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Hernandez SHA, Killian J, Parshall MB, Reno J, Zhu Y. Improving Resiliency in U.S. Air Force Healthcare Personnel: A Randomized Preventive Trial. Mil Med 2024; 189:e250-e258. [PMID: 37552627 DOI: 10.1093/milmed/usad303] [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: 04/05/2023] [Revised: 06/19/2023] [Accepted: 07/19/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION The effectiveness of the Stress Management and Resilience Training (SMART) with U.S. military personnel has not been reported in the literature. The purpose of this study was to examine the effectiveness of SMART in increasing resilience in Air Force healthcare personnel. MATERIALS AND METHODS We conducted a pilot, randomized preventive trial with active component Air Force healthcare personnel. SMART was offered via an in-person, 2-h training session delivered through face-to-face or synchronous video teleconference training, or via a self-paced, computer-based training. A baseline survey included demographics questions and the Connor-Davidson-10 Resilience Scale (CD-10), Perceived Stress Scale (PSS), Generalized Anxiety Disorder Scale (GAD-7), and overall quality of life (QOL) measure. Follow-up surveys with the CD-10, PSS, GAD-7, and quality of life were sent to participants at 12, 18, and 24 weeks after completing SMART. RESULTS Fifty-six service members completed the baseline assessment and were randomized to either the in-person modality (comprised of video teleconference or face-to-face training) or the computer-based training modality, and 49 participants completed SMART. Significant increases in median CD-10 scores were observed among all participants, showing a 4-point (14%), 6-point (21%), and 5-point (17%) increase at week-12, -18, and -24, respectively, from the baseline. A significant overall decrease in median PSS scores from baseline were observed, with 5.5-points (22%), 7.81-points (32%), and 8.5-points (35%) decrease at 12, 18, and 24 weeks post-SMART, respectively. CONCLUSIONS In this pilot study, SMART demonstrated significant and meaningful improvements in self-reported CD-10 and PSS-14 scores at 12, 18, and 24 weeks post-training completion. A future replication of the study is necessary to evaluate the effectiveness of SMART on a larger scale.
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Affiliation(s)
- Stephen H A Hernandez
- University of New Mexico College of Nursing, University of New Mexico, Albuquerque, NM 87102, Mexico
- 944 Aeromedical Staging Squadron, Luke Air Force Base, AZ 85309, USA
| | | | - Mark B Parshall
- University of New Mexico College of Nursing, University of New Mexico, Albuquerque, NM 87102, Mexico
| | - Jessica Reno
- Youth, and Families Department, State of New Mexico Children, Santa Fe, NM 87502, USA
| | - Yiliang Zhu
- School of Medicine, Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, 1 University of New Mexico, Albuquerque, NM 87131, Mexico
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2
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Kluge MG, Maltby S, Kuhne C, Walker N, Bennett N, Aidman E, Nalivaiko E, Walker FR. Evaluation of a Virtual Reality Platform to Train Stress Management Skills for a Defense Workforce: Multisite, Mixed Methods Feasibility Study. J Med Internet Res 2023; 25:e46368. [PMID: 37930751 PMCID: PMC10659241 DOI: 10.2196/46368] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 08/24/2023] [Accepted: 09/18/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Psychological stress-related injuries within first-responder organizations have created a need for the implementation of effective stress management training. Most stress management training solutions have limitations associated with scaled adoption within the workforce. For instance, those that are effective in civilian populations often do not align with the human performance culture embedded within first-responder organizations. Programs involving expert-led instructions that are high in quality are often expensive. OBJECTIVE This study sought to evaluate a tailored stress management training platform within the existing training schedule of the Australian Defense Force (ADF). The platform, known as Performance Edge (PE), is a novel virtual reality (VR) and biofeedback-enabled stress management skills training platform. Focusing on practical training of well-established skills and strategies, the platform was designed to take advantage of VR technology to generate an immersive and private training environment. This study aimed to assess the feasibility of delivering the VR platform within the existing group-based training context and intended training population. In this setting, the study further aimed to collect data on critical predictors of user acceptance and technology adoption in education, including perceived usability, usefulness, and engagement, while also assessing training impacts. METHODS This study used a mixed methods, multisite approach to collect observational, self-reported, and biometric data from both training staff and trainers within a real-world "on-base" training context in the ADF. Validated scales include the Presence Questionnaire and User Engagement Scale for perceived usefulness, usability, and engagement, as well as the State Mindfulness Scale and Relaxation Inventory, to gain insights into immediate training impacts for specific training modules. Additional surveys were specifically developed to assess implementation feedback, intention to use skills, and perceived training impact and value. RESULTS PE training was delivered to 189 ADF trainees over 372 training sessions. The platform was easy to use at an individual level and was feasible to deliver in a classroom setting. Trainee feedback consistently showed high levels of engagement and a sense of presence with the training content and environment. PE is overall perceived as an effective and useful training tool. Self-report and objective indices confirmed knowledge improvement, increased skill confidence, and increased competency after training. Specific training elements resulted in increased state mindfulness, increased physical relaxation, and reduced breathing rate. The ability to practice cognitive strategies in a diverse, private, and immersive training environment while in a group setting was highlighted as particularly valuable. CONCLUSIONS This study found the VR-based platform (PE) to be a feasible stress management training solution for group-based training delivery in a defense population. Furthermore, the intended end users, both trainers and trainees, perceive the platform to be usable, useful, engaging, and effective for training, suggesting end-user acceptance and potential for technology adoption.
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Affiliation(s)
- Murielle G Kluge
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Steven Maltby
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Caroline Kuhne
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, Australia
| | - Nicole Walker
- Army School of Health, Australian Defence Force, Canberra, Australia
| | - Neanne Bennett
- Joint Health Command, Department of Defence, Canberra, Australia
| | - Eugene Aidman
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- Human and Decision Sciences Division, Defence Science & Technology Group, Edinburgh, Australia
| | - Eugene Nalivaiko
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Frederick Rohan Walker
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
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3
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Su P, Yi J, Chen X, Xiao Y. Visual Analysis of Psychological Resilience Research Based on Web of Science Database. Psychol Res Behav Manag 2023; 16:465-481. [PMID: 36846313 PMCID: PMC9948642 DOI: 10.2147/prbm.s394693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/10/2023] [Indexed: 02/20/2023] Open
Abstract
Background The importance of psychological resilience that people show in coping with stress and adversity is prominent, but few studies have used rigorous bibliometric tools to analyze the knowledge structure and distribution of psychological resilience research. Objective The purpose of this study was to sort out and summarize the previous studies on psychological resilience by using bibliometrics. Specifically, the time distribution of psychological resilience research was determined by publication trend, the power distribution was determined by the distribution of countries, authors, institutions and journals, the hot research spots were analyzed according to the results of keyword cluster analysis, and the research frontier was explored according to the results of burst keywords. Methods CiteSpace5.8.R3 was used to analyze the literatures on psychological resilience collected in Web of Science core Collection database from January 1, 2010, to June 16, 2022. Results A total of 8462 literatures were included after screening. Research on psychological resilience has been on the rise in recent years. The United States had made a high contribution in this field. Robert H Pietrzak, George A Bonanno, Connor KM and others were highly influential. J Pers Soc Psychol has the highest citation frequency and centrality. The research hot spots focus on five aspects: study on psychological resilience related to COVID-19 pandemic, influencing factors of psychological resilience, psychological resilience related to PTSD, study on psychological resilience of special population, and the molecular biology and genetic basis of psychological resilience. Psychological resilience related to COVID-19 pandemic was the most cutting-edge research aspect. Conclusion The current situation and trend of psychological resilience research were found in this study, which may be used to identify more hot issues and explore new research directions in this field.
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Affiliation(s)
- Pan Su
- Teaching and Research Section of Clinical Nursing, Emergency Department, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Jindong Yi
- Teaching and Research Section of Clinical Nursing, Emergency Department, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Xiuwen Chen
- Teaching and Research Section of Clinical Nursing, Department of Operating Room, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Yao Xiao
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, People’s Republic of China,International Joint Research Center of Minimally Invasive Endoscopic Technology Equipment & Standards, Xiangya Hospital, Central South University, Changsha, People’s Republic of China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China,Correspondence: Yao Xiao; Xiuwen Chen, Email ;
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4
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Wu C, Liu T, Cheng C, Chang K. Relationship between nurses' resilience and depression, anxiety and stress during the 2021 COVID-19 outbreak in Taiwan. Nurs Open 2022; 10:1592-1600. [PMID: 36285646 PMCID: PMC9874739 DOI: 10.1002/nop2.1411] [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: 04/20/2022] [Revised: 08/31/2022] [Accepted: 10/02/2022] [Indexed: 01/27/2023] Open
Abstract
AIM The COVID-19 outbreak in Taiwan had a significant impact on medical services. These changes posed a threat to nurses' mental health. Resilience may protect nurses from the psychological impact of COVID-19. This study aimed to understand nurses' resilience and its relationship with nurses' characteristics (life and work situations) and mental health (depression, anxiety and stress) during the outbreak. DESIGN A cross-sectional study. METHODS This study surveyed the nurses at a hospital from 9 August 2021, to 20 August 2021. The content of the questionnaire included nurses' characteristics, resilience and mental health. RESULTS There was an association between higher resilience and lower mental health problems. We also found that some nurses' characteristics were positively correlated with mental health problems. CONCLUSION Some nurses' life and work situations predicted high levels of mental health problems during the pandemic. Additionally, higher levels of resilience were associated with lower levels of mental health problems.
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Affiliation(s)
- Chiu‐Feng Wu
- Department of NursingTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationNew Taipei CityTaiwan
| | - Tzu‐Hung Liu
- Department of Family MedicineTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationNew Taipei CityTaiwan,School of MedicineTzu Chi UniversityHualienTaiwan
| | - Chu‐Hsuan Cheng
- Department of NursingTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationNew Taipei CityTaiwan
| | - Kai‐Yen Chang
- Department of NursingTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationNew Taipei CityTaiwan
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5
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Yu F, Mirza F, Chaudhary NI, Arshad R, Wu Y. Impact of Perceived Skillset and Organizational Traits on Digital Wellbeing of Teachers: Mediating Role of Resilience. Front Psychol 2022; 13:923386. [PMID: 35719496 PMCID: PMC9201954 DOI: 10.3389/fpsyg.2022.923386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022] Open
Abstract
Given the current unstable and unpredictable circumstances, especially due to the COVID-19 education system has evolved, requiring frequently distinct skills, and coping behavior. This study intended to empirically test the impact of perceived skillset and organizational traits on teachers' digital wellbeing with the mediating role of three levels of resilience. To serve the cause, non-probability convenience sampling was chosen, and data was gathered through an online survey from 336 on-duty teachers in the education sector of Pakistan. The results of the study have been drawn by using the PLS-SEM partial least squares structural equation modeling technique through the Smart-PLS software 3.0 version. The findings show that perceived skillset had a positive and significant impact on digital wellbeing and organizational traits had an insignificant effect on digital wellbeing. Moreover, results indicate that organizational resilience and employee resilience positively mediate the relationship between perceived skillset and organizational traits on digital wellbeing. Similarly, findings illustrate that team resilience positively mediates the relationship between perceived skillset and digital wellbeing. Furthermore, results show that team resilience negatively and insignificantly mediates the relationship between organizational traits and digital wellbeing. Lastly, discussion, theoretical and practical implications were also discussed in this research article.
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Affiliation(s)
- Fang Yu
- School of Economics and Management, Southeast University, Nanjing, China
| | - Farhan Mirza
- Knowledge Unit of Systems and Technology (KUST) Department, University of Management and Technology, Sialkot, Pakistan
| | | | - Rida Arshad
- Department of Business Administration, University of the Punjab, Lahore, Pakistan
| | - Yingyu Wu
- School of Economics and Management, Southeast University, Nanjing, China
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6
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Merritt VC, Brickell TA, Bailie JM, Hungerford L, Lippa SM, French LM, Lange RT. Low resilience following traumatic brain injury is strongly associated with poor neurobehavioral functioning in U.S. military service members and veterans. Brain Inj 2022; 36:339-352. [PMID: 35171749 DOI: 10.1080/02699052.2022.2034183] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the relationship between resilience and self-reported neurobehavioral functioning following traumatic brain injury (TBI) in U.S. military service members and veterans (SMVs). A secondary objective was to examine the interaction between resilience and posttraumatic stress disorder (PTSD) on neurobehavioral functioning. METHOD Participants included 795 SMVs classified into four groups: Uncomplicated Mild TBI (MTBI; n=300); Complicated Mild, Moderate, Severe, or Penetrating TBI (STBI, n 162); Injured Controls (IC, n=185); and Non-injured Controls (NIC, n=148). Two independent cohorts were evaluated - those assessed within 1-year of injury and those assessed 10-years post-injury. SMVs completed self-report measures including the PTSD Checklist-Civilian version, Neurobehavioral Symptom Inventory, and TBI-Quality of Life. RESULTS Results showed that (1) lower resilience was strongly associated with poorer neurobehavioral functioning across all groups at 1-year and 10-years post-injury, and (2) PTSD and resilience had a robust influence on neurobehavioral functioning at both time periods post-injury, such that SMVs with PTSD and low resilience displayed the poorest neurobehavioral functioning. CONCLUSION Results suggest that regardless of injury group and time since injury, resilience and PTSD strongly influence neurobehavioral functioning following TBI among SMVs. Future research evaluating interventions designed to enhance resilience in this population is indicated.
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Affiliation(s)
- Victoria C Merritt
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Tracey A Brickell
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Bethesda, MD, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Contractor, General Dynamics Information Technology, Falls Church, VA, USA
| | - Jason M Bailie
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Contractor, General Dynamics Information Technology, Falls Church, VA, USA.,Naval Hospital Camp Pendleton, Oceanside, CA, Oceanside, CA, USA
| | - Lars Hungerford
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Contractor, General Dynamics Information Technology, Falls Church, VA, USA.,Naval Medical Center San Diego, San Diego, CA, USA
| | - Sara M Lippa
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Louis M French
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Bethesda, MD, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rael T Lange
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Bethesda, MD, USA.,Contractor, General Dynamics Information Technology, Falls Church, VA, USA.,University of British Columbia, Vancouver, BCCanada
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7
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Ben-Avraham R, Afek A, Berezin Cohen N, Davidov A, Van Vleet T, Jordan J, Ben Yehudah A, Gilboa Y, Nahum M. Feasibility and preliminary effectiveness of mobile cognitive control training during basic combat training in the military. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1969162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rina Ben-Avraham
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Anat Afek
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Noa Berezin Cohen
- Department of Health and Well-Being, Medical Corps, Israel Defense Forces (IDF), Israel
| | - Alex Davidov
- Medical Branch, Ground Forces, Israel Defense Forces (IDF), Israel
| | - Tom Van Vleet
- Department of Research and Development, Posit Science Corporation, San Francisco, California
| | - Josh Jordan
- Department of Psychology, Dominican University of California, San Rafael, California
| | - Ariel Ben Yehudah
- Department of Health and Well-Being, Medical Corps, Israel Defense Forces (IDF), Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
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8
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Brassington K, Lomas T. Can resilience training improve well-being for people in high-risk occupations? A systematic review through a multidimensional lens. THE JOURNAL OF POSITIVE PSYCHOLOGY 2021. [DOI: 10.1080/17439760.2020.1752783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Tim Lomas
- School of Psychology, University of East London, London, UK
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9
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Hernandez S. A Case Report of Air Force Reserve Nurses Deployed to New York City for COVID-19 Support. Mil Med 2021; 186:56-60. [PMID: 34468002 PMCID: PMC8499816 DOI: 10.1093/milmed/usab090] [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: 12/24/2020] [Revised: 02/09/2021] [Accepted: 02/19/2021] [Indexed: 11/22/2022] Open
Abstract
Initial DoD support of Federal Emergency Management Agency (FEMA) operations for New York City (NYC) coronavirus disease 2019 (COVID-19) relief included the deployment of military medics to the Javits New York Medical Station and USNS Comfort. When Air Force (AF) Reservists arrived in NYC, 64th Air Expeditionary Group leaders worked with FEMA, Task Force New York/New Jersey, and NYC chains of command to send Airmen to NYC hospitals, including Lincoln Medical Center (LMC). Within 72 hours of arrival, 60 AF Reservists, including 30 registered nurses and 3 medical technicians, integrated into LMC to provide support during April and May 2020. This assistance began during the peak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Air Force nurses provided over 6,000 hours of care to over 800 patients in the emergency department and ad hoc intensive care and medical-surgical units. As infections declined, AF nurses shifted to providing care in established units. In these units, AF nurses provided patient care and worked directly with LMC nurses to provide directed teaching experiences to improve their comfort and competency with caring for acutely ill COVID-19 patients. The deployment of AF Reservists into civilian facilities was a success and bolstered the capability of three facilities struggling to care for SARS-CoV-2 patients. This effort was recognized by military and civilian healthcare leaders and resulted in over 600 military medical personnel being sent to support 11 NYC public hospitals.
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Affiliation(s)
- Stephen Hernandez
- IMA, United States Air Force School of Aerospace Medicine, Fairborn, OH 45324, USA.,Associate Professor, University of New Mexico, College of Nursing, MSC07 4380, Box 9, 1 University of New Mexico, Albuquerque, NM 87102, USA
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10
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Abraham TH, Cheney AM, Curran GM, Drummond KL. Drinking as routine practice among re-integrating National Guard and Reservists from Arkansas. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2020. [DOI: 10.4081/qrmh.2020.9001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Active duty enlisted military personnel are more likely to misuse alcohol than civilians – a pattern which persists even after the transition to civilian life. We used in-depth, substance use history interviews to elicit drinking trajectories from 54 re-integrating Army National Guard, Air Force Reserve and Army Reserve personnel from Arkansas with a history of problematic substance use. A hybrid inductive-deductive analytic approach revealed institutional norms, shared beliefs about drinking, and social values and expectations among military peers present in the context of military service that Veterans described as having shaped their drinking trajectories. Framing Veterans’ narratives vis-à-vis practice theory revealed the complex processes by which excessive drinking was embodied as routine practice during military service and subsequently reproduced in a very different post-deployment context, often with deleterious results. Elucidating these implicit processes suggested pro-active strategies for preventing problematic drinking by active duty personnel and improving the re-integration experiences of Veterans.
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Musanabaganwa C, Jansen S, Fatumo S, Rutembesa E, Mutabaruka J, Gishoma D, Uwineza A, Kayiteshonga Y, Alachkar A, Wildman D, Uddin M, Mutesa L. Burden of post-traumatic stress disorder in postgenocide Rwandan population following exposure to 1994 genocide against the Tutsi: A meta-analysis. J Affect Disord 2020; 275:7-13. [PMID: 32658827 PMCID: PMC7395874 DOI: 10.1016/j.jad.2020.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 05/21/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The 1994 genocide against Tutsi resulted in a massive death toll that reached one million people. Despite the tremendous efforts made to mitigate the adverse effects of the genocide, a substantial burden of mental health disorders still exists including the notably high prevalence of post-traumatic stress disorder (PTSD) among genocide survivors. However, a synthesized model of PTSD vulnerability in this population is currently lacking. METHODS A meta-analysis of 19 original research studies that reported PTSD prevalence (n = 12,610). Medline-PubMed and Science.gov were key search engines. Random-Effects Model (k = 19; tau^2 estimator: DL) was applied. Data extraction, synthesis, and meta-analysis were carried out using R. RESULTS The total of 2957 out of 11,746 individuals suffered from PTSD. The summary proportion is 25% (95% CI=0.16,0.36). The tau^2 is 0.06 (95% CI=0.03,0.14) in the absence of subgroups, and the Q-statistic is 2827.65 (p<0.0001), all of which suggests high heterogeneity in the effect sizes. Year of data collection and Year of publication were significant moderators. PTSD pooled prevalence in the genocide survivor category was estimated at 37% (95% CI=0.21,0.56). CONCLUSION The PTSD prevalence among genocide survivors is considerably higher compared to the general Rwandan population. The burden of PTSD in the general Rwandan population declined significantly over time, likely due to treatment of symptoms through strong national mental health programs, peace building and resolution of symptoms over time. To the best of our knowledge little evidence has reported the burden of PTSD prevalence in African post conflict zones particularly in Rwanda. LIMITATION Limitations of our review include the use of retrospective studies and studies with very small sample sizes, as well as language criterion.
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Affiliation(s)
- Clarisse Musanabaganwa
- Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;,Medical Research Center, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda;,Genomics Program, College of Public Health, University of South Florida, Florida, USA
| | - Stefan Jansen
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda,,Directorate of Research and Innovation, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Segun Fatumo
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, UK;,Uganda Medical Informatics Centre-MRC/UVRI, Entebbe, Uganda;,Genomics Program, College of Public Health, University of South Florida, Florida, USA
| | - Eugene Rutembesa
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda
| | - Jean Mutabaruka
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda
| | - Darius Gishoma
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda
| | - Annette Uwineza
- Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Yvonne Kayiteshonga
- Division of Mental Health, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
| | - Amal Alachkar
- Department of Pharmacology, School of Medicine, University of California Irvine, California, USA
| | - Derek Wildman
- Genomics Program, College of Public Health, University of South Florida, Florida, USA
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Florida, USA
| | - Leon Mutesa
- Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
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12
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MAO X, LOKE AY, HU X. Developing a tool for measuring the disaster resilience of healthcare rescuers: a modified Delphi study. Scand J Trauma Resusc Emerg Med 2020; 28:4. [PMID: 31959218 PMCID: PMC6971901 DOI: 10.1186/s13049-020-0700-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/07/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Disaster resilience is an essential personal characteristics of health rescue workers to respond to disasters in an effective manner, and maintain a state of adaptation after deployment. It is essential for disaster managers to recruit, assess, and prepare healthcare rescuers with this characteristic. A specific tool for measuring the disaster resilience of healthcare rescuers has yet to be devised. OBJECTIVE The purpose of this study was to establish the content validity of a tool for measuring the disaster resilience of disaster rescue workers. METHODS A modified Delphi approach was employed. Experts in disaster work and research were invited to rate the domains and items of a prototype tool for measuring disaster resilience in healthcare rescue workers. The panel of experts rated the relevance of the items using a 4-point Likert scale. The median and interquartile range, as well as the level of agreement, were calculated for each item using the Kendall coefficient W, to assess the consensus of the experts. The content validity index (CVI) was calculated to assess the content validity of this tool. RESULTS A total of 22 and 21 experts were involved in the first and second rounds of this modified Delphi study (response rate of 91.7 and 95.5%), respectively. After two rounds of expert query, an eight-domain and 27-item disaster resilience measuring tool was established. The median range of all of the included items was 3.50 to 4.00 and the interquartile range was 0.00 to 1.00, and all items achieved ≥85% agreement. The Kendall coordination coefficient W was 0.21 and 0.33 in the first and second rounds, respectively, with P < 0.01. The I-CVI ranged from 0.85 to 1.0, while the S-CVI/UA and S-CVI /Ave were 0.69 and 0.97, respectively. CONCLUSION Consensus was reached on a disaster resilience measuring tool covering 27 items. The content validity of this tool for measuring the disaster resilience of healthcare rescuers was excellent. This tool is validated and ready to be tested in a pilot study to assess its psychometric properties.
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Affiliation(s)
- Xiaorong MAO
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, Sichuan China
- Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan China
- School of Nursing, the Hong Kong Polytechnic University, Hung Hum Kowloon, Hong Kong
| | - Alice Yuen LOKE
- School of Nursing, the Hong Kong Polytechnic University, Hung Hum Kowloon, Hong Kong
| | - Xiuying HU
- School of Nursing / West China Hospital, Sichuan University, Chengdu, Sichuan China
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Regan RV, Fay-Hillier T, Murphy-Parker D. Simulation Clinical Experience of Veteran Care Competence for Psychiatric Mental Health Nurse Practitioner Students with Standardized Patients. Issues Ment Health Nurs 2019; 40:223-232. [PMID: 30620633 DOI: 10.1080/01612840.2018.1543743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this simulation educational activity was to assist psychiatric mental health nurse practitioner students (PMHNPs) with identifying military veterans as a vulnerable group with health care disparities and provide competent military veteran care in the private sector. Mindful of all the varied terms for military service, this article will use the term military veteran. METHODS The simulation educational activity included applying the conceptual frameworks of the healthcare disparities framework (HDF) and nursing education simulation framework (NESF). The psychiatric nurse practitioner students participated in a mandatory clinical standardized patient (SP) simulation for veteran care competence. RESULTS The learning was assessed in the debriefing following the student's performance in the SP simulation scenario. Anecdotally, the students reported that the activity was well received and a valuable learning experience for their practice. CONCLUSIONS SP simulation may increase PMHNPs' quality of assessment of military veterans and treatment to decrease healthcare disparities. Additionally, the education of PMHNPs with military veteran care competence will increase the availability of health care providers in the private sector, where many military veterans are seeking care.
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Affiliation(s)
- Roseann V Regan
- a Gwynedd Mercy University , Gwynedd Valley , Pennsylvania , USA
| | - Theresa Fay-Hillier
- b Drexel University College of Nursing and Health Professions , Philadelphia , Pennsylvania , USA
| | - Dana Murphy-Parker
- b Drexel University College of Nursing and Health Professions , Philadelphia , Pennsylvania , USA
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Lakatos BE, Mitchell MT, Askari R, Etheredge ML, Hopcia K, DeLisle L, Smith C, Fagan M, Mulloy D, Lewis-O'Connor A, Higgins M, Shellman A. An Interdisciplinary Clinical Approach for Workplace Violence Prevention and Injury Reduction in the General Hospital Setting: S.A.F.E. Response. J Am Psychiatr Nurses Assoc 2019; 25:280-288. [PMID: 30009653 DOI: 10.1177/1078390318788944] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND: Workplace violence is a major public health concern. According to the U.S. Bureau of Labor Statistics, from 2002 to 2013, incidents of serious workplace violence (those requiring days off) were four times more common in health care than in private industry. AIMS: An interprofessional committee developed, implemented, and evaluated a quality improvement project from 2012 to 2016 to reduce workplace violence and prevent staff injury. The initiative termed S.A.F.E. Response stands for Spot a threat, Assess the risk, Formulate a safe response, Evaluate the outcome. METHOD: An institutional review board-approved quality improvement survey was implemented and evaluated. The data were analyzed using descriptive statistics. An interprofessional committee developed and implemented a comprehensive program to prevent injury, which included (a) a mandatory eLearning educational training, (b) a S.A.F.E. Response with standardized interventions for the clinical conditions affecting safety, and (c) a clinical debriefing process. A reduction in nursing staff assault incidence rates was identified as a success. RESULTS: Nursing staff injury rates decreased an average of 40%. CONCLUSIONS: A reduction in nursing staff assault incidence rates was notable. Clinicians equipped with knowledge, skills, and resources can identify and defuse unsafe situations to prevent violence. This clinical approach shifts the focus from crisis intervention to crisis prevention, which reduces injury.
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Affiliation(s)
- Barbara E Lakatos
- 1 Barbara E. Lakatos, DNP, PMHCNS-BC, APRN, Brigham and Women's Hospital, Boston, MA, USA
| | - Monique T Mitchell
- 2 Monique T. Mitchell, MS, PMHCNS-BC, APRN, Brigham and Women's Hospital, Boston, MA, USA
| | - Reza Askari
- 3 Reza Askari, MD, Brigham and Women's Hospital, Boston, MA, USA
| | - Mary Lou Etheredge
- 4 Mary Lou Etheredge, MS, PMHCNS-BC, APRN, Brigham and Women's Hospital, Boston, MA, USA
| | - Karen Hopcia
- 5 Karen Hopcia, ScD, CNP, ANP-BC, COHN-S, FAAOHN, Brigham and Women's Hospital, Boston, MA, USA
| | - Leslie DeLisle
- 6 Leslie DeLisle, MS, PMHCNS-BC, APRN, Brigham and Women's Hospital, Boston, MA, USA
| | - Christine Smith
- 7 Christine Smith, RN, MSN, Brigham and Women's Hospital, Boston, MA, USA
| | - Maureen Fagan
- 8 Maureen Fagan, DNP, FNP-BC, FAAN, Brigham and Women's Hospital, Boston, MA, USA
| | - Deborah Mulloy
- 9 Deborah Mulloy, PhD, RN, CNOR, Brigham and Women's Hospital, Boston, MA, USA
| | - Annie Lewis-O'Connor
- 10 Annie Lewis-O'Connor, NP-BC, MPH, PhD, Brigham and Women's Hospital, Boston, MA, USA
| | - Margaret Higgins
- 11 Margaret Higgins, MSN, RN, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrea Shellman
- 12 Andrea Shellman, MHSA, CPPS, Brigham and Women's Hospital, Boston, MA, USA
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