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Liu D, Zhou Y, Tao X, Cheng Y, Tao R. Mental health symptoms and associated factors among primary healthcare workers in China during the post-pandemic era. Front Public Health 2024; 12:1374667. [PMID: 38807997 PMCID: PMC11130373 DOI: 10.3389/fpubh.2024.1374667] [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: 01/22/2024] [Accepted: 05/02/2024] [Indexed: 05/30/2024] Open
Abstract
Background The impact of the COVID-19 pandemic on mental health among healthcare workers has been widely reported during the initial and ongoing phases of the COVID-19 pandemic. Yet, little remains known about the mental health status of primary healthcare workers in China during the post-pandemic era. Methods A cross-sectional study was conducted between March 1, 2023, and May 31, 2023 in Anhui China. A total of 13,530 primary healthcare workers were recruited. Multiple logistic regression was used to identify potential factors associated with the incidence of depression and anxiety among primary healthcare workers. Results The prevalence of depression and anxiety among primary healthcare workers was 50.7 and 26.4%, respectively. Multiple logistic regression revealed that female gender (OR = 1.345, 95%CI = 1.222-1.479), being divorced or widowed (OR = 1.432, 95%CI = 1.128-1.817), being a nurse (OR = 1.250, 95%CI = 1.126-1.388), and working more than 8 h per day (OR = 1.710, 95%CI = 1.583-1.846) were significantly associated with depression. A higher risk of anxiety among primary healthcare workers was associated with female gender (OR = 1.338, 95%CI = 1.198-1.494), being divorced or widowed (OR = 1.373, 95%CI = 1.056-1.770), being a nurse (OR = 1.139, 95%CI = 1.013-1.282), and working more than 8 h per day (OR = 1.638, 95%CI = 1.497-1.794). Better monthly income, more than 21 years of working experience and without experience of workplace violence were protective factors against depression and anxiety during the post-pandemic era. Conclusion Depressive symptoms are more common among primary healthcare workers in China during the post-pandemic era. Female gender, being divorced or widowed, being a nurse, working years, working seniority, monthly income, and experience of workplace violence were identified as associated factors. Targeted intervention is needed when developing strategies to reduce depression and improve primary healthcare workers' wellness and mental health.
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Affiliation(s)
- Difei Liu
- School of Education, Hefei University, Hefei, China
| | - Yuhe Zhou
- School of Education, Hefei University, Hefei, China
| | - Xubowen Tao
- School of Physical Education, Anhui Normal University, Wuhu, China
| | - Yutong Cheng
- School of Education, Hefei University, Hefei, China
| | - Rui Tao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
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Yau BN, Aggarwal R, Coverdale J, Guerrero APS, Beresin EV, Brenner AM. Beyond Psychopharmacology: the Interpersonal Dynamics of Agitation Management. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:1-4. [PMID: 38062338 DOI: 10.1007/s40596-023-01919-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Affiliation(s)
- Bernice N Yau
- Columbia University Irving Medical Center, New York, NY, USA.
| | | | | | | | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Wang X, Peng P, Liu Y, Yang WF, Chen S, Wang Y, Yang Q, Li M, Wang Y, Hao Y, He L, Wang Q, Zhang J, Ma Y, He H, Zhou Y, Long J, Qi C, Tang YY, Liao Y, Tang J, Wu Q, Liu T. Workplace violence inflicted by patients or their family members/visitors and its relationship with suicidal ideation among undergraduate medical students during clinical training in China. Ann Med 2023; 55:2295027. [PMID: 38146746 PMCID: PMC10763877 DOI: 10.1080/07853890.2023.2295027] [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: 09/14/2022] [Accepted: 12/10/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Workplace violence in healthcare settings is a significant public concern that profoundly impacts healthcare workers. However, there is a dearth of knowledge regarding the prevalence of workplace violence and its correlation with suicidal ideation among undergraduate medical students in China during their clinical training. The objective of this study was to evaluate the prevalence of workplace violence inflicted by patients or their family members/visitors and to assess its association with suicidal ideation among undergraduate medical students. METHOD The snowballing sampling technique was used to recruit Chinese medical students. A question designed by the research team was used to ask medical students about their encounters with workplace violence. Students' basic demographic information and mental distresses (learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence, excessive daytime sleepiness and history of mental disorders) were also assessed. As appropriate, the data were analysed using descriptive statistics, chi-square tests, independent-sample t-tests and multiple logistic regression. RESULTS Out of the 1402 undergraduate medical students who participated, 493 (35.2%) reported having experienced workplace violence inflicted by patients or their family members/visitors, of which 394 (28.1%) were verbal abuse, 14 (1.0%) were physical aggression, and 85 (6.1%) were suffered from both verbal abuse and physical aggression. Furthermore, students exposed to workplace violence were more likely to report suicidal ideation and had a higher prevalence of learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence and excessive daytime sleepiness. Depression symptoms, history of mental disorders, learning burnout and having a partner were significantly associated with suicidal ideation in this population. CONCLUSION The prevalence of workplace violence inflicted by patients or their family members/visitors was high among undergraduate medical students in China. This may be associated with their mental distress and suicidal ideation. Consequently, it is crucial to strengthen workplace safety measures and promptly implement interventions to mitigate the potentially serious consequences.
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Affiliation(s)
- Xin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Pu Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yueheng Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Winson Fuzun Yang
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Shubao Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yunfei Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qian Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Manyun Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yingying Wang
- School of Physical Education and Health, Hunan University of Technology and Business, Changsha, China
| | - Yuzhu Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Li He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Junhong Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yuejiao Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Haoyu He
- Department of Psychology, College of Education, Hunan First Normal University, Changsha, Hunan, China
| | - Yanan Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People’s Hospital), Changsha, Hunan, China
| | - Jiang Long
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Qi
- Department of Psychiatry, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Sikstrom L, Maslej MM, Findlay Z, Strudwick G, Hui K, Zaheer J, Hill SL, Buchman DZ. Predictive care: a protocol for a computational ethnographic approach to building fair models of inpatient violence in emergency psychiatry. BMJ Open 2023; 13:e069255. [PMID: 37185650 PMCID: PMC10151964 DOI: 10.1136/bmjopen-2022-069255] [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: 05/17/2023] Open
Abstract
INTRODUCTION Managing violence or aggression is an ongoing challenge in emergency psychiatry. Many patients identified as being at risk do not go on to become violent or aggressive. Efforts to automate the assessment of risk involve training machine learning (ML) models on data from electronic health records (EHRs) to predict these behaviours. However, no studies to date have examined which patient groups may be over-represented in false positive predictions, despite evidence of social and clinical biases that may lead to higher perceptions of risk in patients defined by intersecting features (eg, race, gender). Because risk assessment can impact psychiatric care (eg, via coercive measures, such as restraints), it is unclear which patients might be underserved or harmed by the application of ML. METHODS AND ANALYSIS We pilot a computational ethnography to study how the integration of ML into risk assessment might impact acute psychiatric care, with a focus on how EHR data is compiled and used to predict a risk of violence or aggression. Our objectives include: (1) evaluating an ML model trained on psychiatric EHRs to predict violent or aggressive incidents for intersectional bias; and (2) completing participant observation and qualitative interviews in an emergency psychiatric setting to explore how social, clinical and structural biases are encoded in the training data. Our overall aim is to study the impact of ML applications in acute psychiatry on marginalised and underserved patient groups. ETHICS AND DISSEMINATION The project was approved by the research ethics board at The Centre for Addiction and Mental Health (053/2021). Study findings will be presented in peer-reviewed journals, conferences and shared with service users and providers.
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Affiliation(s)
- Laura Sikstrom
- The Krembil Centre for Neuroinformatics, The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Anthropology, University of Toronto, Toronto, Ontario, Canada
| | - Marta M Maslej
- The Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Zoe Findlay
- The Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Gillian Strudwick
- Information Management Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Katrina Hui
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Juveria Zaheer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Gerald Sheff and Shanitha Kachan Emergency Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sean L Hill
- The Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Z Buchman
- Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Ham E, Seto MC, Rodrigues NC, Hilton NZ. Workplace stressors and PTSD among psychiatric workers: The mediating role of burnout. Int J Ment Health Nurs 2022; 31:1151-1163. [PMID: 35574982 DOI: 10.1111/inm.13015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/28/2022]
Abstract
Critical workplace events (e.g., assaults), chronic stressors, burnout, and work conditions all affect nurse well-being. The present study investigated associations among these sources of stress and posttraumatic stress disorder (PTSD) symptoms in psychiatric nurses, hypothesizing that burnout would mediate the paths between workplace stressors and PTSD. Surveys were completed by 611 psychiatric nurses or allied health staff working on inpatient units in three psychiatric hospitals. Participants reported on critical events and chronic stressors specific to providing psychiatric care and completed the Maslach Burnout Inventory (MBI), Areas of Worklife Survey (AWS) (work conditions), and PTSD Checklist for DSM-5. Data were analysed using structural equation modelling. Burnout had a direct relation to PTSD symptoms and partially mediated the effect of exposure to critical events, but not chronic stressors, on PTSD symptoms. Chronic stressors related to patients' disturbing behaviour (e.g., flooding room, eating non-food items) had a direct effect on PTSD symptoms, but those related to resisting care (e.g., screaming constantly, physically resisting care) had no significant association. Worklife conditions had a negative direct effect on Burnout and indirect effect on PTSD, whereby participants reporting poorer alignment of work conditions with their expectations had higher Burnout and PTSD symptom scores. Different sources of workplace stress have different relations to PTSD symptoms, and Burnout has both direct and mediation effects. Interventions aimed at reducing patients' aggressive and disturbing acts and improving healthcare providers' burnout and worklife factors in hospitals may all be needed to reduce PTSD among psychiatric staff.
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Affiliation(s)
- Elke Ham
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
| | - Michael C Seto
- University of Ottawa's Institute of Mental Health Research, Ottawa, Canada
| | | | - N Zoe Hilton
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
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"The Ugliness of It Seeps into Me": Experiences of Vicarious Trauma among Female Psychologists Treating Survivors of Sexual Assault. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073925. [PMID: 35409607 PMCID: PMC8997998 DOI: 10.3390/ijerph19073925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 11/16/2022]
Abstract
The current study explores the lived experiences of female psychologists who provide psychological treatment to women survivors of sexual assault. These practitioners are a population of special interest due to the frequency of their exposure to narratives and graphic images of sexual trauma. Semi-structured interviews were conducted with 15 female South African psychologists. The data, which were analyzed using an interpretative phenomenological approach, revealed experiences characteristic of vicarious traumatization. Participants reported having an enhanced sense of personal vulnerability to sexual assault and heightened awareness of the betrayals of trust that women experience from male figures, which has led to increased mistrust of men and hypervigilance regarding the safety of their daughters. Internalization of feelings of helplessness experienced by the victim evoked self-blame for practitioners and appraisals of being complicit in abuse. Practitioners also experienced survivor guilt about being spared from harm. Symptoms of intrusive re-experiencing of client trauma and cognitive and behavioral disengagement were evident. These findings have important implications for clinical practice and underscore the necessity for clinicians to cultivate an awareness of the impact of treating sexual trauma and working in ways that are self-protective.
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Liyanage S, Addison S, Ham E, Hilton NZ. Workplace interventions to prevent or reduce post-traumatic stress disorder and symptoms among hospital nurses: A scoping review. J Clin Nurs 2021; 31:1477-1487. [PMID: 34636115 DOI: 10.1111/jocn.16076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to identify literature on evaluated workplace interventions to prevent or reduce the prevalence or impact of work-related post-traumatic stress disorder (PTSD) and PTSD symptoms among hospital nurses. A second objective was to summarise and compare the characteristics and effectiveness of these interventions. BACKGROUND A substantial proportion of nurses report PTSD symptoms. Previous reviews have synthesised interventions to address PTSD in military and other high-risk populations, but similar work focusing on nurses has yet to be conducted. METHODS We conducted a scoping review with the question: What interventions have been studied to prevent or treat PTSD symptoms or PTSD among nurses working in hospitals? We followed the PRISMA Scoping Review Checklist using an unregistered protocol. We searched in twelve academic and grey literature databases (e.g. MedLine, CINAHL) with no language restrictions. We included publications reporting on interventions which were evaluated for measurable impacts on PTSD and PTSD symptoms among nursing staff working in inpatient settings from 1980 to 2019, and charted study characteristics in a spreadsheet. RESULTS From 7746 results, 63 studies moved to full-text screening, and six studies met inclusion criteria. Methodologies included three randomised controlled studies, one quasi-experimental study, one pre-post feasibility study and one descriptive correlational study. Four studies reported a significant reduction in PTSD scores in intervention groups compared with baseline or comparison, when using debriefing, guided imagery or mindfulness-based exercises. CONCLUSIONS This review identified six studies evaluating hospital-based interventions to reduce PTSD and PTSD symptoms among hospital nurses, with some positive effects reported, contributing to a preliminary evidence base on reducing workplace trauma. Larger studies can compare nurse subpopulations, and system-level interventions should expand the focus from individuals to organisations. RELEVANCE TO CLINICAL PRACTICE This review can inform nursing and hospital leaders developing evidence-based interventions for PTSD among nurses.
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Affiliation(s)
- Sugee Liyanage
- Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | - Sonja Addison
- Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | - Elke Ham
- Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | - N Zoe Hilton
- Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
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