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Hall CE, Brooks SK, Potts HWW, Greenberg N, Weston D. Rates of, and factors associated with, common mental disorders in homeworking UK Government response employees' during COVID-19: a cross-sectional survey and secondary data analysis. BMC Psychol 2024; 12:429. [PMID: 39113130 PMCID: PMC11308339 DOI: 10.1186/s40359-024-01921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/23/2024] [Indexed: 08/10/2024] Open
Abstract
INTRODUCTION Working on the frontline during the COVID-19 pandemic has been associated with increased risk to mental health and wellbeing in multiple occupations and contexts. The current study aimed to provide an insight into the rate of probable mental health problems amongst United Kingdom (UK) Government employees who contributed to the COVID-19 response whilst working from home, and to ascertain what factors and constructs, if any, influence mental health and wellbeing in the sample population. METHOD This paper reports on the findings from two studies completed by UK Government employees. Study 1: A cross-sectional online survey, containing standardised and validated measures of common mental health disorders of staff who actively contributed to the COVID-19 response from their own homes. Binary logistic regression was used to assess factors associated with mental health outcomes. Study 2: A secondary data analysis of cross-sectional survey data collected across three timepoints (May, June, and August) in 2020 focusing on the wellbeing of employees who worked from home during the COVID-19 pandemic. RESULTS Study 1: 17.9% of participants met the threshold criteria for a probable moderate anxiety disorder, moderate depression, or post-traumatic stress disorder. Younger, less resilient, less productive individuals, with lower personal wellbeing and less enjoyment of working from home, were more likely to present with poorer mental health. Study 2: Found lower wellbeing was consistently associated with having less opportunities to look after one's physical and mental health, and having unsupportive line managers and colleagues. CONCLUSION It is important to ensure UK Government employees' psychological needs are met whilst working from home and responding to enhanced incidents. It is recommended that workplaces should be seeking to continually build and improve employee resilience (e.g., through opportunities to increase social ties and support networks), essentially ensuring employees have necessary resources and skills to support themselves and others.
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Affiliation(s)
- Charlotte E Hall
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK.
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK
| | - Dale Weston
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UKHSA, Porton Down, Salisbury, SP4 0JG, UK
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Rees H, Hallett N, Hannah F, Hollowood L, Lafayette JO, Bradbury-Jones C. Interventions aimed at preventing suicide in the healthcare workforce: a systematic review. Nurs Manag (Harrow) 2024:e2132. [PMID: 39075928 DOI: 10.7748/nm.2024.e2132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 07/31/2024]
Abstract
Healthcare workers are exposed to various factors in the workplace that may put them at an increased risk of suicide, but there is a lack of evidence reviewing interventions put in place by employers that may modify this risk. The authors undertook a systematic review to identify and assess organisational interventions aimed at preventing suicide in the healthcare workforce. Databases were systematically searched between January 2022 and August 2022. Eligibility for inclusion in the review was determined using a population, intervention, comparison, outcome framework, and 12 studies met the inclusion criteria. Studies were summarised using narrative synthesis and interventions included education, screening, modification of the workplace, referrals for support and/or therapy and peer support. Outcomes included: uptake, satisfaction, pre-training and post-training knowledge, symptoms, risk of suicide and economic costs. It was identified that various suicide prevention interventions are feasible in healthcare organisations and likely to have positive effects for staff. However, there is a lack of robust evaluation of these interventions, so further research is warranted.
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Affiliation(s)
- Helen Rees
- School of Health and Allied Professionals, Nottingham Trent University, Nottingham, England
| | - Nutmeg Hallett
- School of Nursing and Midwifery, University of Birmingham, Birmingham, England
| | - Felicity Hannah
- School of Nursing and Midwifery, University of Birmingham, Birmingham, England
| | - Lorna Hollowood
- School of Nursing and Midwifery, University of Birmingham, Birmingham England
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Foti G, Merlo L, Finstad GL, Giorgi G. COVID-19 Symptoms and Mental Health Outcomes among Italian Healthcare Workers: A Latent Class Analysis. Healthcare (Basel) 2024; 12:1403. [PMID: 39057546 PMCID: PMC11275353 DOI: 10.3390/healthcare12141403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 pandemic has led to long-lasting consequences for workers leading to what has been termed a "psychological pandemic". Some categories, such as healthcare workers (HCWs), are considered high risk due to factors such as increased exposure and stressful working conditions. In this study, we investigate whether levels of posttraumatic stress symptoms and COVID-19-related fear (IES-6 and PSI-4) are associated with illness severity in a sample of 318 infected HCWs in Italy. To investigate the presence of different profiles of COVID-19 severity, Latent Class Analysis (LCA) was performed based on 11 symptoms. Differences in the IES-6 and PSI-4 scores across the latent classes were compared using the non-parametric Kruskal-Wallis (KW) test with Dunn's multiple comparison post hoc testing. Our analyses show that the LCA identified three classes of symptoms, reflecting no/low, mild and severe symptoms. The classes include vomiting, confusion, conjunctivitis, diarrhea, dyspnea, headache, ageusia, fever, anosmia, osteo muscle articular pain and asthenia. We found that HCWs who experienced more intense symptoms reported significantly higher IES-6 and PSI-4 scores. Moreover, we found gender-related differences in IES-6 and PSI-4 scores as females exhibited higher levels than males. Indeed, these findings are useful for developing health prevention and emergency management programs.
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Affiliation(s)
- Giulia Foti
- Department of Human Sciences, European University of Rome, 00163 Rome, Italy; (L.M.); (G.L.F.); (G.G.)
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Freichel R, Herzog P, Billings J, Bloomfield MAP, McNally RJ, Greene T. Unveiling temporal dynamics of PTSD and its functional impairments: A longitudinal study in UK healthcare workers. J Anxiety Disord 2024; 106:102896. [PMID: 39018679 DOI: 10.1016/j.janxdis.2024.102896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 06/18/2024] [Accepted: 07/05/2024] [Indexed: 07/19/2024]
Abstract
PTSD has been associated with negative long-term consequences, including social and occupational impairments. Yet, a nuanced understanding of the interplay between PTSD symptoms and distinct domains of impairments on a short-term basis (weeks/ months) at the within-person level remains underexplored. In a large sample (nwave 1 = 1096, nwave 7 = 304) of UK healthcare workers assessed across seven assessment waves during the COVID-19 pandemic (spaced 6 weeks apart), we employed exploratory graphical vector autoregression models (GVAR) models to discern within-person temporal (across time) and contemporaneous (within same time window) dynamics between PTSD symptoms and functional impairment domains. The contemporaneous network highlighted strong co-occurrences between different symptoms and impairments. The temporal network revealed a mutually reinforcing cycle between intrusion and avoidance symptoms. Intrusion symptoms showed the highest out-strength (i.e., most predictive symptom), predicting avoidance symptoms, elevated sense of current threat, and various functional impairments. Avoidance symptoms, elevated after increased levels of intrusions, predicted work impairments that in turn were associated with difficulties in fulfilling other obligations. Our findings underscore the dynamics between perceived threat and intrusions, and the role intrusions may play in predicting a cascade of adverse effects. Targeted interventions aimed at mitigating intrusions may disrupt this negative cycle.
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Affiliation(s)
- René Freichel
- Department of Psychology, Harvard University, United States; Department of Psychology, University of Amsterdam, the Netherlands
| | - Philipp Herzog
- Department of Psychology, Harvard University, United States; Department of Psychology, University of Kaiserslautern-Landau (RPTU), Germany
| | - Jo Billings
- Division of Psychiatry, University College London, UK
| | - Michael A P Bloomfield
- Translational Psychiatry Research Group, Division of Psychiatry, UCL, UK; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, UK; University College London Hospitals National Institute for Health Research Biomedical Research Centre, UK
| | | | - Talya Greene
- Clinical, Educational and Health Psychology, University College London, UK.
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Schoultz M, Mcgrogan C, Carolan C, Macaden L, Beattie M. Exploring barriers to care home research recruitment during the COVID-19 pandemic: The influence of social media recruitment posts and public sentiment. PLoS One 2024; 19:e0303609. [PMID: 38905189 PMCID: PMC11192410 DOI: 10.1371/journal.pone.0303609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 04/28/2024] [Indexed: 06/23/2024] Open
Abstract
INTRODUCTION Recruitment of care home staff to research studies is recognised as challenging. This was further exacerbated by the COVID-19 pandemic and the associated negative media portrayal of care home workers. Social media use has surged since the onset of COVID-19 lockdowns, offering a plausible approach to understanding the barriers to care home research recruitment and gaining insight into public perceptions of care home workers. AIM To utilise comments from two Facebook recruitment posts to: 1) gain an understanding of potential barriers to recruitment of healthcare workers (HCWs) in UK care homes, and 2) explore public sentiment towards care home research and care homes in the context of the COVID-19 pandemic. METHODS This cross-sectional study analysed comments from two Facebook posts (available June-October 2021) advertising a separate study on psychological support for care staff during the pandemic. This study was situated within a larger investigation into the mental health and wellbeing of care home staff and employed both qualitative analysis and quantitative methods (word count and correlations between words used and between posts). RESULTS Three themes were identified from the qualitative analysis: support, mistrust and blame. There was a greater use of words associated with support and negative emotive words in post 2. Post 2 comments featured significantly more choice words and first-person singular pronouns than post 1 which indicated a resentful sentiment from those who advocate freedom of choice and control. Discussion of mistrust towards researchers was most prominent in post 1 indicating the importance of relationship building between researchers and HCWs in UK care homes. With attribution to blame, there was a larger range of negative emotion words than positive emotion words. DISCUSSION AND CONCLUSION Taken together our findings offer novel insights into why recruitment to care home research during the pandemic including the use of social media might be problematic. Social media is a useful tool for recruitment but should not be considered as a one-time input. Researchers should pro-actively engage with the study population from the start using co-design with resident and public groups to support recruitment and ensure these populations are accurately represented within research.
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Affiliation(s)
- Mariyana Schoultz
- School of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | - Claire Mcgrogan
- School of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | - Clare Carolan
- Centre for Rural Health Sciences, University of the Highlands and Islands, Inverness, United Kingdom
| | - Leah Macaden
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Michelle Beattie
- Centre for Rural Health Sciences, University of the Highlands and Islands, Inverness, United Kingdom
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6
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Broome MR, Rodrigues J, Ritunnano R, Humpston C. Psychiatry as a vocation: Moral injury, COVID-19, and the phenomenology of clinical practice. CLINICAL ETHICS 2024; 19:157-170. [PMID: 38784822 PMCID: PMC11108749 DOI: 10.1177/14777509231208361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
In this article, we focus on a particular kind of emotional impact of the pandemic, namely the phenomenology of the experience of moral injury in healthcare professionals. Drawing on Weber's reflections in his lecture Politics as a Vocation and data from the Experiences of Social Distancing during the COVID-19 Pandemic Survey, we analyse responses from healthcare professionals which show the experiences of burnout, sense of frustration and impotence, and how these affect clinicians' emotional state. We argue that this may relate to the ethical conflicts they experience when they are forced to make clinical decisions where there are no optimal outcomes, and how in turn that impacts on their own emotional state. We then further examine the notion of 'burnout' and the phenomenology of 'moral injury'. Our argument is that these experiences of moral injury across a range of clinicians during the pandemic may be more prevalent and long-standing in psychiatry and mental health than in other areas of healthcare, where ethically difficult decisions and resource constraints are common outside times of crisis. Hence, in these clinical arenas, moral injury and the phenomenology of emotional changes may be independent of the pandemic. The insights gained during the pandemic may provide wider insights into the challenges of developing services and training the workforce to provide appropriate mental health care.
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Affiliation(s)
- Matthew R Broome
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Jamila Rodrigues
- Embodied Cognitive Sciences Lab, Okinawa Institute of Science and Technology Graduate University, Onna, Japan
| | - Rosa Ritunnano
- Institute for Mental Health, University of Birmingham, Birmingham, UK
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7
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Thompson PW. Impact of COVID-19 on Ethnically Minoritised Carers in UK's Care Home Settings: a Systematic Scoping Review. J Racial Ethn Health Disparities 2024; 11:1651-1659. [PMID: 37410355 PMCID: PMC11101518 DOI: 10.1007/s40615-023-01640-3] [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: 04/07/2023] [Revised: 05/06/2023] [Accepted: 05/11/2023] [Indexed: 07/07/2023]
Abstract
COVID-19 has impacted disproportionately two groups in the UK: healthcare workers and people from ethnically minoritised groups. However, there is a lack of evidence on how COVID-19 affected ethnically minoritised carers in care homes. Therefore, the present study aimed to explore the available evidence regarding the impact of COVID-19 on ethnically minoritised carers in UK. The relevant records were systematically searched in Cochrane COVID-19 Study Register and WHO COVID-19 global literature. A total of 3164 records were retrieved. Following duplicate elimination and abstract, title, and full-text screening, 10 studies were identified as eligible for the present scoping review. Most of the studies were conducted in the UK and USA, involving diverse healthcare occupations and methodologies. Multiple studies found anxiety, depression, stress, and post-traumatic stress disorder among carers with high odds among ethnically minoritised carers. Limited access to personal protective equipment and workplace discrimination was noted and linked with poor mental health. The carers reported difficulties in care delivery and managing extra workload arising from staff shortages. The risk of infection and clinically significant mental disorders was higher among carers from the ethnically minoritised background. They exhibited fear about care homes' uncertain futures and consequential financial losses. Conclusively, COVID-19 appeared to exert adverse effects on practices and experiences of ethnically minoritised carers in the UK's care homes; however, further studies are warranted to increase the understanding of COVID-19-related experiences of this group of carers which significantly contribute to the country's healthcare system.
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Kurotori I, Asakura TR, Kimura T, Hori M, Hosozawa M, Saijo M, Iso H, Tamakoshi A. The Association between COVID-19-Related Discrimination and Probable Post-Traumatic Stress Disorder among Patients with COVID-19 in Sapporo, Japan. J Epidemiol 2024:JE20230360. [PMID: 38735739 DOI: 10.2188/jea.je20230360] [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: 05/14/2024] Open
Abstract
BackgroundDisasters such as earthquakes, terrorism, and pandemics have triggered post-traumatic stress disorder (PTSD), and discrimination against the affected individuals has been linked to the development of PTSD. However, there is limited evidence regarding the association between discrimination against coronavirus disease 2019 (COVID-19) patients and probable PTSD in Japan.MethodsWe conducted a cross-sectional study utilizing a web-based questionnaire targeting individuals who had contracted the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Sapporo City. A total of 4247 individuals with laboratory-confirmed SARS-CoV-2 infection spanning from February 2020 to February 2022 completed the questionnaire (response rate: 15.9%). Probable PTSD was measured using the three-item Posttraumatic Diagnostic Scale. The stratified exact logistic regression was applied to calculate the odds ratios (OR) of probable PTSD for COVID-19-related discrimination with adjusted factors.ResultsThis study included 3626 patients who had a history of SARS-CoV-2 infection. Among them, 321 patients (8.9%) experienced COVID-19-related discrimination. The prevalence of probable PTSD was 19.6% (63/321) among the patients who experienced COVID-19-related discrimination, and 4.6% (152/3305) among those who had not encountered such discrimination. The adjusted OR of COVID-19-related discrimination for probable PTSD was 4.68 (95% confidence interval [95% CI], 3.36-6.53). The population attributable fraction of probable PTSD attributable to COVID-19-related discrimination among COVID-19 patients was estimated to be 23.4% (95% CI, 21.5-25.3).ConclusionThe comprehensive epidemiological survey of COVID-19 patients in Japan showed that COVID-19-related discrimination was associated with a higher prevalence of probable PTSD. Mitigating discrimination could be helpful to attenuate PTSD in future pandemics.
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Affiliation(s)
- Isaku Kurotori
- Department of Public Health, Hokkaido University Faculty of Medicine
| | - Toshiaki R Asakura
- Department of Public Health, Hokkaido University Faculty of Medicine
- Department of Infectious Disease Epidemiology and Dynamics, London School of Hygiene & Tropical Medicine
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine
- School of Tropical Medicine and Global Health, Nagasaki University
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Faculty of Medicine
| | - Miyuki Hori
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine
| | - Masayuki Saijo
- Public Health Office, Health and Welfare Bureau, Sapporo Municipal Government
| | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine
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Ahmed Pihlgren S, Johansson L, Holmes EA, Kanstrup M. Exploring healthcare workers' experiences of a simple intervention to reduce their intrusive memories of psychological trauma: an interpretative phenomenological analysis. Eur J Psychotraumatol 2024; 15:2328956. [PMID: 38533843 PMCID: PMC10977018 DOI: 10.1080/20008066.2024.2328956] [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: 12/07/2023] [Accepted: 03/02/2024] [Indexed: 03/28/2024] Open
Abstract
ABSTRACTBackground: Many healthcare workers (HCWs) endured psychologically traumatic events at work during the coronavirus disease 2019 (COVID-19) pandemic. For some, these events are re-experienced as unwanted, recurrent, and distressing intrusive memories. Simple psychological support measures are needed to reduce such symptoms of post-traumatic stress in this population. A novel intervention to target intrusive memories, called an imagery-competing task intervention (ICTI), has been developed from the laboratory. The intervention includes a brief memory reminder cue, then a visuospatial task (Tetris® gameplay using mental rotation instructions for approximately 20 min) thought to interfere with the traumatic memory image and reduce its intrusiveness. The intervention has been adapted and evaluated in a randomized controlled trial (RCT) with Swedish HCWs (ClinicalTrials.gov identifier: NCT04460014).Objective: We aimed to explore how HCWs who worked during the COVID-19 pandemic experienced the use of a brief intervention to reduce their intrusive memories of work-related trauma.Method: Interpretative phenomenological analysis was used for in-depth understanding of the lived experiences of HCWs who used the intervention. Seven participants from the RCT were interviewed by an independent researcher without prior knowledge of the intervention. Interviews were conducted via telephone and transcribed verbatim.Results: Four general themes were generated: 'Triggers and troublesome images', 'Five Ws regarding support - what, when, why, by/with who, for whom', 'Receiving it, believing it, and doing it' and 'The intervention - a different kind of help'; the last two included two subthemes each. The results reflect participants' similarities and differences in their lived experiences of intrusive memories, support measures, and intervention impressions and effects.Conclusion: HCWs' experiences of the novel ICTI reflect a promising appraisal of the intervention as a potential help measure for reducing intrusive memories after trauma, and gives us a detailed understanding of HCWs' needs, with suggestions for its adaption for future implementation.Trial registration: ClinicalTrials.gov identifier: NCT04460014.
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Affiliation(s)
- Sara Ahmed Pihlgren
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Johansson
- The Neurosurgical Intensive Care Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emily A. Holmes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marie Kanstrup
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Theme Women’s Health and Allied Health Professionals, Medical Unit for Medical Psychology, Karolinska University Hospital, Solna, Sweden
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Hutchings HA, Rahman M, Carter K, Islam S, O'Neill C, Roberts S, John A, Fegan G, Dave U, Hawkes N, Ahmed F, Hasan M, Azad AK, Rahman MM, Kibria MG, Rahman MM, Mia T, Akhter M, Williams JG. Did the COVID-19 pandemic affect levels of burnout, anxiety and depression among doctors and nurses in Bangladesh? A cross-sectional survey study. BMJ Open 2024; 14:e079350. [PMID: 38453200 PMCID: PMC10921535 DOI: 10.1136/bmjopen-2023-079350] [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: 09/04/2023] [Accepted: 02/14/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION COVID-19 has caused severe disruption to clinical services in Bangladesh but the extent of this, and the impact on healthcare professionals is unclear. We aimed to assess the perceived levels of anxiety, depression and burnout among doctors and nurses during COVID-19 pandemic. METHODS We undertook an online survey using RedCap, directed at doctors and nurses across four institutions in Bangladesh (The Sheikh Russel Gastro Liver Institute & Hospital (SRNGIH), Dhaka Medical College Hospital (DMCH), Mugda Medical College Hospital (MMCH) and M Abdur Rahim Medical College (MARMC) Hospital). We collected information on demographics, awareness of well-being services, COVID-19-related workload, as well as anxiety, depression and burnout using two validated questionnaires: the Hospital Anxiety and Depression Scale (HADS) and the Maslach Burnout Inventory (MBI). RESULTS Of the 3000 participants approached, we received responses from 2705 (90.2%). There was a statistically significant difference in anxiety, depression and burnout scores across institutions (p<0.01). Anxiety, depression and burnout scores were statistically worse in COVID-19 active staff compared with those not working on COVID-19 activities (p<0.01 for HADS anxiety and depression and MBI emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA)). Over half of the participants exhibited some level of anxiety (SRNGIH: 52.2%; DMCH: 53.9%; MMCH: 61.3%; MARMC: 68%) with a high proportion experiencing depression (SRNGIH: 39.5%; DMCH: 38.7%; MMCH: 53.7%; MARMC: 41.1%). Although mean burnout scores were within the normal range for each institution, a high proportion of staff (almost 20% in some instances) were shown to be classified as experiencing burnout by their EE, DP and PA scores. CONCLUSION We identified a high prevalence of perceived anxiety, depression and burnout among doctors and nurses during the COVID-19 pandemic. This was worse in staff engaged in COVID-19-related activities. These findings could help healthcare organisations to plan for future similar events.
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Affiliation(s)
| | - Mesbah Rahman
- Swansea Bay University Health Board, Port Talbot, UK
| | | | | | | | | | | | | | - Umakant Dave
- Swansea Bay University Health Board, Port Talbot, UK
| | - Neil Hawkes
- Cwm Taf Morgannwg University Health Board, Abercynon, UK
| | - Faruque Ahmed
- Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh
| | | | | | | | - Md Golam Kibria
- Sheikh Russel National Gastroliver Institute, Dhaka, Bangladesh
| | | | - Titu Mia
- Mugda Medical College and Hospital, Dhaka, Bangladesh
| | | | - John G Williams
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
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11
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Zhang M, Bo M, Wang H, Fan W, Kong L, Zhou C, Zhang Z. Prevalence and influencing factors of post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1323111. [PMID: 38425999 PMCID: PMC10902088 DOI: 10.3389/fpsyt.2024.1323111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Background Post-traumatic stress disorder is an important psychological problem affecting the physical mental health of Chinese healthcare workers during the COVID-19 pandemic. Aims To estimate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among Chinese healthcare workers during COVID-19. Methods Search of Chinese and English literature in PubMed, EMbase, Web of Science, Medline, Elsevier, SpringerLink, China Biomedical Literature Database, CNKI, Wan-fang, and CQVIP for the period from December 2019 to August 2023. Stata 14.0 software was used for data analysis. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the Random-effects model. Publication bias was evaluated using Egger's test and Begg's test. Results Twenty-one studies included 11841 Chinese healthcare workers in this review. First, the overall prevalence of Post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic was 29.2% (95% CI: 20.7% to 33.7%). Twelve factors included in the meta-analysis were found to be protective against PTSD among Chinese healthcare workers: female, nurse, married, front-line work, less work experience, family or friend diagnosed with COVID-19, history of chronic disease and fear of COVID-19. Conversely, outside Hubei, higher education, social support and psychological resilience are protective factors. Conclusion These recent findings increase our understanding of the psychological status of Chinese healthcare workers and encourage that long-term monitoring and long-term interventions should be implemented to improve the mental health of Chinese healthcare workers in the aftermath of the COVID-19.
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Affiliation(s)
- Min Zhang
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Mingyu Bo
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Huixin Wang
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Wenyi Fan
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Lingling Kong
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Chunjie Zhou
- School of Information and Electrical Engineering, Ludong University, Yantai, Shandong, China
| | - Zhenxing Zhang
- School of Information and Electrical Engineering, Ludong University, Yantai, Shandong, China
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12
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Olff M. Crises in the Anthropocene. Eur J Psychotraumatol 2023; 14:2170818. [PMID: 37052094 PMCID: PMC9930782 DOI: 10.1080/20008066.2023.2170818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
2022 was a year of crises, not just one but multiple intersecting crises that caused traumatic stress in billions of people worldwide. COVID-19 is still not over. New wars have started, and the climate change impact is bigger than ever. Will the Anthropocene be an era of continued crises? This past year the European Journal of Psychotraumatology (EJPT) has again tried to contribute to how to prevent or treat the consequences of these major crises as well as other events and we will continue to do so the year to come. For instance, we will have special issues or collections addressing these big issues, such as climate change and traumatic stress, or early intervention after trauma or in times of conflict. In this editorial, we also present the past year's excellent journal metrics regarding reach, impact, and quality and the ESTSS EJPT award finalists for best paper of 2022 and look forward to 2023. 2022 was a year of multiple intersecting crises causing traumatic stress to billions of people around the world. European Journal of Psychotraumatology (EJPT) aims to contribute to how to understand, prevent or treat the consequences of these major crises. EJPT's editorial team again achieved excellent journal metrics regarding reach, impact, and quality in 2022.
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam Neuroscience, & Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
- ARQ National Psychotrauma Centre, Diemen, Netherlands
- Miranda Olff Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam1105 AZ, Netherlands
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13
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Dubé CE, Nielsen N, McPhillips E, Lee Hargraves J, Cosenza C, Jesdale B, Lapane KL. U.S. nursing home leadership experiences with COVID-19 and its impact on residents and staff: A qualitative analysis. PLoS One 2023; 18:e0293336. [PMID: 38113231 PMCID: PMC10729989 DOI: 10.1371/journal.pone.0293336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 10/10/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES To explore experiences of U.S. (United States) nursing home leadership during the COVID-19 pandemic in their efforts to address resident loneliness and social isolation and to elicit stories about personal and professional impacts on themselves and staff. DESIGN Qualitative inquiry via three optional open-ended questions appended to a national self-administered survey of American nursing home leaders was employed. Textual data was analyzed using an iterative reflexive thematic approach. SETTING AND PARTICIPANTS A stratified sample frame defined by facility size (beds: 30-99, 100+) and quality ratings (1, 2-4, 5) was employed. Web survey links and paper surveys were sent to 1,676 nursing home directors of nursing between February and May 2022. RESULTS Open text responses were collected from 271 nursing homes. Broad themes included: 1) Addressing needs of residents & families; 2) Challenges; and 3) Personal experiences of nursing home leadership/staff. Respondents described trauma to residents, staff, and leadership. Resident loneliness was addressed using existing and newer technologies and innovative indoor and outdoor activities. Residents experienced fear, illness, loss, and sometimes death. Isolation from family and lack of touch were particularly difficult. Regulations were seen as punitive while ignoring emotional needs of residents. Staffing challenges and pressures to do more with less created additional stress. Leadership and staff made significant sacrifices resulting in physical, social, and emotional consequences. Beneficial outcomes included staff bonding, professional growth, and permanent implementation of new interventions. CONCLUSIONS AND IMPLICATIONS New and creative interventions were successfully implemented to address social isolation and loneliness. Improved Wi-Fi and other nursing home infrastructure upgrades are needed to maintain them. Reimagining often conflicting overlapping federal, state, and local regulations, grounding them in good clinical judgement, and incentivizing performance improvement should be considered. Trauma experienced by staff needs to be addressed to deal with current and future workforce needs.
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Affiliation(s)
- Catherine E. Dubé
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America
| | - Natalia Nielsen
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America
| | - Emily McPhillips
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America
| | - J. Lee Hargraves
- Department of Family Medicine and Community Health University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America
- Center for Survey Research, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - Carol Cosenza
- Center for Survey Research, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - Bill Jesdale
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America
| | - Kate L. Lapane
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America
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14
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Greenwald A, Kelly A, Thomas L. Trauma-informed care in the emergency department: concepts and recommendations for integrating practices into emergency medicine. MEDICAL EDUCATION ONLINE 2023; 28:2178366. [PMID: 36799730 PMCID: PMC9946309 DOI: 10.1080/10872981.2023.2178366] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/08/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The experience of psychological trauma is common and has become even more prevalent during the COVID-19 pandemic for both health care workers and the general population [1-3]. Traumatic experiences can have varied and lasting physical and mental health effects on patients, beyond what we are privy to in the acute environment of the emergency department. The effects of these prior traumatic experiences can be exacerbated by interaction with the healthcare system, and yet emergency medicine physicians have no standardized methods for working with patients in a trauma-informed way. The systematic implementation of trauma-informed care (TIC) practice requires the cooperation of multiple domains within the health care system, including focus on the physical environment, direct care, and administrative practices. Here we provide recommendations specific to emergency medicine for the development and implementation of TIC in the regular patient-clinician interaction, situated within the context of the TIC framework as outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA) [4].
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Affiliation(s)
- Audria Greenwald
- Department of Medical Sciences, Frank H. Netter School of Medicine at Quinnipiac University, North Haven, CT, USA
| | - Amber Kelly
- Department of Medical Sciences, Frank H. Netter School of Medicine at Quinnipiac University, North Haven, CT, USA
| | - Listy Thomas
- Department of Social Work, Quinnipiac University School for Health Sciences, North Haven, CT, USA
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15
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Ford JD, Seedat S. On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021-2023. Eur J Psychotraumatol 2023; 14:2281988. [PMID: 38038964 PMCID: PMC10990445 DOI: 10.1080/20008066.2023.2281988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/17/2023] [Indexed: 12/02/2023] Open
Abstract
This Special Issue of the European Journal of Psychotraumatology (EJPT) presents 51 articles published between 2021 and 2023 and follows the Special Issue on pandemic-related traumatic stress research published in 2021 (O'Donnell, M. L., & Greene, T. [2021]. Understanding the mental health impacts of COVID-19 through a trauma lens. European Journal of Psychotraumatology, 12(1), 1982502). Research on traumatic stress during the pandemic has cast the spotlight on vulnerable populations and groups, notably front-line healthcare workers; people faced with major losses including the deaths of loved ones; those who personally survived debilitating and often life-threatening viral infection; and students who were isolated and experienced profound delays in their education, relationships, and emerging independence. The papers in this collection underscore the associations between COVID-19 related stressors and a plethora of adverse mental health sequelae, including posttraumatic stress reactions, and draw attention to the ubiquity of grief and moral injury and their wide-ranging and detrimental impact. Currently, there is a paucity of evidence on interventions to enhance resources, self-efficacy, and hope for affected groups and individuals through societal, organisational, and healthcare systems; however early research on the prevention of COVID-related traumatic stress disorders provides a basis for both hope and preparedness for the future.
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Affiliation(s)
- Julian D. Ford
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Soraya Seedat
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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16
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Sharma ME, Cousins R. Understanding Moral Injury in Frontline Health Care Professionals 2 Years After the Onset of COVID-19. J Nerv Ment Dis 2023; 211:934-939. [PMID: 37192009 DOI: 10.1097/nmd.0000000000001665] [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] [Indexed: 05/18/2023]
Abstract
ABSTRACT Throughout the COVID-19 pandemic, health care professionals have worked in morally challenging situations. The aim of this research was to investigate the predictors of moral injury in United Kingdom frontline health care professionals working in a variety of roles 2 years after the onset of the pandemic. A cross-sectional survey was conducted January 25-February 28, 2022. A total of 235 participants answered sociodemographic, employment, health, COVID-19-related questions, and the 10-item Moral Injury Symptom Scale-Healthcare Professional version. Nearly three quarters had experienced moral injury. Twelve significant predictors of moral injury were entered into a backward elimination binominal logistic regression. The final model included five independent predictors that explained 25.4% variance in moral injury (χ 2 [5, N = 235] = 45.7, p < 0.001). Odds of moral injury were significantly raised in young health care professionals (<31 years), smokers, and those reporting low workplace confidence, not feeling appreciated, and feeling burned out. The findings support interventions to relieve moral injury in frontline health care professionals.
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17
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Billings J, Zhan Yuen Wong N, Nicholls H, Burton P, Zosmer M, Albert I, Grey N, El-Leithy S, Murphy D, Tehrani N, Wheatley J, Bloomfield MAP, Greene T. Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance. Eur J Psychotraumatol 2023; 14:2281751. [PMID: 38032045 PMCID: PMC10990448 DOI: 10.1080/20008066.2023.2281751] [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: 05/02/2023] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.
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Affiliation(s)
- Jo Billings
- Division of Psychiatry, University College London, London, UK
| | | | - Helen Nicholls
- Division of Psychiatry, University College London, London, UK
| | - Peter Burton
- Division of Psychiatry, University College London, London, UK
| | - Maya Zosmer
- Division of Psychiatry, University College London, London, UK
| | - Idit Albert
- King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Nick Grey
- University of Sussex, Falmer, UK
- Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK
| | | | - Dominic Murphy
- King’s College London, London, UK
- Combat Stress, London, UK
| | | | - Jon Wheatley
- Homerton Healthcare NHS Foundation Trust, London, UK
| | - Michael A. P. Bloomfield
- Division of Psychiatry, University College London, London, UK
- Camden & Islington NHS Foundation Trust, London, UK
| | - Talya Greene
- Clinical, Educational and Health Psychology, University College London, London, UK
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18
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Pankratz L, Gill G, Pirzada S, Papineau K, Reynolds K, Riviere CL, Bolton JM, Hensel JM, Olafson K, Kredentser MS, El-Gabalawy R, Hiebert T, Chochinov HM. "It took so much of the humanness away": Health care professional experiences providing care to dying patients during COVID-19. DEATH STUDIES 2023; 48:706-718. [PMID: 37938174 DOI: 10.1080/07481187.2023.2266639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
COVID-19 has affected healthcare in profound and unprecedented ways, distorting the experiences of patients and healthcare professionals (HCPs) alike. One area that has received little attention is how COVID-19 affected HCPs caring for dying patients. The goal of this study was to examine the experiences of HCPs working with dying patients during the COVID-19 pandemic. Between July 2020-July 2021, we recruited HCPs (N = 25) across Canada. We conducted semi-structured interviews, using a qualitative study design rooted in constructivist grounded theory methodology. The core themes identified were the impact of the pandemic on care utilization, the impact of infection control measures on provision of care, moral distress in the workplace, impact on psychological wellbeing, and adaptive strategies to help HCPs manage emotions and navigate pandemic imposed changes. This is the first Canadian study to qualitatively examine the experiences of HCPs providing care to dying patients during the COVID-19 pandemic. Implications include informing supportive strategies and shaping policies for HCPs providing palliative care.
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Affiliation(s)
- Lily Pankratz
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gagan Gill
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salina Pirzada
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kelsey Papineau
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christian La Riviere
- Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jennifer M Hensel
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kendiss Olafson
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Maia S Kredentser
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Anesthesiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tim Hiebert
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harvey Max Chochinov
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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19
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Mercer L, Cookson A, Müller-Myhsok B, van Vuuren J. Burnout and secondary traumatic stress in staff working with people with intellectual disabilities: The role of adverse childhood experiences, resilience and trauma-informed organisational climate. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1297-1307. [PMID: 37533333 DOI: 10.1111/jar.13148] [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: 10/29/2022] [Revised: 06/01/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND There has been extensive research into adverse childhood experiences (ACEs), however, less consideration has been given to the prevalence and impact of ACEs for staff working with people with intellectual disabilities. METHOD Participants were staff employed by agencies that care for people with intellectual disabilities. An online survey collected demographic information and measures of ACEs, resilience, trauma-informed organisational climate, burnout and secondary traumatic stress. Correlation, regression, mediation and moderation analyses were used. RESULTS 81.7% of 109 participants had experienced at least one ACE. Burnout, secondary traumatic stress and resilience were greater in the present study than in comparable samples. Trauma-informed organisational climate significantly predicted burnout and secondary traumatic stress. Resilience significantly predicted burnout. CONCLUSIONS Staff working with people with intellectual disabilities are likely to have experienced ACEs. Working in a trauma-informed organisational climate and resilience may be effective avenues for reducing burnout and secondary traumatic stress.
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Affiliation(s)
- Louise Mercer
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Alex Cookson
- Learning Disability Community Team, Merseycare NHS Trust, Liverpool, UK
| | | | - Julie van Vuuren
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
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20
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McCann B, Hunter SC, McAloney-Kocaman K, McCarthy P, Smith J, Calveley E. Time for You: A process evaluation of the rapid implementation of a multi-level mental health support intervention for frontline workers during the COVID-19 pandemic. PLoS One 2023; 18:e0293393. [PMID: 37889922 PMCID: PMC10610521 DOI: 10.1371/journal.pone.0293393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
The coronavirus (COVID-19) pandemic had wide-ranging negative impacts on mental health. The pandemic also placed extraordinary strain on frontline workers who were required to continue working and putting themselves at risk to provide essential services at a time when their normal support mechanisms may not have been available. This paper presents an evaluation of the Time for You service, a rapidly developed and implemented intervention aimed at providing frontline workers with quick access to flexible online mental health support. Time for You provided service users with three service options: self-guided online cognitive behavioural therapy (CBT) resources; guided engagement with online CBT resources; 1-1 psychological therapy with trainee sport and exercise psychologists and trainee health psychologists. A process evaluation informed by the Consolidated Framework for Implementation Research considered service fidelity, adaptations, perceived impact, reach, barriers, and facilitators. Interviews with project managers (n = 5), delivery staff (n = 10), and service users (n = 14) explored perceptions of the service implementation and outcomes, supported by data regarding engagement with the online CBT platform (n = 217). Findings indicated that service users valued the flexibility of the service and the speed with which they were able to access support. The support offered by Trainee Psychologists was perceived to be of high quality, and the service was perceived by service users to have improved mental health and wellbeing. The rapid implementation contributed to issues regarding appropriate service user screening that led to trainee psychologists being unable to provide the service users with the support they needed as the presenting issues were outside of trainees' competencies. Overall, the findings suggest that interventions offering flexible, online psychological support to frontline workers can be an effective model for future interventions. Trainee psychologists are also able to play an important role in delivering such services when clear screening processes are in place.
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Affiliation(s)
- Bryan McCann
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Simon C. Hunter
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
- Graduate School of Education, University of Western Australia, Perth, Western Australia, Australia
| | - Kareena McAloney-Kocaman
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Paul McCarthy
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Jan Smith
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Eileen Calveley
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
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21
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Khazaee-Pool M, Moradi M, Pashaei T, Ponnet K. Psychosocial status and risk perception among Iranian healthcare workers during the fifth wave of the COVID-19 pandemic. HUMAN RESOURCES FOR HEALTH 2023; 21:76. [PMID: 37723512 PMCID: PMC10506218 DOI: 10.1186/s12960-023-00862-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Healthcare workers (HCWs) are essential resources, and their health and wellbeing are key not only for offering constant and useful care facilities to clients, but also for maintaining the safety of the workforce and patients. The risk of severe mental health problems among HCWs may have increased during large outbreaks of COVID-19. To evaluate the psychosocial status and risk perception of HCWs who participated in treating COVID-19 patients in Northern Iran, we performed a web-based cross-sectional study. METHODS The web-based cross-sectional design was applied between June 27 and September 2, 2021. Using convenience sampling, 637 HCWs were recruited from hospitals in Northern Iran (Mazandaran). The HCWs completed self-report questionnaires that included a sociodemographic information form, the 12-item General Health Questionnaire, Impact of the Event Scale-Revised, Risk Perception Questionnaire, and Anxiety Stress Scale-21. The data were analyzed via descriptive and inferential statistics and univariate/multivariate logistic regression to assess the risk factors linked to each psychosocial consequence. RESULTS The results reveal that the COVID-19 pandemic had an adverse psychosocial influence on HCWs, which was already apparent 1.5 years after the crisis began. Based on the results, 71.6%, 55.6%, and 32.3% of HCWs reported having anxiety, depression, and stress symptoms, respectively, since the outbreak of this disease. The logistic regression models displayed that marital status, having children, and working hours with patients were all risk factors of psychosocial impairment. CONCLUSIONS The outbreak of COVID-19 can be considered an important experience of a bio-disaster resulting in a significant rate of psychiatric problems in HCWs. There is a need for designing and promoting supportive programs to help HCWs cope and to improve their psychosocial state, and the present study has detected for whom psychosocial support may be effective and practical 1.5 years after the primary outbreak. Moreover, detecting and managing concerns and reducing infection-related embarrassment/stigma are essential for improving HCWs' mental health.
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Affiliation(s)
- Maryam Khazaee-Pool
- Department of Health Education and Promotion, School of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Masoud Moradi
- Department of Biostatistics and Epidemiology, School of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Pashaei
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Koen Ponnet
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
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22
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Shrestha RM, Inoue Y, Yamamoto S, Fukunaga A, Sampei M, Okubo R, Morisaki N, Ohmagari N, Funaki T, Ishizuka K, Yamaguchi K, Sasaki Y, Takeda K, Miyama T, Kojima M, Nakagawa T, Nishimura K, Ogata S, Umezawa J, Tanaka S, Inoue M, Konishi M, Miyo K, Mizoue T. The association between experience of COVID-19-related discrimination and psychological distress among healthcare workers for six national medical research centers in Japan. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1421-1429. [PMID: 36928546 PMCID: PMC10020069 DOI: 10.1007/s00127-023-02460-w] [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: 08/09/2022] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Discrimination is an important determinant of negative mental health outcomes. This study determined the association between the experience of COVID-19-related discrimination and psychological distress among healthcare workers (HCWs) in Japan. METHODS This cross-sectional study conducted a health survey among 5703 HCWs of six national medical and research centers in Japan from October 2020 to March 2021. COVID-19-related discrimination was defined either when participants or their family members were badmouthed or when they felt discriminated against in some way. We used the Kessler Psychological Distress Scale (K6) to assess the presence of severe psychological distress (≥ 13 points). We used logistic regression models to examine the association between discrimination and psychological distress. We also identified factors associated with discrimination. RESULTS Of the participants, 484 (8.4%) reported COVID-19-related discrimination and 486 (8.5%) had severe psychological distress. HCWs who were female vs. male (adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.28-1.55), had high vs. low viral exposure (AOR = 2.31, 95% CI = 1.81-2.93), and worked for 11 or more hours/day vs. 8 or less hours/day (AOR = 1.42, 95% CI = 1.35-1.49) were more likely to have experienced COVID-19-related discrimination. The AOR (95% CI) of severe psychological distress was 1.83 (1.29-2.59) among those who experienced discrimination. In the stratified analysis by sociodemographic and job-related factors, all the interactions did not reach statistical significance (p for interaction > 0.20). CONCLUSION Experience of COVID-19-related discrimination was associated with severe psychological distress among HCWs. During the pandemic, effective measures should be taken to prevent the development of negative mental health outcomes in HCWs who experience discrimination.
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Affiliation(s)
- Rachana Manandhar Shrestha
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan.
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Makiko Sampei
- Department of Health Science, Health Promotion, Nippon Sport Science University, Tokyo, Japan
| | - Ryo Okubo
- Clinical Research and Education Promotion Division, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Science, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takanori Funaki
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Kazue Ishizuka
- Department of Social Science, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Koushi Yamaguchi
- Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yohei Sasaki
- Clinical Research and Education Promotion Division, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kazuyoshi Takeda
- Clinical Research and Education Promotion Division, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takeshi Miyama
- National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masayo Kojima
- Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Takeshi Nakagawa
- Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Jun Umezawa
- Division of Cohort Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Shiori Tanaka
- Division of Prevention, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Manami Inoue
- Division of Prevention, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Kengo Miyo
- Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
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O'Donnell S, Quigley E, Hayden J, Adamis D, Gavin B, McNicholas F. Psychological distress among healthcare workers post COVID-19 pandemic: from the resilience of individuals to healthcare systems. Ir J Psychol Med 2023; 40:508-512. [PMID: 35938227 DOI: 10.1017/ipm.2022.35] [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] [Indexed: 11/06/2022]
Abstract
Since the emergence of the COVID-19 pandemic, there has been increased interest in identifying ways of protecting the mental well-being of healthcare workers (HCWs). Much of this has been directed towards promoting and enhancing the resilience of those deemed as frontline workers. Based on a review of the extant literature, this paper seeks to problematise aspects of how 'frontline work' and 'resilience' are currently conceptualised. Firstly, frontline work is arbitrarily defined and often narrowly focused on acute, hospital-based settings, leading to the needs of HCWs in other sectors of the healthcare system being overlooked. Secondly, dominant narratives are often underpinned by a reductionist understanding of the concept of resilience, whereby solutions are built around addressing the perceived deficiencies of (frontline) HCWs rather than the structural antecedents of distress. The paper concludes by considering what interventions are appropriate to minimise the risk of burnout across all sectors of the healthcare system in a post-pandemic environment.
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Affiliation(s)
- S O'Donnell
- School of Medicine and Medical Science (SMMS), University College Dublin, Belfield, Dublin 4, Ireland
- School of Sociology, University College Dublin, Dublin 4, Ireland
| | - E Quigley
- National University of Ireland, Maynooth University, Department of Law, Maynooth, Ireland
| | - J Hayden
- RCSI School of Pharmacy and Biomolecular Sciences (PBS), Dublin, Ireland
| | - D Adamis
- HSE Sligo Mental Health Services, Sligo, Ireland
| | - B Gavin
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science (SMMS), University College Dublin, Dublin, Ireland
| | - F McNicholas
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science (SMMS), University College Dublin, Dublin, Ireland
- Children Health Ireland, Crumlin, Dublin 12, Ireland
- Lucena Clinic Rathgar, Dublin 6, Ireland
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Polizzi CP, Sleight FG, Aksen DE, McDonald CW, Lynn SJ. Mindfulness and COVID-19-Related Stress: Staying Present During Uncertain Times. Mindfulness (N Y) 2023; 14:1135-1147. [PMID: 37304660 PMCID: PMC10150345 DOI: 10.1007/s12671-023-02132-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/13/2023]
Abstract
Objectives The SARS-CoV-2 (COVID-19) pandemic is recognized as a mass traumatic event in which COVID-19-related stress (CS) can indicate other trauma- and/or stressor-related disorder. The facets of mindfulness (observing, describing, acting with awareness, nonjudging, and nonreacting) have been linked to reductions in stress-related symptoms and thus may protect against CS. We extended previous research by evaluating mindfulness facets as resilience skills negatively related to CS. Method Undergraduate students (n = 495) completed an online battery of questionnaires. A subsample of students endorsing clinically elevated CS (n = 165) was also evaluated. We utilized hierarchical regression to account statistically for the mindfulness facets in addition to indicators of psychological distress (e.g., negative affect, neuroticism, dissociation) and social desirability. We performed analyses twice, once in the overall sample, and once in the high CS subsample. Results Less observing and greater nonjudging related to reduced CS while other study variables were controlled for in the overall sample. In contrast, acting with awareness and nonjudging negatively related to CS in the subsample, but were not related to CS when we accounted for psychological-distress variables that positively related to CS in the analysis. Conclusions Although variables indicative of psychological distress robustly contribute to CS, observing, acting with awareness, and nonjudging may be mindfulness skills that can be targeted to buffer clinically significant CS. Preregistration This study was not pre-registered.
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Affiliation(s)
- Craig P. Polizzi
- Veterans Affairs Boston Healthcare System, 150 S Huntington Ave, Boston, MA 02130 USA
- Department of Psychiatry, Boston University School of Medicine, Boston, USA
| | - Fiona G. Sleight
- Department of Psychology, Binghamton University (SUNY), Binghamton, USA
| | - Damla E. Aksen
- Department of Psychology, Binghamton University (SUNY), Binghamton, USA
| | | | - Steven Jay Lynn
- Department of Psychology, Binghamton University (SUNY), Binghamton, USA
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Soubra K, Tamworth C, Kamal Z, Brook C, Langdon D, Billings J. Health and social care workers experiences of coping while working in the frontline during the COVID-19 pandemic: One year on. PLoS One 2023; 18:e0284306. [PMID: 37043526 PMCID: PMC10096225 DOI: 10.1371/journal.pone.0284306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The unprecedented pressure of working on the frontline during the Covid-19 pandemic had a demonstrable impact on the mental health and wellbeing of health and social care workers in the early stages of the pandemic, however, less research has focused on workers' experiences over the longer course of the pandemic. AIMS We set out to develop an explanatory model of the processes that helped and hindered the coping of HSCWs working over the course of the Covid-19 pandemic. METHOD Twenty HSCWs based in the UK took part in the study. They completed semi-structured interviews 12-18 months after the peak of the first wave in the UK. Interviews were transcribed and analysed using grounded theory methodology. RESULTS The analysis identified eleven theoretical codes: personal context, organisational resources, organisational response, management, colleagues, decision-making and responsibilities, internal impacts, external impactors, safety, barriers to accessing support and temporal factors. The findings suggest that factors related to the individual themselves, their personal context, the organisation they work in, their managers, the support structures around them and their sense of safety impacted on HSCWs; ability to cope. Some factors changed over time throughout the first year of the pandemic, such as workload and staff illness, which further impacted HSCWs' coping. There were many barriers to accessing support that also impacted coping, including availability, awareness and time. The relationship between the factors that impacted coping are represented in an explanatory model. CONCLUSIONS The findings extend previous studies on the mental health impact on frontline HSCWs working during Covid-19, providing novel insight by developing an explanatory model illustrating the underlying factors that impacted their coping experiences over the course of the pandemic in the UK. The findings from this study may assist in the development of improved and more effective support for HSCWs going forwards.
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Affiliation(s)
- Karina Soubra
- Department of Psychology, Royal Holloway University of London, London, United Kingdom
| | - Camilla Tamworth
- Division of Psychiatry, University College London, London, United Kingdom
| | - Zeast Kamal
- Division of Psychiatry, University College London, London, United Kingdom
| | - Clare Brook
- Acorn Group Practice, Twickenham, United Kingdom
| | - Dawn Langdon
- Department of Psychology, Royal Holloway University of London, London, United Kingdom
| | - Jo Billings
- Division of Psychiatry, University College London, London, United Kingdom
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Farrell D, Moran J, Zat Z, Miller PW, Knibbs L, Papanikolopoulos P, Prattos T, McGowan I, McLaughlin D, Barron I, Mattheß C, Kiernan MD. Group early intervention eye movement desensitization and reprocessing therapy as a video-conference psychotherapy with frontline/emergency workers in response to the COVID-19 pandemic in the treatment of post-traumatic stress disorder and moral injury—An RCT study. Front Psychol 2023; 14:1129912. [PMID: 37063579 PMCID: PMC10100089 DOI: 10.3389/fpsyg.2023.1129912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/22/2023] [Indexed: 04/01/2023] Open
Abstract
ObjectiveFrontline mental health, emergency, law enforcement, and social workers have faced unprecedented psychological distress in responding to the COVID-19 pandemic. The purpose of the RCT (Randomized Controls Trial) study was to investigate the effectiveness of a Group EMDR (Eye Movement Desensitization and Reprocessing) therapy (Group Traumatic Episode Protocol—GTEP) in the treatment of Post-Traumatic Stress Disorder (PTSD) and Moral Injury. The treatment focus is an early intervention, group trauma treatment, delivered remotely as video-conference psychotherapy (VCP). This early intervention used an intensive treatment delivery of 4x2h sessions over 1-week. Additionally, the group EMDR intervention utilized therapist rotation in treatment delivery.MethodsThe study’s design comprised a delayed (1-month) treatment intervention (control) versus an active group. Measurements included the International Trauma Questionnaire (ITQ), Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire (PHQ-9), Moral Injury Events Scale (MIES), and a Quality-of-Life psychometric (EQ-5D), tested at T0, T1: pre—treatment, T2: post-treatment, T3: 1-month follow-up (FU), T4: 3-month FU, and T5: 6-month FU. The Adverse Childhood Experiences – International version (ACEs), Benevolent Childhood Experience (BCEs) was ascertained at pre-treatment only. N = 85 completed the study.ResultsResults highlight a significant treatment effect within both active and control groups. Post Hoc comparisons of the ITQ demonstrated a significant difference between T1 pre (mean 36.8, SD 14.8) and T2 post (21.2, 15.1) (t11.58) = 15.68, p < 0.001). Further changes were also seen related to co-morbid factors. Post Hoc comparisons of the GAD-7 demonstrated significant difference between T1 pre (11.2, 4.91) and T2 post (6.49, 4.73) (t = 6.22) = 4.41, p < 0.001; with significant difference also with the PHQ-9 between T1 pre (11.7, 5.68) and T2 post (6.64, 5.79) (t = 6.30) = 3.95, p < 0.001, d = 0.71. The treatment effect occurred irrespective of either ACEs/BCEs during childhood. However, regarding Moral Injury, the MIES demonstrated no treatment effect between T1 pre and T5 6-month FU. The study’s findings discuss the impact of Group EMDR therapy delivered remotely as video-conference psychotherapy (VCP) and the benefits of including a therapist/rotation model as a means of treatment delivery. However, despite promising results suggesting a large treatment effect in the treatment of trauma and adverse memories, including co-morbid symptoms, research results yielded no treatment effect in frontline/emergency workers in addressing moral injury related to the COVID-19 pandemic.ConclusionThe NICE (2018) guidance on PTSD highlighted the paucity of EMDR therapy research used as an early intervention. The primary rationale for this study was to address this critical issue. In summary, treatment results for group EMDR, delivered virtually, intensively, using therapist rotation are tentatively promising, however, the moral dimensions of trauma need consideration for future research, intervention development, and potential for further scalability. The data contributes to the emerging literature on early trauma interventions.Clinical Trial Registration:Clinicaltrials.gov, ISRCTN16933691.
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Affiliation(s)
- Derek Farrell
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
- *Correspondence: Derek Farrell,
| | - Johnny Moran
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Zeynep Zat
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Paul W. Miller
- School of Nursing, Magee Campus, Ulster University, Northern Ireland, United Kingdom
| | - Lorraine Knibbs
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Penny Papanikolopoulos
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Tessa Prattos
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Iain McGowan
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
| | - Derek McLaughlin
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
| | - Ian Barron
- Centre for International Education, College of Education, University of Massachusetts, Amherst, MA, United States
| | - Cordula Mattheß
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Matthew D. Kiernan
- Northern Hub for Veteran and Military Families’ Research, Northumbria University, Newcastle upon Tyne, United Kingdom
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Costa A, Caldas de Almeida T, Fialho M, Rasga C, Martiniano H, Santos O, Virgolino A, Vicente AM, Heitor MJ. Mental Health of Healthcare Professionals: Two Years of the COVID-19 Pandemic in Portugal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3131. [PMID: 36833822 PMCID: PMC9968046 DOI: 10.3390/ijerph20043131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic increased psychosocial risk factors among healthcare professionals (HCPs). Objective: To characterize Portuguese HCPs mental health (MH), estimate anxiety, depression, post-traumatic stress disorder (PTSD) and burnout symptoms, and identify risk/protective factors. A cross-sectional online survey and a longitudinal assessment were conducted in 2020 (T0) and 2021 (T1). Sociodemographic and occupational variables, COVID-19-related experiences and protective behavior data were collected from a non-probabilistic sample of HCPs in Portugal. Symptoms of anxiety, depression, PTSD, burnout and resilience were assessed using the Portuguese versions of the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-9), the Post-traumatic Stress Disorder Checklist (PCL-5), the Shirom-Melamed Burnout Measure (MBSM) and the Connor-Davidson Resilience Scale (CD-RISC-10), respectively. Risk and protective factors were identified through simple and multiple logistic regression models. Overall, 2027 participants answered the survey in T0 and 1843 in T1. The percentage of moderate-to-severe symptoms decreased from T0 to T1; however, a considerable proportion of HCPs reported symptoms of distress in both years. Being a woman, working in a COVID-19-treatment frontline position and work-life balance increased the odds of distress. High resilience, good social/family support, and hobbies/lifestyle maintenance were found to be protective factors. Globally, our results show that performing as a HCP during the pandemic may result in long-term effects on MH.
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Affiliation(s)
- Alexandra Costa
- Departamento de Promoção da Saúde e Prevenção de Doenças Não-Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
| | - Teresa Caldas de Almeida
- Departamento de Promoção da Saúde e Prevenção de Doenças Não-Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
| | - Mónica Fialho
- Environmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 2649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 2649-028 Lisboa, Portugal
| | - Célia Rasga
- Departamento de Promoção da Saúde e Prevenção de Doenças Não-Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
- BioISI–Biosystems and Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Hugo Martiniano
- Departamento de Promoção da Saúde e Prevenção de Doenças Não-Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
- BioISI–Biosystems and Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Osvaldo Santos
- Environmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 2649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 2649-028 Lisboa, Portugal
- Unbreakable Idea Research, 2550-426 Painho, Portugal
| | - Ana Virgolino
- Environmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 2649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 2649-028 Lisboa, Portugal
| | - Astrid Moura Vicente
- Departamento de Promoção da Saúde e Prevenção de Doenças Não-Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
- BioISI–Biosystems and Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Maria João Heitor
- Environmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 2649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 2649-028 Lisboa, Portugal
- Departamento de Psiquiatria e Saúde Mental, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal
- Sociedade Portuguesa de Psiquiatria e Saúde Mental, 1050-096 Lisboa, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS), Faculdade de Medicina, Universidade Católica Portuguesa, 2635-631 Sintra, Portugal
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Yarahmadi S, Khademi M, Ebrahimzadeh F, Cheraghian T, Shahidi Delshad E. Development and psychometric properties of health care workers' concerns in infectious outbreaks scale. Front Psychol 2023; 13:1108835. [PMID: 36743621 PMCID: PMC9891178 DOI: 10.3389/fpsyg.2022.1108835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/26/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction Healthcare workers are a crucial workforce; from a moral perspective, understanding their concerns and how to support them is crucial and makes it possible for health services to keep functioning. This study aimed to develop and validate Health Care Workers' Concerns in Infectious Outbreaks Scale (HCWCIOS). Methods This exploratory sequential mix-method study was employed to design and validate the HCWCIOS. The initial tool was designed after searching similar studies and performing a qualitative phase under the semi-structured approach. Both qualitative and quantitative methods were used to evaluate the face and content validity. The content validity ratio, content validity index, and item-level content validity index were also calculated. Exploratory factor analysis was employed to evaluate the construct validity. Using a convenient sampling method, 354 Iranian healthcare workers participated in the study. Computing Cronbach's alpha coefficient estimated the internal consistency for HCWCIOS and its subscales. Furthermore assessed was test-retest reliability. Results The preliminary scale was designed with 57 items. By eliminating nine items in the content validity phase and 12 items during factor analysis, the final 36-item scale was developed on six factors: inadequate preparedness, lack of knowledge, risk perception, affected social relations, work pressure, and absenteeism. These six factors accounted for 46.507% of the total variance. The whole scale's Cronbach's alpha coefficient was 0.912, and the intra-class correlation coefficient was 0.88. Conclusion A 36-item HCWCIOS has good psychometric properties and is suitable for measuring healthcare workers' concerns during a pandemic.
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Affiliation(s)
- Sajad Yarahmadi
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran,Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Mojgan Khademi
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Farzad Ebrahimzadeh
- Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Tayebeh Cheraghian
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elham Shahidi Delshad
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran,*Correspondence: Elham Shahidi Delshad, ✉
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Liu Y, Zou L, Yan S, Zhang P, Zhang J, Wen J, Mao J, Li L, Wang Y, Fu W. Burnout and post-traumatic stress disorder symptoms among medical staff two years after the COVID-19 pandemic in Wuhan, China: Social support and resilience as mediators. J Affect Disord 2023; 321:126-133. [PMID: 36280200 PMCID: PMC9585849 DOI: 10.1016/j.jad.2022.10.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/01/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Evidence on the relationship between burnout and post-traumatic stress disorder (PTSD) is limited. We aimed to evaluate the association between burnout and PTSD symptoms among medical staff two years after the coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, and explore the mediating roles of social support and psychological resilience. METHODS A multicenter survey was conducted online from January to March 2022 among healthcare professionals from six general hospitals. Hierarchical linear regression was used to detect the predictors of PTSD symptoms. Structural equation modeling (SEM) was used to analyze the pathways from burnout to PTSD symptoms. RESULTS Hierarchical linear regression showed that burnout, social support, and psychological resilience were significant predictors of PTSD symptoms among medical staff. In the SEM, the standardized total effect of burnout on PTSD symptoms was 0.336(bias-corrected 95 % confidence interval [0.303, 0.367], P < 0.001). Social support and psychological resilience partially mediated the relationship between burnout and PTSD symptoms (indirect effects accounted for 22.3 % of the total effect). LIMITATIONS Owing to the cross-sectional design, only clues to causal explanations can be provided. CONCLUSIONS Burnout has significant direct and indirect effects on PTSD symptoms. Furthermore, social support and psychological resilience might be effective ways to reduce the impact of burnout on PTSD symptoms in medical staff after a major public health outbreak.
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Affiliation(s)
- Yifang Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zou
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shijiao Yan
- Department of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China,School of Public Health, Hainan Medical University, Haikou, China
| | - Pu Zhang
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jun Zhang
- Department of Endocrinology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jing Wen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Longti Li
- Department of Nursing, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Ying Wang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Copel LC, Smeltzer SC, Byrne CD, Chen MH, Havens DS, Kaufmann P, Brom H, Durning JD, Maldonado L, Bradley PK, Mensinger J, Yost J. A thematic analysis of shared experiences of essential health and support personnel in the COVID-19 pandemic. PLoS One 2023; 18:e0282946. [PMID: 36940223 PMCID: PMC10027207 DOI: 10.1371/journal.pone.0282946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/27/2023] [Indexed: 03/21/2023] Open
Abstract
AIMS AND OBJECTIVES Studies have shown that the COVID-19 pandemic has taken a toll on individuals who interact with patients with SARS-CoV-2 but focused largely on clinicians in acute care settings. This qualitative descriptive study aimed to understand the experiences and well-being of essential workers across settings during the pandemic. BACKGROUND Multiple studies of the well-being of individuals who have cared for patients during the pandemic have included interviews of clinicians from acute care settings and revealed high levels of stress. However, other essential workers have not been included in most of those studies, yet they may also experience stress. METHODS Individuals who participated in an online study of anxiety, depression, traumatic distress, and insomnia, were invited to provide a free-text comment if they had anything to add. A total of 2,762 essential workers (e.g., nurses, physicians, chaplains, respiratory therapists, emergency medical technicians, housekeeping, and food service staff, etc.) participated in the study with 1,079 (39%) providing text responses. Thematic analysis was used to analyze those responses. RESULTS Four themes with eight sub-themes were: Facing hopelessness, yet looking for hope; Witnessing frequent death; Experiencing disillusionment and disruption within the healthcare system, and Escalating emotional and physical health problems. CONCLUSIONS The study revealed major psychological and physical stress among essential workers. Understanding highly stressful experiences during the pandemic is essential to identify strategies that ameliorate stress and prevent its negative consequences. This study adds to the research on the psychological and physical impact of the pandemic on workers, including non-clinical support personnel often overlooked as experiencing major negative effects. RELEVANCE TO CLINICAL PRACTICE The magnitude of stress among all levels of essential workers suggests the need to develop strategies to prevent or alleviate stress across disciplines and all categories of workers.
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Affiliation(s)
- Linda Carman Copel
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
| | - Suzanne C Smeltzer
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
| | - Christine D Byrne
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
| | - Mu-Hsun Chen
- Department of Mathematics and Statistics, Villanova University, Villanova, Pennsylvania, United States of America
| | - Donna S Havens
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
| | - Peter Kaufmann
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
| | - Heather Brom
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
| | - Jennifer Dean Durning
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
- School of Nursing, Massachusetts General Hospital Institute of Health Professions, Charlestown, Massachusetts, United States of America
| | - Linda Maldonado
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
| | - Patricia K Bradley
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
| | - Janell Mensinger
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, Florida, United States of America
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America
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Network analysis of distress, suicidality, and resilience in a treatment seeking sample of first responders. J Affect Disord 2023; 320:742-750. [PMID: 36179781 DOI: 10.1016/j.jad.2022.09.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 08/30/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION First responders are routinely and regularly exposed to traumatic events that can clinically manifest with a symptom constellation of posttraumatic stress disorder (PTSD), generalized anxiety, depression, and suicidality. METHODS We used network analysis to examine baseline data from treatment seeking first responders (n = 308) to examine the interrelatedness of those constructs, including a measure of resilience. We estimated two models: a regularized partial correlation network and a Bayesian Directed Acyclic Graph (DAG). RESULTS The models reveal converging evidence highlighting the central role of negative alterations in cognitions and mood PTSD cluster along with affective depression. These nodes did not significantly differ, though they were among the strongest in the partial correlation network and shared the most variance with the other nodes. The DAG results suggested that the negative alterations in cognitions and mood PTSD cluster predicted downstream constructs of affective depression; intrusion, hyperarousal, and avoidance PTSD clusters; and resilience. Only resilience and affective depression exhibited direct effects on suicidality. Both somatic depression and suicidality were endogenous endpoints in the DAG. Resilience exhibited an inverse path to suicide. However, resilience was relatively independent of the other constructs in the models and the DAG suggested that it was a consequence of PTSD related distress. LIMITATIONS The data is cross-sectional in nature that should be followed up in longitudinal studies. CONCLUSION Findings are discussed in respect to the role of distress and emotional dysregulation as common factors underlying a broad range of internalizing problems.
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Scott HR, Stevelink SAM, Gafoor R, Lamb D, Carr E, Bakolis I, Bhundia R, Docherty MJ, Dorrington S, Gnanapragasam S, Hegarty S, Hotopf M, Madan I, McManus S, Moran P, Souliou E, Raine R, Razavi R, Weston D, Greenberg N, Wessely S. Prevalence of post-traumatic stress disorder and common mental disorders in health-care workers in England during the COVID-19 pandemic: a two-phase cross-sectional study. Lancet Psychiatry 2023; 10:40-49. [PMID: 36502817 PMCID: PMC9731576 DOI: 10.1016/s2215-0366(22)00375-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous studies on the impact of the COVID-19 pandemic on the mental health of health-care workers have relied on self-reported screening measures to estimate the point prevalence of common mental disorders. Screening measures, which are designed to be sensitive, have low positive predictive value and often overestimate prevalence. We aimed to estimate prevalence of common mental disorders and post-traumatic stress disorder (PTSD) among health-care workers in England using diagnostic interviews. METHODS We did a two-phase, cross-sectional study comprising diagnostic interviews within a larger multisite longitudinal cohort of health-care workers (National Health Service [NHS] CHECK; n=23 462) during the COVID-19 pandemic. In the first phase, health-care workers across 18 NHS England Trusts were recruited. Baseline assessments were done using online surveys between April 24, 2020, and Jan 15, 2021. In the second phase, we selected a proportion of participants who had responded to the surveys and conducted diagnostic interviews to establish the prevalence of mental disorders. The recruitment period for the diagnostic interviews was between March 1, 2021 and Aug 27, 2021. Participants were screened with the 12-item General Health Questionnaire (GHQ-12) and assessed with the Clinical Interview Schedule-Revised (CIS-R) for common mental disorders or were screened with the 6-item Post-Traumatic Stress Disorder Checklist (PCL-6) and assessed with the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) for PTSD. FINDINGS The screening sample contained 23 462 participants: 2079 participants were excluded due to missing values on the GHQ-12 and 11 147 participants due to missing values on the PCL-6. 243 individuals participated in diagnostic interviews for common mental disorders (CIS-R; mean age 42 years [range 21-70]; 185 [76%] women and 58 [24%] men) and 94 individuals participated in diagnostic interviews for PTSD (CAPS-5; mean age 44 years [23-62]; 79 [84%] women and 15 [16%] men). 202 (83%) of 243 individuals in the common mental disorders sample and 83 (88%) of 94 individuals in the PTSD sample were White. GHQ-12 screening caseness for common mental disorders was 52·8% (95% CI 51·7-53·8). Using CIS-R diagnostic interviews, the estimated population prevalence of generalised anxiety disorder was 14·3% (10·4-19·2), population prevalence of depression was 13·7% (10·1-18·3), and combined population prevalence of generalised anxiety disorder and depression was 21·5% (16·9-26·8). PCL-6 screening caseness for PTSD was 25·4% (24·3-26·5). Using CAPS-5 diagnostic interviews, the estimated population prevalence of PTSD was 7·9% (4·0-15·1). INTERPRETATION The prevalence estimates of common mental disorders and PTSD in health-care workers were considerably lower when assessed using diagnostic interviews compared with screening tools. 21·5% of health-care workers met the threshold for diagnosable mental disorders, and thus might benefit from clinical intervention. FUNDING UK Medical Research Council; UCL/Wellcome; Rosetrees Trust; NHS England and Improvement; Economic and Social Research Council; National Institute for Health and Care Research (NIHR) Biomedical Research Centre at the Maudsley and King's College London (KCL); NIHR Protection Research Unit in Emergency Preparedness and Response at KCL.
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Affiliation(s)
- Hannah R Scott
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sharon A M Stevelink
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Rafael Gafoor
- Department of Applied Health Research, University College London, London, UK
| | - Danielle Lamb
- Department of Applied Health Research, University College London, London, UK
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rupa Bhundia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Sarah Dorrington
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Sam Gnanapragasam
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Siobhan Hegarty
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Ira Madan
- Department of Occupational Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sally McManus
- NatCen Social Research, London, UK; Violence and Society Centre City, University of London, London, UK
| | - Paul Moran
- Department of Population Health Sciences, Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emilia Souliou
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, UK
| | - Reza Razavi
- Wellcome/EPSRC Centre For Medical Engineering, London, UK
| | - Danny Weston
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Neil Greenberg
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Yin C, Ji J, Cao X, Jin H, Ma Q, Gao Y. Impact of long working hours on depressive symptoms among COVID-19 frontline medical staff: The mediation of job burnout and the moderation of family and organizational support. Front Psychol 2023; 14:1084329. [PMID: 36874813 PMCID: PMC9975257 DOI: 10.3389/fpsyg.2023.1084329] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/26/2023] [Indexed: 02/17/2023] Open
Abstract
Background During the COVID-19 pandemic, the frontline medical staff faced more workload and heavier physical and mental stress, which increased their job burnout and negative emotions. However, little is known about the potential factors mediating and moderating these relations. This study investigates the association between long working hours and depressive symptoms among frontline medical staff in China, and explores the potential mediating effect of job burnout, and moderating effect of family and organizational support on these associations. Methods Data of 992 frontline medical staff who participated in the prevention and control of COVID-19 was obtained from the online survey conducted in November to December 2021 in China. Depressive symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9). Moderated mediating model was employed to understand the relationship between long working hours (X), depressive symptoms (Y) mediated through job burnout (M), moderated by family support (W1) and organizational support (W2), while controlling all possible covariates. Results 56.96% of participants worked more than 8 h per day. 49.8% of them had depressive symptoms (PHQ-9 ≥ 5) and 65.8% experienced job-related burnout. Long working hours was positively associated with depressive symptoms score (β = 0.26, 95% CI:0.13 ~ 0.40). Mediation analyses revealed that job burnout significantly mediated this relationship (indirect effect = 0.17, 95% CI: 0.08 ~ 0.26). Moderated mediation further indicated that both two interactions of social support (family support W1, organizational support W2) and job burnout were negatively related to depressive symptoms among frontline medical staff, indicating that higher social support being less job burnout with lower depressive symptoms. Conclusion Longer working hours and higher job burnout may contribute to worse mental health among frontline medical staff. Social support could buffer the detrimental effects by reducing their job burnout. Contribution The main contribution of this study was to estimate the negative effect of long working hours on depressive symptoms among frontline medical staff and explore the potential mediating role of job burnout and moderating role of social support on these associations.
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Affiliation(s)
- Chengjie Yin
- Department of Health Management, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jingya Ji
- Department of Health Management, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Xin Cao
- Department of Health Management, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Hui Jin
- Department of Health Management, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Qiang Ma
- Department of Health Management, School of Public Health, Nantong University, Nantong, Jiangsu, China.,Department of Hospital Management, Affiliated Hospital of Nantong University, Nantong, China
| | - Yuexia Gao
- Department of Health Management, School of Public Health, Nantong University, Nantong, Jiangsu, China
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Schwartz Tayri TM. On the Frontlines: The Impact of the COVID-19 Pandemic on Social Workers' Well-Being. SOCIAL WORK 2022; 68:69-80. [PMID: 36409997 DOI: 10.1093/sw/swac050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 06/16/2023]
Abstract
The crisis created by the spread of COVID-19 brought increasing needs and referrals to social welfare services in many countries. However, at the same time, social services suffered from staff cutbacks and service closures, resulting in significant workload increases to address the hardships associated with the pandemic. This article investigates the impact of the COVID-19 pandemic on Israeli social workers' well-being, using a mixed-methods design with a sample of 2,542 licensed social workers. Findings show that over 70 percent of social workers suffered from at least one health problem related to their work. Path analysis findings indicated that social workers who experienced greater service restrictions reported a greater decrease in job satisfaction and experienced higher levels of stress and work-related problems. Machine learning emotion-detection analysis revealed that the pandemic affected their lives, causing feelings of fear, frustration, and sadness. This article demonstrates how social workers whose work was characterized by greater service restrictions were less satisfied with their jobs, more stressed, and experienced greater job-related health problems, and concludes with a discussion of the implications for social work practice in times of crisis.
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Asakura K, Gheorghe RM, Rieger D, Tarshis S, Borgen S, D’Angiulli A. Exploring Shared Trauma in the Time of COVID: A Simulation-Based Survey Study of Mental Health Clinicians. CLINICAL SOCIAL WORK JOURNAL 2022; 51:163-174. [PMID: 36536816 PMCID: PMC9751501 DOI: 10.1007/s10615-022-00860-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
From fear of contracting the virus, isolation from physical distancing, to navigating lifework balance, the COVID-19 pandemic is expected to leave long-lasting psychosocial impacts on many. Shared trauma refers to similar psychological reactions to an extraordinary community event when experienced by both the clinicians and clients. We examined the experiences mong mental health clinicians in Canada and the United States (n = 196) in this online survey study during the second phase of the pandemic (Spring 2021). In addition to using traditional survey items (e.g., demographics, scales, and short answers), we also used video-recorded Simulated Clients (SC; i.e., professional actors) as a novel method to elicit the participants' assessment of the SCs and the psychosocial impacts of the COVID-19 pandemic. Using shared trauma as a theoretical framework, we analyzed both quantitative and qualitative data. Quantitative results suggested that although these mental health clinicians certainly reported experiencing psychosocial impacts of the pandemic themselves, these shared experiences with client and general populations did not greatly impact how they understood the SCs. Qualitative results helped further contextualize the clinicians' own personal and professional lives. Implications for clinical practice and further research related to shared trauma are discussed.
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Affiliation(s)
- Kenta Asakura
- Smith College School for Social Work, Northampton, MA USA
| | | | - Danielle Rieger
- Department of Psychology, Carleton University, Ottawa, ON Canada
| | - Sarah Tarshis
- Carleton University School of Social Work, Ottawa, ON Canada
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Zhou X, Chen C, Yao Y, Xia J, Cao L, Qin X. The scar that takes time to heal: A systematic review of COVID-19-related stigma targets, antecedents, and outcomes. Front Psychol 2022; 13:1026712. [PMID: 36533056 PMCID: PMC9752089 DOI: 10.3389/fpsyg.2022.1026712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/14/2022] [Indexed: 09/19/2023] Open
Abstract
COVID-19, as a crucial public health crisis, has affected our lives in nearly every aspect. Besides its major health threats, COVID-19 brings severe secondary impacts, one of which is the rise of social stigma. Although numerous studies have examined the antecedents and outcomes of COVID-19-related stigma, we still lack a systematic understanding of who is being stigmatized during the COVID-19 pandemic, what exacerbates COVID-19-related stigma, and what impacts COVID-19-related stigma has on victims. Therefore, this review aims to provide a systematic overview of COVID-19-related stigma. With 93 papers conducted with 126,371 individuals in more than 150 countries and territories spanning five continents, we identify three targets that have received the most research: Chinese/Asian people, (suspected) patients and survivors, and healthcare workers. Furthermore, we find that for each stigma target, characteristics of the stigmatized, stigmatizer, and context contribute to COVID-19-related stigma and that this stigma negatively influences victims' health and non-health outcomes. We call for future research to provide a more integrative, balanced, and rigorous picture of COVID-19-related stigma via conducting research on neglected topics (e.g., contextual factors that contribute to stigma toward HCWs) and stigma interventions and using a longitudinal design. In practice, we urge governments and institutions (e.g., ministries of public health, hospitals) to pay close attention to stigma issues and to promote safe and inclusive societies.
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Affiliation(s)
- Xiang Zhou
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Chen Chen
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Yuewei Yao
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Jingtian Xia
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Limei Cao
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Xin Qin
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
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Mallory JB, Ponder WN, Sherrill T, Carbajal J, Schuman DL, Jetelina KK, Stafford J. The Impact of COVID-19 on Veterans’ Resilience, Attachment, and Negative Affect. JOURNAL OF VETERANS STUDIES 2022. [DOI: 10.21061/jvs.v8i3.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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de Araujo CAR, Ribeiro DV, de Oliveira DB, Barbieri W, de Castilho GS, Jimenez M, Tedesco TK, Jordão MC, Novaes TF, Palacio DDC, Heller D. Psychological Impact of the COVID-19 Pandemic on Dentists in Latin America's Epicenter: São Paulo, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15028. [PMID: 36429748 PMCID: PMC9691075 DOI: 10.3390/ijerph192215028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/29/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to assess the prevalence and associated factors of stress and anxiety symptoms among dentists during the COVID-19 pandemic in the state of São Paulo, Brazil. A structured questionnaire was sent electronically to 93,280 dentists with active registration in the Dental Council of São Paulo, Brazil, enquiring about information regarding the first-wave peak period in Brazil. Descriptive analyses of background characteristics, perceptions of preparedness, and psychological impact were calculated. Multiple logistic regression analysis was performed, and independent variables that showed p < 0.20 were used in the adjusted logistic regression model to compare the psychological impact on dental professionals. Among the 2113 respondents, female participants had 63% lower chance of reporting anxiety than males. Older dentists had a lower likelihood of reporting anxiety compared to 21-30-year-old dentists (p ≤ 0.05). Dentists working in the public health service were 1.78 times more likely to report anxiety than those who worked in private practice. Finally, dentists in the COVID-19 high-risk group and those with a family or team member with a positive COVID-19 diagnosis were more likely to have anxiety. This study can help dental and other healthcare professionals to better understand the consequences of COVID-19 in terms of mental health.
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Affiliation(s)
| | - Danielle Viana Ribeiro
- Postgraduate Program in Dentistry, Universidade Cruzeiro do sul, São Paulo 08060-070, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
| | - Danielle Boina de Oliveira
- Postgraduate Program in Dentistry, Universidade Cruzeiro do sul, São Paulo 08060-070, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
| | - Wander Barbieri
- Postgraduate Program in Dentistry, Universidade Cruzeiro do sul, São Paulo 08060-070, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
| | | | - Manuel Jimenez
- Department of Physical Education and Health, Faculty of Education, International University of Lá Rioja, 26006 Logronõ, Spain
| | - Tamara Kerber Tedesco
- Postgraduate Program in Dentistry, Universidade Cruzeiro do sul, São Paulo 08060-070, Brazil
| | - Maisa Camillo Jordão
- Postgraduate Program in Dentistry, Universidade Cruzeiro do sul, São Paulo 08060-070, Brazil
| | | | | | - Debora Heller
- Postgraduate Program in Dentistry, Universidade Cruzeiro do sul, São Paulo 08060-070, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
- Department of Periodontology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
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Andhavarapu S, Yardi I, Bzhilyanskaya V, Lurie T, Bhinder M, Patel P, Pourmand A, Tran QK. Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114890. [PMID: 36260970 PMCID: PMC9573911 DOI: 10.1016/j.psychres.2022.114890] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/02/2022] [Accepted: 10/06/2022] [Indexed: 01/05/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I2 >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I2 >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.
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Affiliation(s)
- Sanketh Andhavarapu
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Isha Yardi
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Vera Bzhilyanskaya
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Tucker Lurie
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mujtaba Bhinder
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Priya Patel
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, 22 South Greene Street, Suite T3N45, Baltimore, MD 21043, United States; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States.
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Cogan N, Kennedy C, Beck Z, McInnes L, MacIntyre G, Morton L, Tanner G, Kolacz J. ENACT study: What has helped health and social care workers maintain their mental well-being during the COVID-19 pandemic? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6656-e6673. [PMID: 36068667 PMCID: PMC9539329 DOI: 10.1111/hsc.13992] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 07/07/2022] [Accepted: 08/20/2022] [Indexed: 06/01/2023]
Abstract
A growing body of research has highlighted the adverse impact of COVID-19 stressors on health and social care workers' (HSCWs) mental health. Complementing this work, we report on the psychosocial factors that have had both a positive and negative impact on the mental well-being of HSCWs during the third lockdown period in Scotland. Using a cross-sectional design, participants (n = 1364) completed an online survey providing quantitative data and free open-text responses. A multi-method approach to analysis was used. The majority of HSCWs were found to have low well-being scores, high levels of COVID-19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut-off for acute stress (indicative of PTSD). HSCWs with higher scores on adaptive coping strategies and team resilience reported higher scores on mental well-being. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems compared to formal supports. Barriers to formal help-seeking were identified including stigma and fear of the consequences of disclosure. HSCWs mostly valued peer support, workplace supports, visible leadership and teamwork in maintaining their mental well-being. Our findings illuminate the complexity of the effects of the COVID-19 pandemic on HSCWs' well-being and will inform future intervention development seeking to increase positive adaptation and improve staff well-being. Addressing barriers to mental health help-seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics.
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Affiliation(s)
- Nicola Cogan
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Chloe Kennedy
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Zoe Beck
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Lisa McInnes
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Gillian MacIntyre
- School of Social Work & Social PolicyUniversity of StrathclydeGlasgowUK
| | - Liza Morton
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Gary Tanner
- School of Psychological Sciences & HealthUniversity of StrathclydeGlasgowUK
| | - Jacek Kolacz
- Traumatic Stress Research Consortium (TSRC)Kinsey Institute, Indiana UniversityBloomingtonIndianaUSA
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Comparing the Mental Wellbeing and Quality of Working Life among Nurses and Social Care Workers in the UK and Japan in Older Adults’ Care Services during the COVID-19 Pandemic. PSYCH 2022. [DOI: 10.3390/psych4040062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study explored and compared the psychological wellbeing, burnout, coping strategies and work-related quality of life amongst health and social care workers in older adults’ care homes and community settings during the COVID-19 pandemic in the United Kingdom (UK) and Japan. A cross-sectional online survey was conducted in the UK (May–July 2021) and a postal survey conducted in Japan (September–October 2021). Participants recruited were health and social care professionals within nursing, social care and social work occupations working in care home or community settings in the UK and Japan during the pandemic. Data were analysed using SPSS. 1327 respondents across the UK and Japan completed the survey. Respondents’ psychological wellbeing was significantly lower in Japan compared to the UK (p ≤ 0.001). UK respondents had significantly higher personal burnout (p < 0.05) and work-related burnout (p < 0.05) while those in Japan had significantly higher client-related burnout (p < 0.001). The novelty of this study relates to exploring mental wellbeing and quality of working life in two culturally contrasting countries. The overall psychological wellbeing and work-related quality of life of staff who work with older adults in the UK and Japan during the COVID-19 pandemic were lower than the population norm. Greater support and flexible working conditions for this workforce are needed to reduce burnout by improving wellbeing and work-related quality of life.
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Brainard DJ, Bunn DD, Watts ML, Killett DA, O'Brien PSJ, Lake PIR, Mumford MS, Lane DK. English care home staff morale and preparedness during the Covid pandemic: A longitudinal analysis. Am J Infect Control 2022:S0196-6553(22)00778-7. [PMID: 36332725 PMCID: PMC9626402 DOI: 10.1016/j.ajic.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND : Staff actions to prevent infection introduction and transmission in long-term care facilities (LTCFs) were key to reducing morbidity and mortality from COVID-19. Implementing infection control measures (ICMs) requires training, adherence and complex decision making while trying to deliver high quality care. We surveyed LTCF staff in England about their preparedness and morale at three timepoints during the COVID-19 epidemic. METHODS : Online structured survey targeted at LTCF workers (any role) administered at three timepoints (November 2020-January 2021; August-November 2021; March-May 2022). Narrative summary of answers, narrative and statistical summary (proportionality with Pearson's chi-square or Fisher's Exact Test) of possible differences in answers between waves. RESULTS : Across all three survey waves, 387 responses were received. Morale, attitudes towards working environment and perception about colleague collaboration were mostly positive at all survey points. Infection control training was perceived as adequate. Staff felt mostly positive emotions at work. The working environment remained challenging. Masks were the single form of PPE most consistently used; eye protection the least used. Mask-wearing was linked to poorer communication and resident discomfort as well as mild negative health impacts on many staff, such as dehydration and adverse skin reactions. Hand sanitiser caused skin irritation. CONCUSIONS : Staff morale and working practices were generally good even though the working environment provided many new challenges that did not exist pre-pandemic.
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Gray KL, Birtles H, Reichelt K, James IA. The experiences of care home staff during the COVID-19 pandemic: A systematic review. Aging Ment Health 2022; 26:2080-2089. [PMID: 34967232 DOI: 10.1080/13607863.2021.2013433] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: To examine experiences of care home staff to better understand how to support them during the ongoing pandemic and in the future.Method: A systematic review examining experiences of care staff over the last year (March 2020-2021).Results: Fourteen papers related to experiences of staff and one was an intervention study. Quantitatively there was evidence of anxiety, PTSD and depression amongst the staff. Qualitatively, seven themes were identified: Poor working conditions; Lack of skills and knowledge; Psychological/Mental health concerns; Feeling undervalued and abandoned; Fears of contagion; Support and the positive impacts of COVID. The intervention study recommended employing needs-based approaches, including educational and wellbeing components.Conclusion: Recommendations are made in terms of how to work with staff, both practically and clinically. There are also suggestions about how to deal with similar situations if they were to reoccur. It is evident that lessons need to be learned because errors were made. Indeed, from a UK perspective, discharging thousands back to care homes, without testing, cost lives. This may have been done to protect the NHS, but it unwittingly 'lockdown' the virus within the care sector.
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Affiliation(s)
- Kristina Lily Gray
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, North East and North Cumbria staff wellbeing hub, Akenside Psychology Offices, Campus for ageing and vitality, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Heather Birtles
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Older adult psychology services, United Kingdom of Great Britain and Northern Ireland
| | - Katharina Reichelt
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Older adult psychology services, United Kingdom of Great Britain and Northern Ireland
| | - Ian Andrew James
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Older adult psychology services, United Kingdom of Great Britain and Northern Ireland
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Titley HK, Young S, Savage A, Thorne T, Spiers J, Estabrooks CA. Cracks in the foundation: The experience of care aides in long-term care homes during the COVID-19 pandemic. J Am Geriatr Soc 2022; 71:198-205. [PMID: 36082802 PMCID: PMC9538008 DOI: 10.1111/jgs.18024] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/28/2022] [Accepted: 08/14/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Care aides (certified nursing assistants, personal support workers) are the largest workforce in long-term care (LTC) homes (nursing homes). They provide as much as 90% of direct care to residents. Their health and well-being directly affect both quality of care and quality of life for residents. The aim of this study was to understand the impact of COVID-19 on care aides working in LTC homes during the first year of the pandemic. METHODS We conducted semi-structured interviews with a convenience sample of 52 care aides from 8 LTC homes in Alberta and one in British Columbia, Canada, between January and April 2021. Nursing homes were purposively selected across: (1) ownership model and (2) COVID impact (the rate of COVID infections reported from March to December 2020). Interviews were recorded and analyzed using inductive content analysis. RESULTS Care aides were mainly female (94%) and older (74% aged 40 years or older). Most spoke English as an additional language (76%), 54% worked full-time in LTC homes, and 37% worked multiple positions before "one worksite policies" were implemented. Two themes emerged from our analysis: (1) Care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID-19, increased workload combined with staffing shortages, and rapidly changing policies. (2) Care aides' resilience was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes. CONCLUSIONS These findings suggest significant, ongoing adverse effects for care aides in LTC homes from working through the COVID-19 pandemic. Our data demonstrate the considerable strength of this occupational group. Our results emphasize the urgent need to appropriately and meaningfully support care aides' mental health and well-being and adequately resource this workforce. We recommend improved policy guidelines and interventions.
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Affiliation(s)
| | - Sandra Young
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Amber Savage
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Trina Thorne
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Jude Spiers
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
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Karanikola M, Mpouzika M, Papathanassoglou E, Kaikoushi K, Hatzioannou A, Leontiou I, Livadiotis C, Christophorou N, Chatzittofis A. Work-Related Traumatic Stress Response in Nurses Employed in COVID-19 Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191711049. [PMID: 36078761 PMCID: PMC9518142 DOI: 10.3390/ijerph191711049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 05/27/2023]
Abstract
Nurses may be at a higher risk of experiencing work-related traumatic stress response during the COVID-19 pandemic compared to other clinicians. This study aimed to investigate the correlations between work-related trauma symptoms and demographic factors, psychosocial hazards and stress response in a census sample of nurses working in COVID-19 settings in Cyprus. In this nationwide descriptive and cross-sectional study, data were collected between April and May 2020 using a questionnaire that included sociodemographic, educational and employment and work-related variables, as well as a modified version of the Secondary Traumatic Stress Scale (STSS) for the assessment of work-related trauma symptoms during the pandemic. Overall, 233 nurses participated (with a response rate of 61.3%) and 25.7% of them reported clinical work-related trauma symptoms (STSS-M > 55; actual scale range: 17-85). The mean value for emotional exhaustion was 7.3 (SD: 2.29; visual scale range: 1-10), while the value for distress that was caused by being avoided due to work in COVID-19 units was 6.98 (SD: 2.69; visual scale range: 1-10). Positive associations were noted between trauma symptoms and both emotional exhaustion and distress from being avoided by others due to work in a COVID-19 setting and a negative association was also found between trauma symptoms and satisfaction from organizational support variables (all p < 0.002). Working in COVID-19 settings during the pandemic is a stressful experience that has been linked to psychologically traumatic symptoms Thus, supportive measures are proposed for healthcare personnel, even in countries with low COVID-19 burden.
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Affiliation(s)
- Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Meropi Mpouzika
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | | | | | - Anna Hatzioannou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Ioannis Leontiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Chris Livadiotis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | | | - Andreas Chatzittofis
- Medical School, University of Cyprus, Nicosia 1065, Cyprus
- Department of Clinical Sciences/Psychiatry, Umeå University, 901 85 Umeå, Sweden
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Coppola A, Kirby K, Black S, Osborne R. The impact of COVID-19 on emergency medical service-led out-of-hospital cardiac arrest resuscitation: a qualitative study. Br Paramed J 2022; 7:8-15. [PMID: 36451710 PMCID: PMC9662152 DOI: 10.29045/14784726.2022.09.7.2.8] [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: 09/03/2023] Open
Abstract
Background Following the emergence of COVID-19, there have been local and national changes in the way emergency medical service (EMS) staff respond to and treat patients in out-of-hospital cardiac arrest (OHCA). The views of EMS staff on the impact of COVID-19 and management of OHCA have not previously been explored. This study aimed to explore the views of staff, with a specific focus on communication during resuscitation, resuscitation procedures and the perception of risk. Methods A qualitative phenomenological enquiry was conducted. A purposive sample of n = 20 participants of various clinical grades was selected from NHS EMS providers in the United Kingdom. Data were collected using semi-structured interviews, transcribed verbatim and inductive thematic analysis was applied. Results Three main themes emerged which varied according to clinical grade, location and guidelines.Decision making: Staff generally felt supported to make best-interest termination of resuscitation decisions. Staff made informed decisions to compromise on recommended levels of personal protective equipment (PPE), since it felt impractical in the pre-hospital context, to improve communication or to reduce delays to care.Service pressures: Availability of operational staff and in-hospital capacity were reduced. Staff felt pressure and disconnect from the continuous updates to clinical guidelines which resulted in organisational change fatigue.Moral injury: The emotional impacts of prolonged and frequent exposure to failed resuscitation attempts and patient death caused many staff to take time away from work to recover. Conclusion This qualitative study is the first known to explore staff views on the impacts of COVID-19 on OHCA resuscitation, which found positive outcomes but also negative impacts important to inform EMS systems. Staff felt that COVID-19 created delays to the delivery of resuscitation, which were multi-faceted. Staff developed new ways of working to overcome the barriers of impractical PPE. There was little impact on resuscitation procedures. Moving forwards, EMS should consider how to limit organisational change and better support the ongoing emotional impacts on staff.
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Affiliation(s)
- Ali Coppola
- South Western Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0003-0135-3783
| | - Kim Kirby
- South Western Ambulance Service NHS Foundation Trust; University of the West of England
| | - Sarah Black
- South Western Ambulance Service NHS Foundation Trust
| | - Ria Osborne
- South Western Ambulance Service NHS Foundation Trust
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Smith AJ, Shoji K, Griffin BJ, Sippel LM, Dworkin ER, Wright HM, Morrow E, Locke A, Love TM, Harris JI, Kaniasty K, Langenecker SA, Benight CC. Social cognitive mechanisms in healthcare worker resilience across time during the pandemic. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1457-1468. [PMID: 35217891 PMCID: PMC8881189 DOI: 10.1007/s00127-022-02247-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 01/22/2022] [Indexed: 12/18/2022]
Abstract
PURPOSE Healthcare workers are at increased risk for mental health problems during disasters such as the COVID-19 pandemic. Identifying resilience mechanisms can inform development of interventions for this population. The current study examined pathways that may support healthcare worker resilience, specifically testing enabling (social support enabled self-efficacy) and cultivation (self-efficacy cultivating support) models. METHODS Healthcare workers (N = 828) in the Rocky Mountain West completed self-report measures at four time points (once per month from April to July of 2020). We estimated structural equation models to explore the potential mediating effects that received social support and coping self-efficacy had (at time 2 and time 3) between traumatic stress symptom severity (at time 1 and time 4). Models included covariates gender, age, minority status, and time lagged co-variations between the proposed mediators (social support and coping self-efficacy). RESULTS The full model fit the data well, CFI = .993, SRMR = .027, RMSEA = .036 [90% CIs (0.013, 0.057)]. Tests of sequential mediation supported enabling model dynamics. Specifically, the effects of time 1 traumatic stress severity were mediated through received social support at time 2 and time 3 coping self-efficacy, in sequential order to reduce time 4 traumatic stress severity. CONCLUSIONS Findings show the importance of received social support and coping self-efficacy in mitigating psychopathology risk. Interventions can support mental health by focusing on social resource engagement that facilitates coping empowerment, which may decrease risk for mental health job-related problems among frontline healthcare workers exposed to highly stressful events.
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Affiliation(s)
- Andrew J Smith
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, 501 Chipeta Way, Salt Lake City, UT, 84018, USA.
- Lyda Hill Institute for Human Resilience, Colorado Springs, USA.
| | - Kotaro Shoji
- Lyda Hill Institute for Human Resilience, Colorado Springs, USA
- University of Human Environments, Okazaki, Japan
| | - Brandon J Griffin
- Lyda Hill Institute for Human Resilience, Colorado Springs, USA
- Mental Health Service, Central Arkansas VA Health Care System, Little Rock, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Lauren M Sippel
- VA Northeast Program Evaluation Center, West Haven, CT, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- National Center for PTSD, West Haven, CT, USA
| | - Emily R Dworkin
- Lyda Hill Institute for Human Resilience, Colorado Springs, USA
- University of Washington School of Medicine, Seattle, USA
| | - Hannah M Wright
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Ellen Morrow
- University of Utah, Resiliency Center, Salt Lake City, USA
| | - Amy Locke
- University of Utah, Resiliency Center, Salt Lake City, USA
| | - Tiffany M Love
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - J Irene Harris
- Bedford VA Healthcare System, University of Minnesota, Minneapolis, USA
| | - Krzysztof Kaniasty
- Department of Psychology, Indiana University of Pennsylvania, Indiana, USA
- Institute of Psychology, Polish Academy of Sciences (Poland), Warsaw, Poland
| | - Scott A Langenecker
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Charles C Benight
- Lyda Hill Institute for Human Resilience, Colorado Springs, USA
- Department of Psychology, University of Colorado-Colorado Springs, Colorado Springs, USA
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Hajebi A, Abbasinejad M, Zafar M, Hajebi A, Taremian F. Mental Health, Burnout, and Job Stressors Among Healthcare Workers During the COVID-19 Pandemic in Iran: A Cross-Sectional Survey. Front Psychiatry 2022; 13:891430. [PMID: 35633777 PMCID: PMC9133377 DOI: 10.3389/fpsyt.2022.891430] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/19/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction The COVID-19 pandemic has caused increasing levels of mental health problems such as anxiety and depression among doctors, nurses and other healthcare workers in hospitals or health centers. The main objective of this study was to assess the mental health, job stressors, and burnout among healthcare workers in Iran. Materials and Methods A cross-sectional study was performed in the primary healthcare centers and hospitals affiliated with six of the medical universities in Iran. The selection of participants was done using multi-center convenient sampling. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Copenhagen Burnout Inventory were used for gathering data through an online platform. Data related to job stressors were obtained using a validated checklist. Data analysis was performed using Chi-square and multiple regression tests and the phi coefficient. Results The results of our study showed that 53% of the healthcare workers of the hospitals and primary healthcare centers enrolled in our study either had generalized anxiety disorder or major depressive disorder or both disorders. Moderate and high levels of burnout were seen among 48.9% of the study participants. The prevalence of mental disorders and burnout were significantly higher among the female healthcare workers compared to the male (p = 0.0001) and a higher rate of mental disorder and burnout was also seen among healthcare workers of hospitals compared to those working in primary healthcare centers (p = 0.024). "Worry about children and old members of family," "family worries for my health condition" and "lack of specific effective treatment for COVID-19" were found to be predictive of mental disorder and burnout. The most prevalent job stressor among the total sample was "low payment or income during the COVID-19 period". Conclusion The results of our study revealed high psychological distress and burnout among healthcare workers of the hospitals during the fourth peak of the COVID-19 pandemic in Iran. This study highlights the need for health officials to pay attention to the job stressors of healthcare workers and obliges them to perform effective interventions to address their needs and concerns.
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Affiliation(s)
- Ahmad Hajebi
- Psychiatric Department, Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Abbasinejad
- Department for Mental Health and Substance Abuse, Ministry of Health and Medical Education, Tehran, Iran
| | - Masoud Zafar
- University Counselling Center, Shahed University, Tehran, Iran
| | - Amirali Hajebi
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Taremian
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Brennan CJ, McKay MT, Cole JC. Morally injurious events and post-traumatic embitterment disorder in UK health and social care professionals during COVID-19: a cross-sectional web survey. BMJ Open 2022; 12:e054062. [PMID: 35523494 PMCID: PMC9082726 DOI: 10.1136/bmjopen-2021-054062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To estimate the prevalence and predictors of morally injurious events (MIEs) and post-traumatic embitterment disorder (PTED) in UK health and social care professionals during the COVID-19 pandemic. DESIGN Cross-sectional study. SETTING September-October 2020 in the UK. Online survey hosted on Qualtrics, and recruited through Prolific. PARTICIPANTS 400 health and social care workers, aged 18 or above and living and working in the UK during the pandemic. MAIN OUTCOME MEASURES MIEs were assessed using the Moral Injury Events Scale and PTED was assessed using the PTED self-rating scale. Potential predictors were measured using surveys of exposure to occupational stressors, optimism, self-esteem, resilient coping style, consideration of future consequences and personal belief in a just world. RESULTS 19% of participants displayed clinical levels of PTED, and 73% experienced at least one COVID-related MIE. Exposure to occupational stressors increased the risk of experiencing PTED and MIEs, whereas personal belief in a procedurally just world, which is the belief that they experienced fair processes, was a protective mechanism. CONCLUSIONS MIEs and PTED are being experienced by UK health and social care professionals, particularly in those exposed to work-related stressors.
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Affiliation(s)
- Chloe J Brennan
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Michael T McKay
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jon C Cole
- Department of Psychology, University of Liverpool, Liverpool, UK
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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.
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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
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