The Role of Peer Support in Managing Occupational Stress: A Qualitative Study of the Sustaining Resilience at Work Intervention

The mediating role of social support on the relationship between secondary traumatic stress and burnout of nurses caring for COVID-19 patients: A cross-sectional study

BACKGROUND

Social support can help nurses cope with occupational stress and trauma, and maintain overall well-being, particularly in stressful situations such as outbreaks.

AIM

To determine the mediating role of social support on the relationship between secondary traumatic stress (STS) and burnout among nurses who cared for COVID-19 patients.

DESIGN

A cross-sectional, correlational, descriptive design.

METHODS

Two hundred nurses who had provided direct care to COVID-19 patients were recruited from wards in two hospitals in Riyadh, Saudi Arabia. Data were collected using the Multidimensional Scale of Perceived Social Support and the Professional Quality of Life Scale tools.

RESULTS

STS had a significant and positive correlation with burnout (r = 0.610, p = 0.000); social support from family, friends, and significant others were each significantly and negatively associated with STS (r = -0.147, p = 0.038; r = -0.547, p < 0.0001; r = -0.225, p = 0.001, respectively) and burnout (r = 0-0.282, p < 0.0001; r = -0.716, p = 0.026; r = -0.377, p < 0.0001, respectively). STS had a significant effect on social support (β = -0.21, p = 0.042) and burnout (β = 0.61, p < 0.0001). Social support had a significant and partial effect on the relationship between STS and burnout (Z = 2.99, p = 0.002).

CONCLUSION

Social support can reduce and mitigate the negative effects of STS and burnout. This understanding could enhance nurses' occupational lives by assisting policymakers and nurse managers in creating positive work environments that promote social support. Such policies could reduce the incidence and impact of burnout and STS.

Assessment of factors leading to resilience among adults in violence-affected area of Kashmir: an exploratory study employing content analysis and best-worst method

Exposure to violence can have profound and lasting effects on individuals and communities, impacting various aspects of their lives. Understanding the relationship between exposure to violence and resilience is crucial for designing effective interventions and support systems. This study aims to identify resilience factors among adults living in such areas and rank them from most to least important. Two staged mixed-method approaches, including face-to-face interviews and the best-worst method, were used to identify factors, assign weights, and rank them. A total of twenty-three sub-factors classified under seven broader factors were identified and ranked by triangulating the opinions of victims, experts, and scholars. Out of twenty-three sub-factors, the top-ranked six factors included family support, trusting higher powers, peer support, better interpersonal relationships, engaging in regular prayers, and better role models, which contributes fifty two percent to resilience formation. By promoting these factors, individuals and communities can better cope with the stress and trauma of violence, promote positive adaptation and growth, and build social support networks to help promote recovery and healing. Implications for practice, policy, and future directions are discussed.

Unpacking the Experiences of Health Care Professionals About the Web-Based Building Resilience At Work Program During the COVID-19 Pandemic: Framework Analysis

BACKGROUND

The COVID-19 pandemic has resulted in a greater workload in the health care system. Therefore, health care professionals (HCPs) continue to experience high levels of stress, resulting in mental health disorders. From a preventive perspective, building resilience has been associated with reduced stress and mental health disorders and promotes HCPs' intent to stay. Despite the benefits of resilience training, few studies provided an in-depth understanding of the contextual factors, implementation, and mechanisms of impact that influences the sustainability of resilience programs. Therefore, examining target users' experiences of the resilience program is important. This will provide meaningful information to refine and improve future resilience programs.

OBJECTIVE

This qualitative study aims to explore HCPs' experiences of participating in the web-based Building Resilience At Work (BRAW) program. In particular, this study aims to explore the contextual and implementational factors that would influence participants' interaction and outcome from the program.

METHODS

A descriptive qualitative approach using individual semistructured Zoom interviews was conducted with participants of the web-based resilience program. A framework analysis was conducted, and it is guided by the process evaluation framework.

RESULTS

A total of 33 HCPs participated in this qualitative study. Three themes depicting participants' experiences, interactions, and impacts from the BRAW program were elucidated from the framework analysis: learning from web-based tools, interacting with the BRAW program, and promoting participants' workforce readiness.

CONCLUSIONS

Findings show that a web-based asynchronous and self-paced resilience program is an acceptable and feasible approach for HCPs. The program also led to encouraging findings on participants' resilience, intent to stay, and employability. However, continued refinements in the components of the web-based resilience program should be carried out to ensure the sustainability of this intervention.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05130879; https://clinicaltrials.gov/ct2/show/NCT05130879.

Assessing Mental Healthcare Worker Experiences of Workplace Fairness and Organizational Value: A National Survey of Peer-Support Specialists

BACKGROUND

Peer-support specialists-individuals with diagnosed mental illnesses who provide support services to other adults with diagnosed mental health issues-often feel stigmatized and undervalued at work, leading to negative personal- and job-related outcomes. Given their important link to positive service user outcomes, this study assessed how peer-support specialists perceive fairness and feel valued in the workplace.

METHODS

Peer-support specialists (N = 274) were recruited online from peer-support specialist listservs, social media groups, and patient-run organizations to take a cross-sectional survey that included a 14-item scale on how workplace fairness relates to job satisfaction and four questions on how valued they felt by administrators, clinicians, the people they serve, and fellow peer-support specialists. Descriptive and bivariate statistics were used to assess total scores and differences by gender and race.

FINDINGS

Ranging in age from 20 to 77 years and identifying predominantly as White (81.0%) and female (62.9%), respondents noted that fair practices in the workplace would increase their job satisfaction, with no significant differences observed by gender or race. Most peer-support specialists felt valued by the people they serve (97.1%) and fellow peer-support specialists (92.7%). However, fewer reported feeling valued by administrators (64.6%) and clinicians (60.6%).

CONCLUSIONS/APPLICATION TO PRACTICE

Peer-support specialists value fairness at the workplace and feel undervalued by some staff. This study highlights peer-support specialists' important role in behavioral health services and suggests that healthcare professionals, including occupational health specialists, are important stakeholders in creating fairer workplaces and increasing peer-support specialists' sense of being valued, leading to improved personal and organizational outcomes.

The Implications of Stress Among Correctional Officers: A Summary of the Risks and Promising Intervention Strategies

This paper provides a detailed summary and discussion of the concept of stress and how it relates to the health, wellbeing, and performance of corrections officers. In line with these objectives, we focus on three areas: (1) providing a more detailed definition of the concept of stress; (2) a discussion of the ways that increased exposure to stress may impact corrections officers' physical and mental health; and (3) a summary of prevention and intervention strategies that are relevant for corrections officers and have shown promise in dampening the consequences of increased stress exposure. More in-depth knowledge of the concept of stress and the underlying processes that link stress to negative outcomes will provide policy makers and corrections departments with an understanding of the characteristics of prevention and intervention strategies that are expected to be most effective in limiting the consequences of stress.

Peer Support Programs to Reduce Organizational Stress and Trauma for Public Safety Workers: A Scoping Review

BACKGROUND

Public safety workers (PSWs), including correctional officers (COs), law enforcement, firefighters, emergency medical service, and military personnel, are at risk of organizational stress and burnout. Exposure to traumatic events, job hazards, injuries, fatalities, and work-related stressors such as work overload, irregular shift assignments, and lack of administrative support can negatively impact PSWs' mental health. Peer support programs (PSPs) have been cited as an intervention to address the mental health of PSWs.

PURPOSE

The purpose of this review is to explore the use, including facilitators and barriers, of PSPs to reduce organizational stress and trauma for PSWs. Implications for COs will be discussed.

METHOD

A scoping review was conducted using the Arksey and O'Malley methodology. A search was conducted for articles published between 1996 and 2021 using six databases. Selected articles described, implemented, or evaluated peer support as an intervention to reduce PSW organizational stress and trauma.

FINDINGS

Thirteen articles met eligibility criteria. Organizational support, including policies, practices, and peer leadership training, contributed to the sustainability of PSPs. Confidentiality, trust, and shared lived experience were also essential to PSP. Stigma was identified as the primary barrier to participation. Public safety workers found PSP helpful in normalizing experiences, increasing hope, and decreasing stigma. Peer support programs also serve to bridge the gap in mental health services use.

CONCLUSIONS

Peer support programs are a potential mental health intervention to reduce organizational stress and trauma for COs. Awareness of the facilitators and barriers to PSPs is the first step in developing such programs.

Peer support interventions in maternal and child healthcare delivery in sub-Saharan Africa: protocol for a realist review

BACKGROUND

Peer support has been proposed as a promising policy intervention for addressing adverse maternal and child healthcare (MCH) outcomes in sub-Saharan Africa (SSA). Existing reviews on peer support largely draw on evidence from high-income countries or focus on single services like breastfeeding, nutrition or postnatal care. In contrast, this review aims to provide a comprehensive overview of the empirical literature on peer support interventions across various MCH services in sub-Saharan Africa. Specifically, we aim to understand how, why, for whom, and in what circumstances different forms of MCH peer support interventions contribute to improving healthcare outcomes in sub-Saharan Africa.

METHODS

This review follows five iterative steps for undertaking realist reviews (1) defining the review scope; (2) developing initial programme theories; (3) searching for evidence; (4) selecting and appraising evidence; and (5) extracting, analysing and synthesising evidence. Four databases-Cochrane Library, PubMed, CINAHL, and EMBASE-were repeatedly searched between March and June 2021. From a large volume of records retrieved from the database and citation search, 61 papers have been selected for review. We will conduct a second search of the same database covering June 2021 to the present before the final extraction and synthesis. The final list of selected papers will be imported into NVivo 12 software and organised, extracted, analysed and synthesised iteratively to examine and illustrate the causal links between contexts, mechanisms and outcomes of MCH peer support interventions in SSA. We have drawn on the existing literature on peer support in healthcare generally to develop initial programme theories. We will then use the empirical literature on MCH peer support interventions in SSA, inputs from a stakeholders' workshop in Ghana and a conference presentation to refine the initial programme theory.

DISCUSSION

The review will develop an explicit theory of peer support intervention in healthcare delivery and provide insights for developing evidence-informed policy on the intervention. Drawing lessons from the different national contexts and diverse areas of MCH in SSA, the review will provide an analytically generalizable programme theory that can guide intervention design and implementation. While focusing on MCH peer support interventions in SSA, the review contributes to evolving conversations on the use of theory for health policy planning and complex intervention design and implementation globally.

TRIAL REGISTRATION

PROSPERO registration ID: CRD42023427751 .

Mental Health Allyship

There is increasing focus by corporations to support mental health in the workplace. This editorial will present an example of a corporation’s internally developed Mental Health Ally course which helped employees understand their role in advocating and promoting a positive culture of workplace mental health. The positive participant feedback received highlights the importance of having this type of global offering, but also serves as a call to action for further research to evaluate the longer-term benefits.

A concept analysis: Support for lay healthcare workers in HIV services, Bojanala District, North West

BACKGROUND

 Different lay healthcare workers play an important role in the retention of clients to human immunodeficiency virus (HIV) care. Retention to HIV care is crucial to promote treatment continuation, viral suppression and reduced risk of transmission. However, lay healthcare workers view and perceive support differently.

OBJECTIVES

 The aim of the study was to investigate perceptions of healthcare workers regarding support provided to lay healthcare workers in HIV services. This article is a report of a concept analysis of healthcare workers' support provided to lay healthcare workers in HIV services, that was collected during the study. A concept analysis was done to explore the support attributes, clarify meaning and to understand its use within the lay healthcare workers' context in Bojanala District, situated in the North West province of South Africa.

METHOD

 The initial phase was data collection from lay healthcare workers, their supervisors and clients on antiretroviral therapy. Thereafter, the eight concept analysis steps of Walker and Avant were followed. Peer-reviewed articles on the support concept were searched and guided by data saturation.

RESULTS

 Responsiveness, provision, reciprocity and integration are key characteristics of support.

CONCLUSION

 Despite support being an interpersonal process, it is perceived subjectively. Support is necessary to continuously promote growth or endurance during adverse times.Contribution: The concept analysis will provide common understanding of support and information that is responsive to the needs of different lay healthcare workers.

Old-age mental telehealth services at primary healthcare centers in low- resource areas in Greece: design, iterative development and single-site pilot study findings

BACKGROUND

Even though communities in low-resource areas across the globe are aging, older adult mental and cognitive health services remain mainly embedded in tertiary- or secondary hospital settings, and thus not easily accessible by older adults living in such communities. Here, the iterative development of INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) services addressing the mental and cognitive healthcare needs of older adults residing in low-resource areas of Greece is depicted.

METHODS

INTRINSIC was developed and piloted in three iterative phases: (i) INTRINSIC initial version conceptualization; (ii) A 5-year field testing in Andros island; and (iii) Extending the services. The INTRINSIC initial version relied on a digital platform enabling videoconferencing, a flexible battery of diagnostic tools, pharmacological treatment and psychosocial support and the active involvement of local communities in service shaping.

RESULTS

Ιn 61% of the 119 participants of the pilot study, new diagnoses of mental and/or neurocognitive disorders were established. INTRINSIC resulted in a significant reduction in the distance travelled and time spent to visit mental and cognitive healthcare services. Participation was prematurely terminated due to dissatisfaction, lack of interest or insight in 13 cases (11%). Based on feedback and gained experiences, a new digital platform, facilitating e-training of healthcare professionals and public awareness raising, and a risk factor surveillance system were created, while INTRINSIC services were extended to incorporate a standardized sensory assessment and the modified problem adaptation therapy.

CONCLUSION

The INTRINSIC model may be a pragmatic strategy to improve access of older adults with mental and cognitive disorders living in low-resource areas to healthcare services.

Work-Family Conflict and Depression Among Healthcare Workers: The Role of Sleep and Decision Latitude

BACKGROUND

Healthcare workers report a higher incidence of depression than the general population. Work-family conflict is a risk factor, but the mechanisms explaining its association with depression are not well understood. This study examines the potential mediating and moderating role of sleep and decision latitude in translating work-family conflict into depression.

METHODS

In 2018, a cross-sectional survey was collected from healthcare workers (n = 1,059) in five public sector facilities in the northeast United States. The survey included questions on participants' work-family conflict, depression, sleep duration and disturbances, decision latitude, and other work environments and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables.

FINDINGS

There was a significant association between work-family conflict and depression (β = 2.70, p < .001). Sleep disturbances, although not short sleep duration, partially mediated this association. The association between work family-conflict and depression was stronger among workers with low decision latitude.

CONCLUSIONS

Depression was prevalent among healthcare workers and was associated with work-family conflict. Sleep disturbances served as a significant mediator, while decision latitude modified the strength of the association.

APPLICATION TO PRACTICE

Evidence-based interventions seeking to alleviate the effect of work-family conflict and improve healthcare workers' mental health should consider promoting employee sleep quality and improving employees' decision-making on the job.

What Could Highly Engaged Workers Gain From Mental Health Promotion Programs?: An Exploratory Analysis of Secondary Outcomes of Brief Daily Workplace Well-being Programs

OBJECTIVE

The current study aims to examine the effects of mental health programs on well-being among highly engaged workers.

METHODS

Participants were randomly allocated to body-mind-spiritual or peer support program. Of the whole sample, we examined participants' work engagement and positive affect from the highest quarter and the lowest quarter of work engagement at baseline. Measures were taken at baseline and 1-month intervals during 3-month programs and 3-month follow-up.

RESULTS

The programs had decreasing effects on work engagement in the HWE subgroup. There is an increasing trend of positive affect on the HWE group only in the body-mind-spiritual program. The trajectories of work engagement in the HWE group moved toward a moderate level.

CONCLUSION

Our results suggest that the work engagement's decrease in the HWE group could be a sign of recovery and relaxation.

Is it time to rethink education and training? Learning how to perform under pressure: An observational study

Emergency medicine workers are exposed daily to various stressors, especially work-related stress, which have been aggravated by the current SARS-CoV 2 pandemic and impact their physical and mental wellbeing. Nonetheless, although the efficacy of programs and strategies to improving the health of medical staff and patient care has been demonstrated, such programs and strategies are scarce. To assess the prevalence, types and consequences of stress in emergency medical workers in healthcare institutions and explore tools to cope with stressful situations at workplace. Two surveys were conducted. Survey 1 assessed the subjective stress levels and stressors of 21 emergency medicine professionals. Survey 2 was conducted amongst 103 healthcare workers at 3 hospitals in Germany. It comprised selected aspects of the German Mental Risk Assessment and a validated workload scale. None. The answer frequencies on Likert scales were descriptively evaluated. Survey 1: Emergency medical professionals experienced and reported the following high stress levels in acute situations: multitasking during a complex situation; factors associated with the work environment; fear of not appropriately controlling the situation; and lack of sleep. Survey 2: The highest stress levels were experienced in the areas "work environment" and "work organization." The highest scores on the workload scale were obtained for statements on work division, exhaustion, insufficient patient care due to time constraints, regulations, and lack of information. Approximately 80% of healthcare workers had experienced emotionally stressful situations at the workplace, and > 30% had lost a colleague to suicide. There are effective and proven methods to learn how to deal with stress that can easily be established in everyday clinical practice. Healthcare workers are subjected to numerous stressors in their work environment and observe the consequences of these stressors on their own and their colleagues' wellbeing. Coping strategies for high-pressure reduces and resists the job- immanent pressure and stress in healthcare workers.

COVID-19 Pandemic Response Preparedness and Risk Perceptions Among Peruvian Veterinarians and Animal Care Workers

Peruvian veterinarians and animal care workers (VACW) are primary responders in the event of disasters or emergencies, yet they face unique concerns that could impede or block their essential functions in public health preparedness in comparison with VACWs in other countries. In this study, we used the Ready, Willing, and Able model via electronic survey to evaluate the perception of risks and barriers that Peruvian VACWs faced when deciding whether to continue working during the COVID-19 pandemic between July and December 2020. We used logistic regression models to evaluate associations between demographic characteristics, perceived role, and contact scores with 8 outcomes: knowledge of COVID-19; confidence in safety protocols; perceived threat; perceived job efficacy; perceived barriers; and readiness, willingness, and ability to respond to the COVID-19 pandemic. Less than 50% of respondents reported barriers to report to work during the pandemic. Respondents who reported higher contact with coworkers had an increased confidence in safety protocols (OR 5.16; 95% CI, 1.36 to 19.61) and willingness (OR 3.76; 95% CI, 1.14 to 12.47) to respond to the pandemic. Close contacts with essential workers and higher economic income were associated with higher reported knowledge of COVID-19. Respondents with higher perceived job efficacy had higher odds of reporting being ready, willing, and able to respond to COVID-19, while those who identified more barriers to report to work had lower odds of being ready, willing, and able to respond. The findings from this study, which showed differences from VACWs in the United States, can be used by individuals designing programs to improve pandemic and disaster preparedness in this essential, yet understudied and vulnerable, workforce.

Profiles of emerging adults' resilience facing the negative impact of COVID-19 across six countries

Although emerging adults (i.e., individuals aged 18-29 years old) may be at a lesser risk of COVID-19 severe illness and mortality, studies have found that the negative impact of COVID-19 on mental health and well-being is higher among emerging adults when compared to other age groups. The current study aimed to identify profile(s) based on resilience resources, which could help emerging adults in managing the disruptions to their lives following the pandemic. A cross-national sample of 1,768 emerging adults from China, Italy, Lithuania, Portugal, Slovenia, and the US was utilized to identify profiles based on different resilience dimensions (ego-resiliency, positivity, religiosity, socioeconomic status, family support, peer support). Results of the Latent Profile Analysis suggest the presence of four different profiles: no resources, only peer, only family, and well-equipped. The association of these profiles with demographic variables, adulthood markers, self-perceived COVID-19 impact, present well-being, and future life perception was investigated. Implications for resilience theory as well as for future interventions are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03658-y.

Three-Questions-Method for Coping with the Emotional Burden of Nurses and Nursing Students during COVID-19

BACKGROUND

Nurses and nursing students experienced an emotional burden while working during the COVID-19 outbreak. During the COVID-19 outbreak three questions for nurses working under these extreme circumstances were formulated: 1. What today's events do you remember? 2. How do you feel (physically and mentally)? 3. Do you have enough support? The purpose of this study was to obtain insight into whether nurses and nursing students perceive that the use of the three-questions-method contributes to effective coping with the emotional burden during the COVID-19 outbreak.

METHODS

Focus group interviews were held with hospital nurses (n = 11) and nursing students with internships in mental health care (n = 2), hospital (n = 9), and homecare/nursing home care (n = 3) in September 2020 followed by twenty semi-structured interviews one year later.

RESULTS

Almost all nurses and nursing students named factors that contributed to the emotional burden: fear, powerlessness, frustration, lack of knowledge about COVID-19, and pressure to pass the internship. Participants indicated that using the three-questions-method can help to effectively cope with the emotional burden during and after the COVID-19 outbreak.

CONCLUSIONS

Using the three-questions-method offers added value in coping with emotional burden and can be used in education as well as in practice.

“Everything Is Changing, but I Am Not Alone”: Nurses’ Perceptions of Social Support during COVID-19

COVID-19 has created numerous stressors for nurses, which have impacted their work, self-efficacy, and wellness. Social support helps manage stress and burnout. Through 24 semi-structured interviews, the current article explores the perspectives of nurses who worked with COVID-19 patients in the initial days of the pandemic in the United States. This study unpacks the types and sources of social support nurses sought during this time, especially as they faced significant burnout. Through thematic analysis, the current study found that these nurses interacted with the crisis situation to evaluate their social support needs and the plausibility of fulfilling these needs. They focused on the support that was available or at least perceived to be available and let go of certain needs that could not plausibly be addressed in that moment. Peer-to-peer support was critical during this process, and nurses avoided sharing concerns with their families as they enacted protective buffering. The findings also highlight the complex and dynamic nature of social support as nurses interact with their peers and evaluate the support they receive. Peers helped with haptic support like providing hugs to coworkers, and at times even became surrogates for coworkers’ family members as they participated in communal coping. Organizational support was critical for sharing information centrally with nurses and for organizational sustainability.

Effects of a hospital-based leisure activities programme on nurses' stress, self-perceived anxiety and depression: A mixed methods study

AIMS

To determine the effects of a hospital-based leisure activities programme on nurses' stress, self-perceived anxiety and depression.

BACKGROUND

Nursing work in clinical settings is highly stressful and may result in an increase in nurses' turnover rate, which threatens the quality of nursing care and patient safety.

METHODS

We used a mixed methods design and a three-month intervention (January to April, 2019) involving a convenience sample of 176 nurses working at a Chinese tertiary hospital. We conducted 12 semi-structured interviews and performed a content analysis. The pre- and post-intervention comparisons of nurses' stress, self-perceived anxiety and depression were performed using a paired t test.

RESULTS

The 3-month leisure activities programme significantly decreased nurses' job stress (t = 3.80, p < .01), perceived personal stress (t = 3.30, p < .01), self-perceived anxiety (t = 3.76, p < .01) and depression (t = 2.73, p < .01). The qualitative findings revealed five mechanisms linking leisure activities to subjective well-being: detachment recovery, autonomy, mastery, meaning and affiliation.

CONCLUSIONS

A hospital-based leisure activities programme had a positive effect on job stress, self-perceived anxiety and depression, thus improving nurses' well-being.

IMPLICATIONS FOR NURSING MANAGEMENT

A hospital-based leisure activities programme provides a beneficial strategy for ameliorating nurses' psychosocial issues. Interventions aimed at facilitating or increasing nurses' participation in leisure activities are greatly needed.

Identifying Psychosocial Risks and Protective Measures for Workers’ Mental Wellbeing at the Time of COVID-19: A Narrative Review

The spread of the SARS-CoV-2 virus has caused crucial changes in the workplace. Almost two years after the start of the COVID-19 era, new and old psychosocial risks in the workplace threaten workers’ mental wellbeing and represent an occupational health challenge. The aim of this review is to identify the most relevant psychosocial factors, negative or protective, contributing to occupational stress during the current pandemic. A literature search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, Google Scholar and PsycINFO and a total of 51 articles were deemed suitable for inclusion in the review. Analysis of the retrieved articles revealed five main topics related to psychosocial wellbeing in the workplace: 1. Support from colleagues and organizations; 2. Home–work interface and balance; 3. Changes in workload and work demand; 4. Job competence and appropriate training; 5. Job insecurity and financial stress. All five themes were associated with occupational stress and poor mental outcomes, like anxiety, depression, and burnout symptoms. Peer and organizational support seem to have a major impact on workers’ mental wellbeing. Recognizing these factors and projecting interventions that mitigate their effects or boost their efficacy is a fundamental step towards dealing with COVID-19 in the workplace, or any such future emergencies.

Psychosocial support for providers working high-risk exposure settings during a pandemic: A critical discussion

Psychological first aid is a form of support designed to lessen disaster-related distress. In a pandemic, providers may need such support but with the high risk of exposure, such a program is offered only virtually. The research is scant for traditional post-disaster support and non-existent for virtual; therefore, by using related research this discussion considers the likelihood of providers accessing and benefiting from this program. The virtual platform is heralded as the responsible way to provide support in a pandemic but this standard may be ineffective and is inherently inequitable. As a global event, pandemics require containment strategies applicable on an international level; therefore, psychosocial support should also be developed with an international audience in mind. Online psychosocial support falls short of being such a strategy as it incorrectly assumes global internet access. Many low-income areas such as Sub-Saharan Africa will need support strategies which compliment local frontline staff and fit with community-driven initiatives, whereas wealthier countries may use a combination of onsite and online support. Provider psychosocial support needs in a pandemic, if articulated, are globally similar but how this support is offered requires contextually sensitive considerations not yet found in the literature.

Resilience Training Programs in Organizational Contexts: A Scoping Review

The importance of resilience for employees' well-being and performance at work has grown steadily in recent years. This development has become even more pronounced through the recent COVID-19 pandemic and its consequences, including major changes in occupational settings. Although there is increasing interest in resilience in general and a growing number of publications focusing on the development of resilience in particular, many questions remain about resilience training, especially in organizational contexts. The purpose of this scoping review is to uncover what is known about resilience training in organizational contexts. A systematic search of four databases for articles published through 2021 was conducted. A total of 48 studies focusing on resilience training programs in organizational contexts were included in this review. The review provides relevant insights into resilience training programs by focusing on program characteristics, target group, study design, and outcomes. Based on the results, the main aspects that concern the development of resilience training programs for organizational settings and requirements for the study design for empirical investigation were summarized. The results of the review highlight possible directions for future research and offer useful insights for resilience-enhancing training programs in organizations.

Burnout in trauma and orthopaedic surgeons: can the UK military stress management model help?

The recent coronavirus disease (COVID-19) pandemic has increased doctors' stresses at work and at home, putting them at increased risk of burnout. Considering this, we recently conducted the British Orthopaedic Association (BOA) Burnout and Wellbeing Survey which showed that, from 1298 respondents (approximately 25% of the membership of the BOA), 40% reported burnout and a further 50% were just below the threshold. The burnout rates were found to be higher in Black, Asian and minority ethnic (BAME), female and LGBTQ+ groups (45.6%) compared to white, heterosexual males (33.6% - p < 0.001) and also higher in trainees (49.1%) and associate specialists (52.1%) compared to consultants (35.7% - p < 0.001). We discuss what can be learned from the experience of the UK Armed Forces in their programme for stress management, their mental resilience training and their campaign to destigmatize mental wellbeing, that may mitigate burnout in our profession. We also put forward the case for appropriate resources to be allocated to tackling burnout in orthopaedic doctors and introduce the BOA's Wellbeing Initiative.

Association between Self-Perceived Social Support in the Workplace and the Presence of Depressive/Anxiety Symptoms

This study aimed to investigate the association of support from colleagues and supervisors at the workplace on depressive and anxiety symptoms in wage earners from Korea. The data used in this study were from the fifth Korean Working Conditions Survey (KWCS) conducted in 2017 and analyzed using a multivariate logistic regression model. Furthermore, we measured the odds ratios (ORs) and 95% confidence intervals (CIs) of depressive and anxiety symptoms by stratifying covariates. The ORs of depressive and anxiety symptoms for the “non-support” group were higher than for the “support group” in terms of support from both colleagues and supervisors. The results of the stratified analysis of covariates, male, young, highly-educated, full-time, and white-collar groups were associated with the lack of support. Support from colleagues and supervisors was significantly associated with the Korean wage worker’s mental health—depressive and anxiety symptoms, respectively. Further longitudinal and clinical studies on the relationship between mental health and support at the workplace are required.

Understanding Moral Injury and Belief Change in the Experiences of Police Online Child Sex Crime Investigators: an Interpretative Phenomenological Analysis

Little is known about the psychological and physiological impacts of moral injury within organizational contexts such as Internet Child Abuse Teams (hereafter abbreviated to ICAT), who are repeatedly exposed to trauma through viewing and grading graphic images of children being sexually abused. The aims of the current research were to explore the key features of, and contributing factors to, moral injury and trauma as experienced by Internet Child Abuse Teams, how these manifested and how these factors can be mitigated. Six participants were recruited from ICATs located at two police constabularies. Data were gathered using semi-structured interviews and analysed using interpretative phenomenological analysis. Findings indicated that the moral injury experienced by the participants was predominantly attributable to repeated exposure to traumatising images, with too little decompression time. Dysfunctional coping mechanisms, most commonly substance misuse, cognitive avoidance of distressing thoughts and emotional numbing, amplified the psychological and physical symptoms of anxiety. For many ICAT investigators, such tactics were attempts to manage the moral violations arising from their work and experienced as moral injury. These findings will be used to inform psychological review systems and interventions within policing.

Psychosocial and behavioral problems of children and adolescents in the early stage of reopening schools after the COVID-19 pandemic: a national cross-sectional study in China

This study aims to explore the psychosocial and behavioral problems of children and adolescents in the early stage of reopening schools. In this national cross-sectional study, a total of 11072 students from China were naturally divided into two groups based on their schooling status: reopened schools (RS) and home schooling (HS) group. The psychosocial and behavioral functioning were measured by Achenbach Child Behaviour Checklist (CBCL) and compared in these two groups. Multivariable logistic regression analyses were conducted to explore the independent predictors associated with the psychosocial and behavioral problems. Our results showed that the students in the RS group had more adverse behaviors than that of HS group. The RS group had the higher rates of parent-offspring conflict, prolonged homework time, increased sedentary time and sleep problems (all p < 0.001). When separate analyses were conducted in boys and girls, the RS group had the higher scores for (1) overall behavioral problems (p = 0.02 and p = 0.01), internalizing (p = 0.02 and p = 0.02) and externalizing (p = 0.02 and p = 0.004) behaviors in the 6-11 age group; (2) externalizing (p = 0.049 and p = 0.006) behaviors in the 12-16 age group. Multivariable regression showed parent-offspring conflict and increased sedentary time were the most common risk factors, while physical activity and number of close friends were protective factors for behavior problems in RS students (p < 0.01 or 0.05). The present study revealed that students' psychosocial and behavioral problems increased in the early stage of schools reopened unexpectedly. These findings suggest that close attention must be paid and holistic strategies employed in the school reopening process of post-COVID-19 period.