment Health Nurs 2022; 31:1021-1029. [PMID: 35574711 PMCID: PMC9321098 DOI: 10.1111/inm.13013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 01/15/2023]
Abstract
This article discusses insights arising from a Community of Practice (CoP) initiative within a mental health short stay inpatient unit adjacent to a major Emergency Department to explore how COVID-19 has influenced engagement and support of people in mental distress. The present initiative was designed as a collaboration between the University of South Australia and SA Health. Community of Practice (CoP) is combined with a narrative review of current evidence to explain specific nursing care responses within an operating environment of pandemic-induced fear and uncertainty. Meetings discussed the challenges associated with delivering mental health care for people experiencing mental health distress in the COVID-19 context. Applying trauma-informed principles to mental health care delivery was identified to be of relevance in the context of an ongoing pandemic. Humanizing nursing care and increasing people's sense of predictability and safety contributed to therapeutic engagement and support during COVID-19. Factors discussed to mitigate the effects of safety measures include, for example, nuanced verbal and non-verbal engagement of health workers with people in mental distress when wearing personal protective equipment (PPE). We highlight the need to 'humanise' nursing and openly communicating that both practitioners and people in distress are navigating special circumstances. The CoP participants additionally acknowledged that the experience of moral distress among frontline health workers needs to be addressed in future policy responses to COVID-19. Person-centred and trauma-informed responses at the point of care might help to mitigate the pandemic short- and long-term effects for both service users and frontline health workers.
Collapse
Affiliation(s)
- Davi Manzini Macedo
- University of South Australia's Mental Health and Suicide Prevention Research and Education Group, South Australia, Adelaide, Australia
| | - Julie-Anne Reilly
- Royal Adelaide Hospital Mental Health Short Stay Unit, South Australia, Adelaide, Australia
| | - Sophie Pettit
- Royal Adelaide Hospital Mental Health Short Stay Unit, South Australia, Adelaide, Australia
| | - Carmen Negoita
- Royal Adelaide Hospital Mental Health Short Stay Unit, South Australia, Adelaide, Australia
| | - Laura Ruth
- Royal Adelaide Hospital Mental Health Short Stay Unit, South Australia, Adelaide, Australia
| | - Elizabeth Cox
- Royal Adelaide Hospital Mental Health Short Stay Unit, South Australia, Adelaide, Australia
| | - Rima Staugas
- Royal Adelaide Hospital Mental Health Short Stay Unit, South Australia, Adelaide, Australia
| | - Nicholas Procter
- University of South Australia's Mental Health and Suicide Prevention Research and Education Group, South Australia, Adelaide, Australia
| |
Collapse
|
12
|
Javakhishvili JD, Arnberg F, Greenberg N, Kazlauskas E, Lotzin A, Xavier M. Dealing with the COVID-19 pandemic in Europe: five lessons from the European Society for Traumatic Stress Studies. Eur J Psychotraumatol 2022; 13:2046330. [PMID: 35558684 PMCID: PMC9090369 DOI: 10.1080/20008198.2022.2046330] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/24/2022] [Accepted: 02/21/2022] [Indexed: 11/04/2022] Open
Abstract
The paper provides insights into the mental health consequences of the coronavirus disease 2019 (COVID-19) pandemic from the Central, Eastern, Nordic, Southern, and Western subregions of Europe, represented by five member countries of the European Society for Traumatic Stress Studies (ESTSS). On the basis of the existing national research and experiences in these countries, we propose five lessons learned. (1) There is no evidence of a mental health pandemic so far in the countries in focus. No increase in severe mental disorders but some increase in the symptoms of common mental health disorders are observable. More high-quality longitudinal studies are needed to understand the mental health burden of the pandemic. (2) The pandemic affects countries (including the mental health situation) differently, depending on the level of the exposure, management policies, pre-pandemic structural characteristics, and healthcare resources. (3) The pandemic affects people differently: the exposure severity to pandemic-related stressors differs between individuals, as well as individual resources to cope with these stressors. There are winners and losers as well as identifiable at-risk groups that need particular attention. (4) Besides the negative consequences, the pandemic has had a positive impact. The rapidly applied innovations within the system of healthcare responses provide a window of opportunity for positive changes in mental healthcare policies, strategies, and practices. The increased focus on mental health during the pandemic may contribute to the prioritization of mental health issues at policy-making and organizational levels and may reduce stigma. (5) A stress- and trauma-informed response to COVID-19 is required. The European community of psychotraumatologists under the leadership of ESTSS plays an important role in promoting stress- and trauma-informed healthcare and policies of pandemic management. Based on the lessons learned, we propose a stepped-care public mental health model for the prevention of adverse mental health outcomes during pandemics. HIGHLIGHTS Population mental health is affected differently in the COVID-19 pandemic: there are winners and losers, as well as identifiable at-risk groups that need particular attention.A stress- and trauma-informed public mental health stepped-care model can address pandemic-related mental health burden in a systematic way.
Collapse
Affiliation(s)
- Jana D. Javakhishvili
- Institute of Addiction Studies, School of Arts and Science, Ilia State University, Tbilisi, Georgia
| | - Filip Arnberg
- National Centre for Disaster Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Miguel Xavier
- Faculty of Medical Sciences, NOVA Medical School, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
13
|
Greene T, El-Leithy S, Billings J, Albert I, Birch J, Campbell M, Ehntholt K, Fortune L, Gilbert N, Grey N, Hana L, Kennerley H, Lee D, Lunn S, Murphy D, Robertson M, Wade D, Brewin CR, Bloomfield MAP. Anticipating PTSD in severe COVID survivors: the case for screen-and-treat. Eur J Psychotraumatol 2022; 13:1959707. [PMID: 35096282 PMCID: PMC8797726 DOI: 10.1080/20008198.2021.1959707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Based on research from previous pandemics, studies of critical care survivors, and emerging COVID-19 data, we estimate that up to 30% of survivors of severe COVID will develop PTSD. PTSD is frequently undetected across primary and secondary care settings and the psychological needs of survivors may be overshadowed by a focus on physical recovery. Delayed PTSD diagnosis is associated with poor outcomes. There is a clear case for survivors of severe COVID to be systematically screened for PTSD, and those that develop PTSD should receive timely access to evidence-based treatment for PTSD and other mental health problems by multidisciplinary teams.
Collapse
Affiliation(s)
- Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel.,Division of Psychiatry, Institute of Mental Health, University College London, London, UK
| | - Sharif El-Leithy
- Traumatic Stress Service, South West London & St George's Mental Health NHS Trust, London, UK
| | - Jo Billings
- Division of Psychiatry, Institute of Mental Health, University College London, London, UK
| | - Idit Albert
- Centre for Anxiety Disorders and Trauma, South London & Maudsley NHS Trust, London, UK.,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jennifer Birch
- Department of Clinical Psychology and Psychology Therapies, Norwich Medical School, University of East Anglia, Norwich, UK.,Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | - Kim Ehntholt
- The Traumatic Stress Clinic, St Pancras Hospital, Camden & Islington NHS Foundation Trust, London, UK
| | - Lorna Fortune
- Barnet Enfield & Haringey MHT, London, UK.,North Middlesex University Hospital NHS Trust, London, UK
| | | | - Nick Grey
- Sussex Partnership NHS Foundation Trust, Sussex, UK.,School of Psychology, University of Sussex, Brighton, UK
| | - Laurinne Hana
- The Traumatic Stress Clinic, St Pancras Hospital, Camden & Islington NHS Foundation Trust, London, UK.,University College London Hospitals NHS Foundation Trust, London, UK
| | - Helen Kennerley
- Oxford Cognitive Therapy Centre, Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK.,Oxford Cognitive Therapy Centre, University of Oxford, Oxford, UK
| | - Deborah Lee
- Berkshire Traumatic Stress Service, Berkshire Foundation NHS Trust, Reading, UK
| | - Sarah Lunn
- The Traumatic Stress Clinic, St Pancras Hospital, Camden & Islington NHS Foundation Trust, London, UK.,Whittington Health NHS Trust, London, UK
| | - Dominic Murphy
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mary Robertson
- The Traumatic Stress Clinic, St Pancras Hospital, Camden & Islington NHS Foundation Trust, London, UK
| | - Dorothy Wade
- Critical Care Department, University College London Hospitals NHS Foundation Trust, London, UK
| | - Chris R Brewin
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Michael A P Bloomfield
- The Traumatic Stress Clinic, St Pancras Hospital, Camden & Islington NHS Foundation Trust, London, UK.,University College London Hospitals NHS Foundation Trust, London, UK.,Translational Psychiatry Research Group, Department of Mental Health Neuroscience, Division of Psychiatry, Institute of Mental Health, University College London, London, UK.,National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London, UK
| |
Collapse
|
14
|
Leiderman LM, Klein RH. An Integrative Systems-Oriented Interpersonal/Relational Group Approach to Understanding and Treating Mass Trauma, Dissociation and Enactments During the COVID-19 Pandemic. Int J Group Psychother 2022; 72:34-63. [PMID: 38446567 DOI: 10.1080/00207284.2021.1991234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The coronavirus pandemic (COVID-19) is a new ongoing, long-term mass trauma event occurring simultaneously with overwhelming sociopolitical stressors. We propose an integrative, psychodynamic, systems-oriented, interpersonal/relational trauma group model to address the multiple losses, heightened anxieties, and complicated grief that have resulted from the pandemic, as well as various forms of interpersonal abuse associated with racist and oppressive systems. These manifest as dissociation and unconscious enactments in small and large psychotherapy groups. We examine the role and responsibilities of the group leader in working therapeutically with these phenomena. Case examples for large and small psychotherapy groups are provided.
Collapse
|
15
|
Eimontas J, Pakalniškienė V, Biliunaite I, Andersson G. A tailored Internet-delivered modular intervention based on cognitive behavioral therapy for depressed older adults: a study protocol for a randomized controlled trial. Trials 2021; 22:925. [PMID: 34915909 PMCID: PMC8674830 DOI: 10.1186/s13063-021-05903-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 12/01/2021] [Indexed: 11/12/2022] Open
Abstract
Background Depression is most common among the elderly and is associated with major impairment. With limited accessible treatments available, remotely provided interventions are needed. Internet-based interventions have been proven effective for a number of mental and somatic health problems. However, the elderly population has received relatively limited attention in previous studies. This study aims to address this gap by investigating the effectiveness of a tailored Internet-delivered modular intervention based on cognitive behavioral therapy (CBT). Methods A minimum of 60 participants will be recruited and randomly assigned to groups in a two-armed parallel controlled trial with a waiting list. The intervention group will have access to an 8-week therapist-supported modular intervention. The waiting list group will be instructed to wait for 8 weeks and then granted access to the intervention for 8 weeks. Pre, post, and 3-, 12-, and 24-month follow-up assessments are planned for measuring changes in depression symptoms, anxiety symptoms, and psychological well-being using PHQ-9, GDS, GAD-7, and WHO-5. Primary outcomes of all the participants will be analyzed using the intention-to-treat principle, and within- and between-group effect sizes will be calculated. Discussion Internet-based interventions could help address the existing treatment gap for depressed older adults. However, to date, the effectiveness of Internet-based CBT (ICBT) for depressed older adults has only been tested in a few studies. This trial will demonstrate if Internet-based CBT is effective for this population when compared to a waiting list control. Further analysis of secondary outcomes and participant behavior in the intervention will potentially reveal effectiveness moderating factors. Trial registration ClinicalTrials.gov NCT04728204. Registered on 15 January 2021. https://www.clinicaltrials.gov/ct2/show/NCT04728204?term=NCT04728204&draw=2&rank=1
Collapse
Affiliation(s)
- Jonas Eimontas
- Institute of Psychology, Vilnius University, Vilnius, Lithuania.
| | | | - Ieva Biliunaite
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
16
|
Carney JR, Behrens B, Miller-Graff LE. A qualitative exploration of families' experiences and resilience factors during the COVID-19 pandemic. J Health Psychol 2021; 27:1318-1330. [PMID: 34856832 DOI: 10.1177/13591053211061411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic has prompted widespread changes and challenges worldwide. In the context of the early months of the pandemic, the current study utilized thematic analysis to assess parents' (N = 13) perspectives of need for resources to foster their family's wellbeing. Five themes emerged: Information Deficits, Need for More Instrumental Supports, Frustration and Worry, Resources Promoting Resilience, and Positive Perspective Shift. Results indicate the importance of information and expanded access to community resources to scaffold resilience in the face of ongoing mass stressors.
Collapse
|
17
|
O’Donnell ML, Greene T. Understanding the mental health impacts of COVID-19 through a trauma lens. Eur J Psychotraumatol 2021; 12:1982502. [PMID: 34745445 PMCID: PMC8567864 DOI: 10.1080/20008198.2021.1982502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 01/10/2023] Open
Abstract
This special issue of the European Journal of Psychotraumatology (EJPT) presents the first studies published by EJPT on COVID-19. We present 26 qualitative and quantitative studies assessing the prevalence of trauma-related symptoms and psychopathology within specific vulnerable populations such as health-care workers, students, children, and managers, or more broadly at a country level with a diverse set of outcomes including post-traumatic stress, moral injury, grief and post-traumatic growth. Intervention studies focus on whether telehealth delivery of mental health therapy in the pandemic environment was useful and effective. It is clear that the pandemic has brought with it a rise in trauma exposure and consequently impacted on trauma-related mental health. While for many individuals, COVID-19-related events met criteria for a DSM-5 Criterion A event, challenges remain in disentangling trauma exposure from stress, anxiety, and other phenomena. It is important to determine the contexts in which a trauma lens makes a useful contribution to understanding the mental health impacts of COVID-19 and the ways in which this may facilitate recovery. The papers included in this Special Issue provide an important and much-needed evidence-based foundation for developing trauma-informed understanding and responses to the pandemic.
Collapse
Affiliation(s)
- Meaghan L. O’Donnell
- Phoenix Australia: Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne, Australia
| | - Talya Greene
- University of Haifa and Division of Psychiatry, University College London, London, UK
| |
Collapse
|
18
|
Kazlauskas E, Gelezelyte O, Nomeikaite A, Zelviene P. Posttraumatic Stress Disorder and Adjustment Disorder in Lithuanian Healthcare in 2018-2020: A Nation-Wide Cohort Study of the Effects of COVID-19 Pandemic. Healthcare (Basel) 2021; 9:1422. [PMID: 34828469 PMCID: PMC8623943 DOI: 10.3390/healthcare9111422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/10/2021] [Accepted: 10/20/2021] [Indexed: 11/29/2022] Open
Abstract
Multiple empirical studies have revealed significant pandemic effects of COVID-19 on mental health in various populations. This study aimed to analyze the incidences of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) in national healthcare in 2018-2020 in one of the European countries-Lithuania-and estimate the effect of the COVID-19 pandemic on PTSD and AjD incidences in 2020. The national healthcare registry was used for estimations of diagnosis of PTSD, AjD, and major depressive disorder (MD). The study revealed that stress-related disorders PTSD and AjD are diagnosed rarely, resulting in a considerable gap between the expected prevalence and incidences of these diagnoses in healthcare in Lithuania. Moreover, a significant decline in mental disorders incidence in healthcare in 2020, in comparison to 2018 and 2019, was found, revealing that the COVID-19 pandemic had a negative impact on access to healthcare services and increased barriers for mental disorders treatment. The study indicates that major developments in building up knowledge about the effects of trauma and life stressors on mental health are needed in Lithuania and other countries to increase awareness about stress-related disorders and improve care for trauma survivors, in particular in the context of the pandemics or other large-scale disasters.
Collapse
Affiliation(s)
- Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio Str. 29, LT-03100 Vilnius, Lithuania; (O.G.); (A.N.); (P.Z.)
| | | | | | | |
Collapse
|
19
|
Hugelius K, Johansson S, Sjölin H. "We Thought We Were Prepared, but We Were Not": Experiences from the Management of the Psychosocial Support Response during the COVID-19 Pandemic in Sweden. A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179079. [PMID: 34501668 PMCID: PMC8431117 DOI: 10.3390/ijerph18179079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022]
Abstract
This study aimed to describe experiences of managing mental health and psychosocial activities during the first six months of the COVID-19 pandemic in Sweden. A national survey was answered by a non-probability sample of 340 involved in the psychosocial response. The psychosocial response operations met several challenges, mainly related to the diverse actors involved, lack of competence, and lack of preparations. Less than 20% of the participants had received specific training in the provision of psychosocial support during major incidents. The interventions used varied, and no large-scale interventions were used. The psychosocial response organizations were overwhelmed by the needs of health care staff and failed to meet the needs of patients and family members. An efficient and durable psychosocial response in a long-term crisis requires to be structured, planned and well-integrated into the overall pandemic response. All personnel involved need adequate and specific competence in evidence-based individual and large-scale interventions to provide psychosocial support in significant incidents. By increasing general awareness of mental wellbeing and psychosocial support amongst health professionals and their first-line managers, a more resilient health care system, both in everyday life and during major incidents and disasters, could be facilitated.
Collapse
Affiliation(s)
- Karin Hugelius
- Faculty of Medicine and Health, Örebro University, 702 81 Örebro, Sweden;
- Correspondence:
| | | | - Helena Sjölin
- Faculty of Medicine and Health, Örebro University, 702 81 Örebro, Sweden;
| |
Collapse
|
20
|
Letica-Crepulja M, Stevanović A, Grković J, Rončević-Gržeta I, Jovanović N, Frančišković T. Posttraumatic stress disorder symptoms and coping with the lockdown among help-seeking veterans before and during the COVID-19 pandemic. Croat Med J 2021; 62:241-249. [PMID: 34212561 PMCID: PMC8275948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/05/2021] [Indexed: 04/03/2024] Open
Abstract
AIM To compare the severity of posttraumatic stress disorder (PTSD) symptoms and of particular PTSD clusters among help-seeking veterans before and during the COVID-19 lockdown. The second aim was to identify the main coping strategies used. METHODS Male war veterans (N=176) receiving outpatient treatment at the Referral Center for PTSD were assessed at baseline (12-18 months before the pandemic declaration in March 2020) and during the COVID-19 pandemic lockdown (March-June 2020). The Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, and The Brief COPE were used. RESULTS Direct exposure to the virus in our sample was low, and the majority of participants followed the preventive measures. The severity of the overall PTSD symptoms and of clusters of symptoms significantly decreased compared with the first assessment. At the second assessment, all participants still fulfilled the PTSD diagnosis criteria. During the lockdown, the participants used emotion-focused and problem-focused coping rather than dysfunctional coping. CONCLUSION The severity of PTSD symptoms decreased during the lockdown. Further research is needed to study the trajectories of long-term psychopathology.
Collapse
Affiliation(s)
- Marina Letica-Crepulja
- Marina Letica-Crepulja, Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia,
| | | | | | | | | | | |
Collapse
|
21
|
Ju Y, Liu J, Ng RMK, Liu B, Wang M, Chen W, Huang M, Yang A, Shu K, Zhou Y, Zhang L, Liao M, Liu J, Zhang Y. Prevalence and predictors of post-traumatic stress disorder in patients with cured coronavirus disease 2019 (COVID-19) one month post-discharge. Eur J Psychotraumatol 2021; 12:1915576. [PMID: 34992752 PMCID: PMC8725742 DOI: 10.1080/20008198.2021.1915576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) can place an immense psychological strain on the infected patient. The psychological distress can linger after the initial recovery from the infection. Objective: This study aimed to evaluate the prevalence and predictors of provisional post-traumatic stress disorder (PTSD) in patients with cured COVID-2019. Methods: The baseline survey was conducted from 10 to 25 February 2020 in patients with COVID-19 in a designated hospital. Demographic and clinical characteristics were acquired, and depression and anxiety levels were assessed, using the 9-item Patient Health Questionnaire and 7-item Generalized Anxiety Disorder scale, respectively. A follow-up survey was conducted 1 month post-discharge. PTSD symptoms were measured by the Impact of Event Scale-6 (IES-6) and patients' perception of supportive care during hospitalization was investigated using a self-developed questionnaire. Results: In total, 114 patients completed both the baseline and follow-up surveys. Of these, 41 (36.0%) met the cut-off score for provisional PTSD diagnosis according to the IES-6. Female gender [odds ratio (OR) = 4.69, 95% confidence interval (CI) 1.54-14.37], educational level of high school or below (OR = 15.49, 95% CI 1.13-212.71), higher anxiety levels (OR = 1.34, 95% CI 1.12-1.61) and lower perceptions of emotional support during hospitalization (OR = 0.41, 95% CI 0.17-0.96) predicted a higher risk for provisional PTSD. Conclusions: PTSD is commonly seen in patients with COVID-19 1 month post-discharge. Female patients, and patients with lower educational levels, higher anxiety levels and lower perceptions of emotional support during hospitalization may be more likely to develop PTSD in the near future. Enhancing emotional support during hospitalization could help to prevent PTSD in patients with COVID-19.
Collapse
Affiliation(s)
- Yumeng Ju
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| | - Jin Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| | - Roger M. K. Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong SAR, P.R. China
| | - Bangshan Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| | - Mi Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| | - Wentao Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| | - Mei Huang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| | - Aiping Yang
- Department of Obstetrics & Gynecology, The First Hospital of Changsha, Changsha, Hunan, P.R. China
| | - Kongliang Shu
- Department of Neurology, The First Hospital of Changsha, Changsha, Hunan, P.R. China
| | - Yun Zhou
- Department of Orthopedics, The First Hospital of Changsha, Changsha, Hunan, P.R. China
| | - Li Zhang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| | - Mei Liao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| | - Jiyang Liu
- Administrative Office, The First Hospital of Changsha, Changsha, Hunan, P.R. China
| | - Yan Zhang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
- China National Clinical Research Center on Mental Disorders (Xiangya), 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, P.R. China
| |
Collapse
|
22
|
Maftei A, Holman AC. The prevalence of exposure to potentially morally injurious events among physicians during the COVID-19 pandemic. Eur J Psychotraumatol 2021; 12:1898791. [PMID: 33968327 PMCID: PMC8075083 DOI: 10.1080/20008198.2021.1898791] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: Given the profound psychological distress caused by the Covid-19 pandemic, healthcare workers are at high risk of being exposed to potentially morally injurious events (PMIEs). Objective: We aimed to explore the prevalence and associated factors with PMIEs in a sample of Romanian physicians, of which almost half worked in Covid-19 treatment medical units. Method: We ran a web-based survey in April 2020, three weeks after the general lockdown to contain the novel coronavirus. Participants (N = 114, aged 23 to 67, M = 38.85, SD = 9.82, 74.6% females) answered the PMIE scale items, in addition to questions related to the physical and emotional self-impact related questions, and demographical and work-related variables (i.e. age, gender, medical experience, and speciality). Results: Results suggested that almost 50% of the participants reported high levels of PMIE exposure. No significant associations were found between PMIE exposure, and the type of medical unit physicians worked in (Covid-19 or non-Covid-19), nor their specialization and medical experience. Demographic variables (i.e. age and gender) and experience did not predict PMIE exposure. However, we found significant associations between PMIE and the physicians' physical and emotional self-reported impact. Conclusions: Healthcare systems, governments, and societies worldwide need to recognize that physicians are prone to PMIE exposure and related adverse psychological outcomes due to their daily activity in containing the pandemic. Public policies need to actively offer and promote psychological support, to protect and help physicians from the adverse mental health outcomes following the pandemic.
Collapse
Affiliation(s)
- Alexandra Maftei
- Faculty of Psychology and Educational Sciences, "Alexandru Ioan Cuza" University, Iasi, Romania
| | - Andrei-Corneliu Holman
- Faculty of Psychology and Educational Sciences, "Alexandru Ioan Cuza" University, Iasi, Romania
| |
Collapse
|
23
|
Greene T, Harju-Seppänen J, Adeniji M, Steel C, Grey N, Brewin CR, Bloomfield MA, Billings J. Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19. Eur J Psychotraumatol 2021; 12:1882781. [PMID: 33968317 PMCID: PMC8075082 DOI: 10.1080/20008198.2021.1882781] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background: Studies have shown that working in frontline healthcare roles during epidemics and pandemics was associated with PTSD, depression, anxiety, and other mental health disorders. Objectives: The objectives of this study were to identify demographic, work-related and other predictors for clinically significant PTSD, depression, and anxiety during the COVID-19 pandemic in UK frontline health and social care workers (HSCWs), and to compare rates of distress across different groups of HCSWs working in different roles and settings. Methods: A convenience sample (n = 1194) of frontline UK HCSWs completed an online survey during the first wave of the pandemic (27 May - 23 July 2020). Participants worked in UK hospitals, nursing or care homes and other community settings. PTSD was assessed using the International Trauma Questionnaire (ITQ); Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9); Anxiety was assessed using the Generalized Anxiety Disorder Scale (GAD-7). Results: Nearly 58% of respondents met the threshold for a clinically significant disorder (PTSD = 22%; anxiety = 47%; depression = 47%), and symptom levels were high across occupational groups and settings. Logistic regression analyses found that participants who were concerned about infecting others, who could not talk with their managers if there were not coping, who reported feeling stigmatized and who had not had reliable access to personal protective equipment (PPE) were more likely to meet criteria for a clinically significant mental disorder. Being redeployed during the pandemic, and having had COVID were associated with higher odds for PTSD. Higher household income was associated with reduced odds for a mental disorder. Conclusions: This study identified predictors of clinically significant distress during COVID-19 and highlights the need for reliable access to PPE and further investigation of barriers to communication between managers and staff.
Collapse
Affiliation(s)
- Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel.,Division of Psychiatry, University College London, London, UK
| | - Jasmine Harju-Seppänen
- Division of Psychiatry, University College London, London, UK.,Division of Psychology and Language Sciences, University College London, London, UK
| | - Mariam Adeniji
- Division of Psychiatry, University College London, London, UK
| | - Charlotte Steel
- Division of Psychiatry, University College London, London, UK
| | - Nick Grey
- Sussex Partnership NHS Foundation Trust, Worthing, UK.,School of Psychology, University of Sussex, Brighton, UK
| | - Chris R Brewin
- Clinical Educational & Health Psychology, University College London, London, UK
| | - Michael A Bloomfield
- Division of Psychiatry, University College London, London, UK.,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, University College London, London, UK.,Epidemiology and Applied Clinical Research Department, University College London, London, UK.,St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, UK.,National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK.,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
| |
Collapse
|
24
|
BinDhim NF, Althumiri NA, Basyouni MH, Alageel AA, Alghnam S, Al-Qunaibet AM, Almubarak RA, Aldhukair S, Ad-Dab'bagh Y. Saudi Arabia Mental Health Surveillance System (MHSS): mental health trends amid COVID-19 and comparison with pre-COVID-19 trends. Eur J Psychotraumatol 2021; 12:1875642. [PMID: 34025918 PMCID: PMC8128114 DOI: 10.1080/20008198.2021.1875642] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: The impact of the COVID-19 pandemic on populations' mental health has started to emerge. Objectives: To describe the mental health trends of the risk of major depressive disorder (MDD) and generalized anxiety disorder (GAD) between May and August 2020. It also compares the results with pre-COVID-19 results and identifies risk factors associated with increased likelihood of being at risk of MDD and GAD. Method: This study utilizes repeated cross-sectional design, at national-level coverage of mental health screenings via computer-assisted phone interviews conducted in four waves monthly (between May and August 2020). Arabic-speaking adults from Saudi Arabia were recruited via a random phone list. The questionnaire includes the Arabic version of the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). Pre-COVID-19 comparison was done using the PHQ-2 score to allow for comparison with a previous and similar national study conducted in 2018. Results: Across the four waves, 16,513 participants completed the interviews, with an overall response rate of 81.3%. The weighted national prevalence of people at risk of MDD was 14.9% overall, and 13.8%, 13.6%, 16.8%, and 15.3% in Waves 1, 2, 3, and 4, respectively. The weighted national prevalence of people at risk of GAD was 11.4%, overall, and 10.9%, 10.7%, 12.4%, and 11.7% in Waves 1, 2, 3, and 4, respectively. The weighted national proportion of individuals who were at risk of MDD and GAD at the same time was 7.4% overall. The risk of MDD on PHQ-2 increased by 71.2%, from 12.5% in 2018 to 21.4% in 2020. Conclusions: The risks of MDD and GAD in this study are relatively high. These results can help decision makers to understand the impact of the COVID-19 pandemic on the population's mental health and the most-impacted subgroups.
Collapse
Affiliation(s)
- Nasser F BinDhim
- Scientific Affairs Department, Sharik Association for Health Research, Riyadh, Saudi Arabia.,CEO Office, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,Public Health Department, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Nora A Althumiri
- Scientific Affairs Department, Sharik Association for Health Research, Riyadh, Saudi Arabia
| | - Mada H Basyouni
- Scientific Affairs Department, Sharik Association for Health Research, Riyadh, Saudi Arabia.,Small and medium enterprises Department, Ministry of Health, Riyadh, Saudi Arabia
| | - Asem A Alageel
- Department of Clinical Neurosciences, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Suliman Alghnam
- Population Health Department, King Abdulah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Ada M Al-Qunaibet
- Public Health Research and Health Statistics Department, The National Center for Disease Prevention and Control (Weqaya), Riyadh, Saudi Arabia
| | - Rasha A Almubarak
- Scientific Affairs Department, Sharik Association for Health Research, Riyadh, Saudi Arabia
| | - Shahla Aldhukair
- Research and Studies Department, Saudi Health Council, Riyadh, Saudi Arabia
| | - Yasser Ad-Dab'bagh
- Small and medium enterprises Department, Ministry of Health, Riyadh, Saudi Arabia.,Mental Health Department, King Fahd Specialist Hospital, Dammam, Saudi Arabia
| |
Collapse
|
25
|
Ikizer G, Karanci AN, Gul E, Dilekler I. Post-traumatic stress, growth, and depreciation during the COVID-19 pandemic: evidence from Turkey. Eur J Psychotraumatol 2021; 12:1872966. [PMID: 34025916 PMCID: PMC8128125 DOI: 10.1080/20008198.2021.1872966] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: A worldwide health threat, the COVID-19 pandemic, has highlighted the need to focus on its mental health impact. However, literature on mental health effects including post-traumatic consequences of the pandemic is scarce. Objective: The current study examined post-traumatic stress (PTS), growth (PTG), and depreciation (PTD) during the pandemic, and explored factors associated with these mental health outcomes in an adult community sample from Turkey. Method: A total of 685 participants responded to an online survey that gathered data on sociodemographic characteristics, financial loss during the pandemic, time spent at home and frequency of social media use, perception of COVID-related risks, stress, and event-related rumination. Data analysis included correlation and regression analyses. Results: Results showed that PTS, PTG, and PTD were positively correlated with each other. Younger age and being single were associated with higher PTS and PTD, and lower education levels predicted all three outcomes. Experiencing financial loss during the pandemic, more frequent social media use to follow COVID-related news and posts, and longer time spent at home during the pandemic were associated with higher PTS. Anticipating financial risks during the pandemic were associated with all outcomes while anticipating health-related risks due to COVID-19 and perceived stress levels predicted PTS and PTD but not PTG. Both intrusive and deliberate rumination were associated with higher levels of PTS and PTD, and PTG was predicted solely by deliberate rumination. Moreover, provisional PTSD was indicated in 47.9% of the participants. Membership to the provisional PTSD group was predicted by age, level of education, time spent on social media, anticipating COVID-19-related health risks, perceived stress, and event-related rumination. Conclusions: The current study provides empirical evidence for the short-term post-traumatic effects of the COVID-19 pandemic and related factors, which can help to guide mental health services during the pandemic.
Collapse
Affiliation(s)
- Gözde Ikizer
- Department of Psychology, TOBB University of Economics and Technology, Cankaya Ankara, Turkey
| | - Ayse Nuray Karanci
- Department of Psychology, TOBB University of Economics and Technology, Cankaya Ankara, Turkey
| | - Ervin Gul
- Department of Psychotherapy, Fachklinik St. Vitus GmbH, Visbek, Germany
| | - Ilknur Dilekler
- Department of Psychology, TOBB University of Economics and Technology, Cankaya Ankara, Turkey
| |
Collapse
|
26
|
Vasileva M, Alisic E, De Young A. COVID-19 unmasked: preschool children's negative thoughts and worries during the COVID-19 pandemic in Australia. Eur J Psychotraumatol 2021; 12:1924442. [PMID: 34249241 PMCID: PMC8245093 DOI: 10.1080/20008198.2021.1924442] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: The COVID-19 pandemic and its consequences are stressful for many children and their families. Previous research with school-aged children has shown that negative thoughts and worries can predict mental health symptoms following stressful events. So far preschool children have been neglected in these investigations. Objective: The aim of this study was to explore negative thoughts and worries that preschool aged children are having during the COVID-19 pandemic. Method: As part of a larger mixed-method study, caregivers of N = 399 preschoolers aged between 3 and 5 years (M = 4.41) answered open-ended questions about their COVID-19 related thoughts and worries. Reflexive thematic analysis was used to identify relevant themes from the qualitative data. A theoretical model of child thoughts and worries was developed based on these qualitative findings and the existing empirical and theoretical literature. Results: Caregivers gave examples that indicated that preschoolers had difficulties understanding causality and overestimated the risk of COVID-19 infection. Caregivers reported that their children expressed worries about getting sick and infecting others as well as about changes in daily life becoming permanent. Caregivers observed their children's preoccupation with COVID-19 and worries in conversations, play and drawings as well as in behavioural changes - increased arousal, cautiousness, avoidance and attachment-seeking behaviour. Conclusion: Preschool children can and do express negative thoughts and worries and have also experienced threat and increased vulnerability during the COVID-19 pandemic. A theoretical model is proposed that could inform assessments, interventions and future research in the field.
Collapse
Affiliation(s)
- Mira Vasileva
- Child and Community Wellbeing Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Eva Alisic
- Child and Community Wellbeing Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Alex De Young
- Queensland Centre for Perinatal & Infant Mental Health, Children's Health Queensland Hospital and Health Service & Child Health Research Centre, Brisbane, Australia.,School of Psychology, University of Queensland, Brisbane, Australia
| |
Collapse
|
27
|
BinDhim NF, Althumiri NA, Basyouni MH, Alageel AA, Alghnam S, Al-Qunaibet AM, Almubark RA, Aldhukair S, Ad-Dab'bagh Y. A Mental Health Surveillance System for the General Population During the COVID-19 Pandemic: Protocol for a Multiwave Cross-sectional Survey Study. JMIR Res Protoc 2020; 9:e23748. [PMID: 33156802 PMCID: PMC7695540 DOI: 10.2196/23748] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/07/2020] [Accepted: 11/03/2020] [Indexed: 01/07/2023] Open
Abstract
Background The COVID-19 outbreak can potentially be categorized as a traumatic event. Public health surveillance is one of the cornerstones of public health practice, and it empowers decision makers to lead and manage public health crises and programs more effectively by providing timely and useful evidence. Objective This paper presents the protocol for a study that aims to identify, track, and monitor trends in the population in Saudi Arabia at risk of major depressive disorders and anxiety during the COVID-19 pandemic. Methods This study utilizes continuous, cross-sectional, national-level mental health screening via computer-assisted phone interviews, conducted in four waves on a monthly basis (between May and August 2020). Arabic-speaking adults, aged ≥18 years, and living in Saudi Arabia were recruited via a random phone list. This surveillance system used the proportional quota sampling technique to achieve an equal distribution of participants, stratified by age and gender, and region, within and across the 13 administrative regions of Saudi Arabia. A sample size of 4056 participants per wave was calculated to achieve enough power to detect changes in mental health status. The questionnaire includes the Arabic version of the Patient Health Questionnaire-9 (PHQ-9) to measure depressive symptoms and the General Anxiety Disorder-7 (GAD-7) to measure anxiety. In addition, it will collect data on sociodemographic variables and potential risk factors. Results Study recruitment began in May 2020. The data analysis was completed in October 2020, and the final report is expected to be published by the end of December 2020. Conclusions Monitoring the population’s mental health status during the COVID-19 pandemic will inform decision makers of any potential deterioration in mental health on a national level and among subgroups, including across regions, age groups, and gender groups. It will allow decision makers to recognize issues and intervene sooner. It will also provide valuable scientific data to help understand the effects of epidemics and pandemics on mental health. As far as we know, this is the only study that attempts to monitor the mental health status of the general population on a monthly basis. International Registered Report Identifier (IRRID) DERR1-10.2196/23748
Collapse
Affiliation(s)
- Nasser F BinDhim
- Sharik Association for Health Research, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | | | - Mada H Basyouni
- Sharik Association for Health Research, Riyadh, Saudi Arabia.,Ministry of Health, Riyadh, Saudi Arabia
| | - Asem A Alageel
- College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- King Abdulah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ada M Al-Qunaibet
- The National Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | | | | | - Yasser Ad-Dab'bagh
- Ministry of Health, Riyadh, Saudi Arabia.,King Fahd Specialist Hospital, Dammam, Saudi Arabia
| |
Collapse
|
28
|
Gersons BPR, Smid GE, Smit AS, Kazlauskas E, McFarlane A. Can a 'second disaster' during and after the COVID-19 pandemic be mitigated? Eur J Psychotraumatol 2020; 11:1815283. [PMID: 33062215 PMCID: PMC7534298 DOI: 10.1080/20008198.2020.1815283] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In most disasters that have been studied, the underlying dangerous cause does not persist for very long. However, during the COVID-19 pandemic a progressively emerging life threat remains, exposing everyone to varying levels of risk of contracting the illness, dying, or infecting others. Distancing and avoiding company have a great impact on social life. Moreover, the COVID-19 pandemic has an enormous economic impact for many losing work and income, which is even affecting basic needs such as access to food and housing. In addition, loss of loved ones may compound the effects of fear and loss of resources. The aim of this paper is to distil, from a range of published literature, lessons from past disasters to assist in mitigating adverse psychosocial reactions to the COVID-19 pandemic. European, American, and Asian studies of disasters show that long-term social and psychological consequences of disasters may compromise initial solidarity. Psychosocial disruptions, practical and financial problems, and complex community and political issues may then result in a 'second disaster'. Lessons from past disasters suggest that communities and their leaders, as well as mental healthcare providers, need to pay attention to fear regarding the ongoing threat, as well as sadness and grief, and to provide hope to mitigate social disruption.
Collapse
Affiliation(s)
- Berthold P. R. Gersons
- Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Geert E. Smid
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- University of Humanistic Studies, Utrecht, The Netherlands
| | - Annika S. Smit
- Police Academy of the Netherlands, Apeldoorn, The Netherlands
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Alexander McFarlane
- Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
29
|
Lotzin A, Acquarini E, Ajdukovic D, Ardino V, Böttche M, Bondjers K, Bragesjö M, Dragan M, Grajewski P, Figueiredo-Braga M, Gelezelyte O, Javakhishvili JD, Kazlauskas E, Knefel M, Lueger-Schuster B, Makhashvili N, Mooren T, Sales L, Stevanovic A, Schäfer I. Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic - study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study. Eur J Psychotraumatol 2020; 11:1780832. [PMID: 33029321 PMCID: PMC7473046 DOI: 10.1080/20008198.2020.1780832] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND During the current COVID-19 pandemic, the people in Europe are exposed to self-isolation, quarantine, job loss, risk of contracting COVID-19, or grief of loved ones. Such a complex array of stressors may lead to symptoms of adjustment disorder or posttraumatic stress disorder. This research protocol describes a study launched by the European Society of Traumatic Stress Studies (ESTSS) to investigate the impact of the COVID-19 pandemic on symptoms of adjustment disorder across European countries. OBJECTIVE The longitudinal online cohort study aims (1) to explore psychosocial reactions to the COVID-19 pandemic across ten European countries; (2) to examine the relationships between risk and resilience factors, stressors and symptoms of adjustment disorder during the pandemic; and (3) to investigate whether these relationships are moderated by coping behaviours. METHOD In ten countries (Austria, Croatia, Georgia, Germany, Italy, Lithuania, Netherlands, Poland, Portugal, and Sweden), between 1,000 and 2,000 participants will be recruited, depending on the size of the country. Participants will be assessed at two timepoints with a six-month interval. Following a conceptual framework based on the WHO's social framework of health, an assessment of risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behaviours will be measured to estimate their contribution to symptoms of adjustment disorder. The Adjustment Disorder New Module 8 (ADNM-8) will be used to assess symptoms of adjustment disorder. As a secondary measure, symptoms of posttraumatic stress disorder will be measure using the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). DATA ANALYSIS The relative contribution of risk factors, resilience factors, and stressors on symptoms of adjustment disorder or symptoms of posttraumatic stress disorder will be estimated using multilevel analysis. To determine the moderating effects of different types of coping behaviours on these relationships, a multilevel mediation analysis will be carried out.
Collapse
Affiliation(s)
- Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elena Acquarini
- Department of Communication Sciences, Humanities and International Studies (DISCUI), University of Urbino, Italy
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Vittoria Ardino
- Department of Communication Sciences, Humanities and International Studies (DISCUI), University of Urbino, Italy
| | | | - Kristina Bondjers
- Division of Clinical Psychological Intervention, National Centre for Disaster Psychiatry, Uppsala University, Uppsala, Sweden
| | - Maria Bragesjö
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Margarida Figueiredo-Braga
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Odeta Gelezelyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | | | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Matthias Knefel
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Nino Makhashvili
- Institute of Addiction Studies, Ilia State University, Tbilisi, Georgia
| | - Trudy Mooren
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Luisa Sales
- Centre of Trauma, Centre for Social Studies (CES), University of Coimbra, Portugal
| | - Aleksandra Stevanovic
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|