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Chang CC, Hsieh KY, Hsu ST, Wang YY, Chou FHC, Huang JJ. Understanding the mental health impacts of biological disasters: Lessons from Taiwan's experience with COVID-19. J Formos Med Assoc 2024:S0929-6646(24)00176-1. [PMID: 38519322 DOI: 10.1016/j.jfma.2024.03.015] [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: 11/30/2023] [Revised: 02/18/2024] [Accepted: 03/17/2024] [Indexed: 03/24/2024] Open
Abstract
Biological disasters pose a growing challenge in the 21st century, significantly impacting global society. Taiwan has experienced such disasters, resulting in long-term consequences like loss of life, trauma, economic decline, and societal disruptions. Post-disaster, mental health issues such as fear, anxiety, depression, post-traumatic stress disorder (PTSD), and stress surge, accompanied by increased suicide rates. The Coronavirus disease 2019 (COVID-19) (also called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) pandemic, recognized as a biological disaster, triggered lockdowns and quarantines in Taiwan, causing lifestyle changes, economic recession, and so on. These shifts may elevate uncertainty about the future, intensifying mental stress and leading to a rise in various mental illnesses. This article reviews mental health studies conducted in Taiwan during the pandemic, emphasizing the need to integrate this research for future preparedness and interventions regarding the mental health impacts of biological disasters, including COVID-19. Further research is essential to explore long-term effects, interventions, and generalizability.
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Affiliation(s)
- Chih-Chieh Chang
- Department of Addiction Prevention, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Kuan-Ying Hsieh
- Department of Child and Adolescent Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Taiwan
| | - Su-Ting Hsu
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Yu-Yuan Wang
- Department of Neuropsychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Frank Huang-Chih Chou
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
| | - Joh-Jong Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Hatukay AL, Shochat T, Zion N, Baruch H, Cohen R, Azriel Y, Srulovici E. The relationship between quick return shift schedules and burnout among nurses: A prospective repeated measures multi-source study. Int J Nurs Stud 2024; 151:104677. [PMID: 38211364 DOI: 10.1016/j.ijnurstu.2023.104677] [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: 08/15/2023] [Revised: 11/19/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND In today's world, essential health care services are expected round the clock, leading to distinct shift work requirements. A notable aspect is the "quick return," where the rest interval between nursing shifts is <11 h. Preliminary research suggests a potential association between quick return schedules, diminished sleep quality, and possible nurse burnout. Yet, the motivation of nurses could potentially moderate this relationship. OBJECTIVE To examine a moderated-mediation model, whereby sleep duration and nurse's motivation act together to mediate the link between quick return schedules and nurse's burnout. DESIGN A prospective repeated measures (4-5 nursing shifts per nurse) multi-source (self-report and objective measures) study. SETTING Internal and surgical departments across one large and one medium scale teaching hospitals in Israel. PARTICIPANTS Registered nurses who provide direct patient care (n = 79) across 369 shifts. METHODS Nurses completed a questionnaire containing personal information and information regarding their shifts during the study week. They wore an accelerometer (a wrist worn device that monitors and records an individual's activity level) during a work-week to objectively determine their sleep duration, completed a motivation questionnaire at the beginning of each shift, and completed a burnout questionnaire at the end of the week. Mixed-model regression analysis was used to test a moderated-mediation model following Hayes' recommendations, whereby the joint effect of sleep duration and motivation mediates the link between quick return schedules and burnout. RESULTS The moderated-mediation model was supported. Quick return schedules were negatively statistically significantly associated with sleep duration (b = -126.54, SE = 20.85, p < 0.001); so that more frequent quick return schedules were related to shorter sleep duration. However, no direct correlation was observed between sleep duration and burnout (p = 0.171). A statistically significant interaction was observed between sleep duration and motivation (b = 0.00, SE = 0.00, p < 0.001) concerning burnout. Thus, nurses with lower motivation were prone to experiencing higher levels of burnout with shorter sleep duration compared to nurses with higher motivation. CONCLUSIONS The mediating role of sleep duration, moderated by motivation, plays a role in the connection between quick return schedules and burnout. This indicates that nurses can sustain their work motivation even within the demands of quick return schedules, consequently mitigating burnout levels. To prioritize employees' well-being, organizations should adopt shift work structures that minimize quick return schedules and extend nurses' sleep duration. Consequently, managers must employ strategies to enhance nurses' motivation when addressing scenarios that necessitate quick return schedules.
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Affiliation(s)
- Ania Lauz Hatukay
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel; Baruch Padeh Medical Cener, Lower Galilee, Israel
| | - Tamar Shochat
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
| | - Natalie Zion
- The Dr. Y. Zayda School of Nursing, Bnai Zion Medical Center, Haifa, Israel
| | - Hagar Baruch
- Nursing Directorate, Rambam Health Care Campus, Haifa, Israel
| | - Ricky Cohen
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
| | - Yarden Azriel
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel; The Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Einav Srulovici
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel.
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Are Nurses Prepared for What's Next? J Emerg Nurs 2024; 50:169-170. [PMID: 38453339 DOI: 10.1016/j.jen.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 03/09/2024]
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Garnett A, Hui L, Oleynikov C, Boamah S. Compassion fatigue in healthcare providers: a scoping review. BMC Health Serv Res 2023; 23:1336. [PMID: 38041097 PMCID: PMC10693134 DOI: 10.1186/s12913-023-10356-3] [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: 08/07/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023] Open
Abstract
The detrimental impacts of COVID-19 on healthcare providers' psychological health and well-being continue to affect their professional roles and activities, leading to compassion fatigue. The purpose of this review was to identify and summarize published literature on compassion fatigue among healthcare providers and its impact on patient care. Six databases were searched: MEDLINE (Ovid), PsycINFO (Ovid), Embase (Ovid), CINAHL, Scopus, Web of Science, for studies on compassion fatigue in healthcare providers, published in English from the peak of the pandemic in 2020 to 2023. To expand the search, reference lists of included studies were hand searched to locate additional relevant studies. The studies primarily focused on nurses, physicians, and other allied health professionals. This scoping review was registered on Open Science Framework (OSF), using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension to scoping review. From 11,715 search results, 24 met the inclusion criteria. Findings are presented using four themes: prevalence of compassion fatigue; antecedents of compassion fatigue; consequences of compassion fatigue; and interventions to address compassion fatigue. The potential antecedents of compassion fatigue are grouped under individual-, organization-, and systems-level factors. Our findings suggest that healthcare providers differ in risk for developing compassion fatigue in a country-dependent manner. Interventions such as increasing available personnel helped to minimize the occurrence of compassion fatigue. This scoping review offers important insight on the common causes and potential risks for compassion fatigue among healthcare providers and identifies potential strategies to support healthcare providers' psychological health and well-being.
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Affiliation(s)
- Anna Garnett
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada.
| | - Lucy Hui
- Medical Sciences, Western University, London, ON, Canada
| | - Christina Oleynikov
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Sheila Boamah
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Pourmand A, Caggiula A, Barnett J, Ghassemi M, Shesser R. Rethinking Traditional Emergency Department Care Models in a Post-Coronavirus Disease-2019 World. J Emerg Nurs 2023:S0099-1767(23)00037-5. [PMID: 37086252 PMCID: PMC10116161 DOI: 10.1016/j.jen.2023.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 04/23/2023]
Abstract
As the nursing shortage in United States emergency departments has drastically worsened since the coronavirus disease-2019 (COVID-19) pandemic, emergency departments have experienced increased rates of inpatient onboarding, higher rates of patients leaving without being seen, and declining patient satisfaction scores. This paper reviews the impacts of the coronavirus disease-2019 pandemic on the current nursing shortage and considers how various medical personnel (emergency nurse-extenders) can ameliorate operational challenges by redesigning emergency department systems. During the height of the coronavirus disease-2019 pandemic, the psychological effects of increased demand for emergency nurses coupled with the fear of coronavirus infection exacerbated nursing turnover rates. Health care workers who can be trained to augment the existing emergency department workforce include paramedics, Emergency Medical Technicians, emergency department technicians, ancillary staff, scribes, and motivated health sciences students. Utilizing non-nurse providers to fulfill tasks traditionally assigned to emergency nurses can improve emergency department flow and care delivery in a post-coronavirus disease-2019 world.
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Lai CC, Lee PI, Hsueh PR. How Taiwan has responded to COVID-19 and how COVID-19 has affected Taiwan, 2020-2022. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023:S1684-1182(23)00078-6. [PMID: 37061349 PMCID: PMC10079311 DOI: 10.1016/j.jmii.2023.04.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/28/2023] [Accepted: 04/01/2023] [Indexed: 04/17/2023]
Abstract
From January 2020 to December 2022, there was a total of 8,872,955 confirmed COVID-19 cases in Taiwan. In addition, a total of 15,253 COVID-19 related deaths were reported. During these three years, the government and health authority did many efforts to response this pandemic. In the early pandemic, Taiwan Central Epidemic Command Center was established in the early 2020 to organize associated resource, develop effective policy and implement strict intervention. In response to COVID-19 pandemic, many infection control policy and interventions, including universal mask wearing with increasing production of face mask, hand hygiene, border control, introduce of digital technology incorporating big data, quarantine of COVID-19 cases, travel and gathering restriction, were implemented. In the meanwhile, two COVID-19 vaccines, namely MVC-COV1901 and UB-612, have been developed under the support of government. Furthermore, MVC-COV1901 was taken into clinical practice after received emergency use approval. In addition, two traditional Chinese medicines, including NRICM101 and NRICM102 showed their promising effect against SARS-CoV-2 infection and were recommended as potential therapeutic options for COVID-19. During the pandemic, the nonpharmacologic intervention help reduce many infectious diseases, especially for airborne/droplet-transmitted diseases. However, COVID-19 exhibited some adverse impacts on the healthcare systems, such as emergency medical service on out of hospital cardiac arrest, cancer screening, HIV screening and prevention services, and public health, namely the psychosocial status of healthcare workers. Although the outbreak of SARS-CoV-2 infections may gradually subsided, we should keep monitoring its associated impact and appropriately response to this pandemic.
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Affiliation(s)
- Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Children's Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Ren Hsueh
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan; Department of Laboratory Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan; PhD Program for Ageing, School of Medicine, China Medical University, Taichung, Taiwan.
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Postpandemic Stress Disorder among Health Care Personnel: A Cross-Sectional Study (Silesia, Poland). Behav Neurol 2022; 2022:1816537. [DOI: 10.1155/2022/1816537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/16/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Postpandemic stress disorder (PPSD) is an unofficial term that refers to posttraumatic stress disorder (PTSD), a mental disorder resulting from increased stress, anxiety, and trauma associated with unpleasant life experiences. Many scientific studies indicate that symptoms of increased stress, job burnout, anxiety, and depressive disorders are associated with medical personnel performing their professional duties around COVID-19 patients. Objective. The purpose of this study was to assess the prevalence of symptoms that may indicate the presence of PPSD symptoms—depression, anxiety, and stress—in medical personnel. Material and Methods. The survey included 300 people, representatives of medical personnel. The group was divided into two sections. The first section numbered 150 and consisted of personnel in direct contact with COVID-19 patients (FR); the second group also consisted of 150 medical professionals, who but no longer directly involved in helping with COVID-19 cases (SR). The survey was conducted by indirect survey method using CAWI (computer-assisted web interview). The survey used a questionnaire technique. A proprietary tool enriched with standardized psychometric scales: BDI, GAD-7, FCV-19S, and PSS-10 was used. Kruskal-Wallis and Mann–Whitney
statistical tests were used in the statistical processing of the data. The probability level was 0.05. Results. Statistical inference made it clear that mental health problems that may indicate trauma are mainly present in the FR group. These symptoms decreased slightly in comparison between periods 2020 and 2021 (
). Conclusions. The COVID-19 pandemic significantly increased the prevalence of depression, anxiety, and stress among first responders. To ensure the psychological well-being of first responders, early assessment and care of mild depression, anxiety, and stress should be promoted to prevent the development of moderate and severe forms.
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