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Chan CC, Faherty C, Rahman N, Murrough JW, Benn EKT, Clark U, Mohamed N, DePierro JM, Ripp JA, Peccoralo LA. Suicidal ideation among non-physician hospital system staff: Prevalence and workplace correlates. J Affect Disord 2024; 362:638-644. [PMID: 39029665 DOI: 10.1016/j.jad.2024.07.109] [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: 02/05/2024] [Revised: 06/24/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Research suggests that healthcare workers are at greater risk for suicide than other occupations, but most published studies focus on physicians. This study examines the prevalence of suicidal ideation (SI) and associated occupational factors among a broad group of non-physician healthcare staff. METHODS An anonymous online survey was sent to a random sample of 30 % of non-physician healthcare staff at a large urban healthcare system between September and November 2022. Weighted multivariable binary logistic regressions were conducted to determine the workplace and mental health factors associated with SI. RESULTS The 1084 respondents included nurses, administrative staff, research staff, medical assistants, nurse practitioners, physician assistants, and other roles. Of the sample, 8.8 % endorsed having SI over the prior two weeks. Results of the regression indicated that, after adjusting for demographic factors, greater odds of SI were associated with physical violence experienced from a patient or visitor (odds ratio [OR] = 2.15, 95 % confidence interval [CI] = 1.06-4.37), lower perceived leadership support (OR = 0.95, 95 % CI = 0.92-0.98), and positive screening for depression (OR = 4.66, 95 % CI = 2.45-8.86). Exploratory analysis suggests that depression may be a mediating factor between workplace stressors and SI. LIMITATIONS Limitations include the response rate, the use of a single item to assess SI, and the cross-sectional design. CONCLUSION Findings suggest that workplace violence and leadership support are important occupational factors associated with SI among healthcare workers. Reducing and mitigating workplace violence, enhancing leadership support, and improving access to mental health care should be considered targets for interventions to decrease suicide risk in this population.
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Affiliation(s)
- Chi C Chan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; James J. Peters Department of Veterans Affairs Medical Center, New York, NY, United States of America; Office of Well-being and Resilience, Mount Sinai Health System, New York, NY, United States of America.
| | - Cara Faherty
- Office of Well-being and Resilience, Mount Sinai Health System, New York, NY, United States of America
| | - Nimra Rahman
- Office of Well-being and Resilience, Mount Sinai Health System, New York, NY, United States of America; The City University of New York Graduate School of Public Health and Health Policy, New York, NY, United States of America
| | - James W Murrough
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Depression and Anxiety Center for Discovery and Treatment, New York, NY, United States of America; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Emma K T Benn
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Center for Scientific Diversity, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Uraina Clark
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Center for Scientific Diversity, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Nihal Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Center for Scientific Diversity, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Jonathan M DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Jonathan A Ripp
- Office of Well-being and Resilience, Mount Sinai Health System, New York, NY, United States of America; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Lauren A Peccoralo
- Office of Well-being and Resilience, Mount Sinai Health System, New York, NY, United States of America; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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Xu YH, Wu F, Yu S, Zhang XY, Xu PJ, Sun QM. Prevalence of mental health symptoms and associated risk factors among healthcare workers in specialized COVID-19 hospitals in Anyang, China: A cross-sectional survey. Heliyon 2024; 10:e32593. [PMID: 38961983 PMCID: PMC11219988 DOI: 10.1016/j.heliyon.2024.e32593] [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: 01/15/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
Background The novel coronavirus disease 2019 (COVID-19) pandemic spread worldwide and brought unprecedented challenges to healthcare systems. Healthcare workers experienced tremendous pressure and psychological issues. Methods A cross-sectional online survey was conducted from January 2022 to April 2022 among healthcare workers in Anyang, Henan Province, China. Insomnia, anxiety, depression, post-traumatic stress disorder (PTSD), and problematic internet use (PIU) were evaluated. Logistic regression analyses were used to explore the factors that were associated with mental health problems. Results A total of 242 participants (mean [SD] age, 34.7 [6.6] years, 187 female [77.3 %]) were included in the study. The prevalence of symptoms of insomnia, anxiety, depression, PTSD and PIU during the COVID-19 pandemic in China was 53.7 %, 100.0 %, 7.0 %, 20.3 %, and 19.4 %, respectively. Participants who smoked, used sedative-hypnotic drugs and may need psychological assistance were at a higher risk for mental health problems. Respondents who were older than 45 years and were married displayed a lower risk of insomnia and PTSD, respectively. Conclusions Mental health symptoms are pervasive among healthcare workers in specialized COVID-19 hospitals during the outbreak. Risk factors include smoking, sedative-hypnotic drug use, and the need for psychological assistance, while protective factors include age and marital status. Developing social media platforms and providing psychological assistance may be effective interventions for healthcare workers.
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Affiliation(s)
- Ya-Hui Xu
- Corresponding author. Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang Henan, 453002, China.
| | | | - Shuai Yu
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Xiao-Yang Zhang
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Peng-Jiao Xu
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Qi-Meng Sun
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
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3
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de Vargas D, Volpato RJ, Dos Santos LC, Pereira CF, de Oliveira SR, da Silva RR, Maciel MED, Fernandes IL, de Oliveira Santana K, Aguilar TF. Prevalence of psychological and mental health symptoms among nursing professionals during the COVID-19 pandemic in the Americas: Systematic review and meta-analysis. Int J Ment Health Nurs 2024; 33:582-599. [PMID: 38151828 DOI: 10.1111/inm.13274] [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: 04/26/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
To assess the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent. A systematic review and meta-analysis of observational studies that estimated the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic was performed through bibliographic database searches. A three-level meta-analysis model was used with the inverse variance method, tau was estimated via restricted maximum likelihood and logistic transformation, and heterogeneity was presented as tau2 and I2. Of the 7467 studies obtained, 62 were included in the meta-analysis, which involved 52 270 nursing professionals. The overall prevalence for at least one mental health symptom was 56.3% (50.4%, 62.1%; I2 = 98.6%, p < 0.001). Eight mental health symptoms were found; among them, the most prevalent were burnout (52.1%, 37.1%, 88.8%; I2 = 98.5%, p < 0.001) and fear (52.1%, 30.1%, 73.3%; I2 = 98.1%, p < 0.001). The prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent was high, and strategies should be developed and implemented by managers and government agencies to promote the well-being, physical and mental health of nursing professionals. Studies like this one are necessary to highlight the need for efforts in the implementation of promotion and prevention actions to be developed by health organisations, managers and leaders with a view to improving the quality of life of nursing workers.
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Affiliation(s)
| | | | | | | | | | | | - Marjorie Ester Dias Maciel
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo, Brazil
| | | | | | - Thiago Faustino Aguilar
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo, Brazil
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Ngo VK, Vu TT, Punter MA, Levine D, Borrell LN, Mateu-Gelabert P. Mental Health Service Use, Barriers, and Service Preferences During COVID-19 among Low-Income Housing and Market-Rate Housing Residents of Harlem in New York City. J Community Health 2024; 49:439-447. [PMID: 38066218 PMCID: PMC10981563 DOI: 10.1007/s10900-023-01301-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 03/27/2024]
Abstract
This study examined the differences in mental health service use, barriers, and service preferences among 393 low-income housing (LIH) and market-rate housing (MRH) Harlem residents in New York City. One-third (34.6%) endorsed the need for professional support for psychological issues, 27.2% and 15.8% reported using counseling services and psychotropic medication, with no differences between housing types. LIH residents (21.6-38.8%) reported significantly higher use of all types of mental health resources (e.g., websites, anonymous hotlines, self-help tools) compared with MRH residents (16.1-26.4%). Eighty-six percent reported barriers to mental health access, with LIH residents reporting more than double the barriers. Particularly, LIH residents reported greater difficulty getting time off work (34.1% vs. 14%), lack of health insurance (18.7% vs. 9.8%), lack of trust in mental health providers (14.6% vs. 4.7%), and stigma (12.2% vs. 5.1%) compared with MRH residents. Residents most preferred places of services were health clinics and houses of worship; provided by healthcare and mental health providers; and services delivered in-person and phone-based counseling. In contrast, residents least preferred getting support at mental health clinics; from family/friends; and by the Internet. No differences were found between service preferences by housing type. LIH residents reported higher use of mental health services and resources, but they face significantly more barriers to mental health care, suggesting a need to address specific barriers. Preferences for mental health services suggest a need for expanding mental health services to different settings given the low preference for services to be delivered at mental health clinics.
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Affiliation(s)
- Victoria K Ngo
- Center for Innovation in Mental Health, Graduate School of Public Health & Health Policy, The City University of New York, New York, NY, USA
- Department of Community Health and Social Sciences, Graduate School of Public Health & Health Policy, The City University of New York, New York, NY, USA
| | - Thinh T Vu
- Center for Innovation in Mental Health, Graduate School of Public Health & Health Policy, The City University of New York, New York, NY, USA.
- Department of Community Health and Social Sciences, Graduate School of Public Health & Health Policy, The City University of New York, New York, NY, USA.
| | - Malcolm A Punter
- Harlem Congregations for Community Improvement, Inc, New York, NY, USA
| | - Deborah Levine
- Harlem Health Initiative, Graduate School of Public Health & Health Policy, The City University of New York, New York, NY, USA
| | - Luisa N Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health & Health Policy, The City University of New York, New York, NY, USA
| | - Pedro Mateu-Gelabert
- Department of Community Health and Social Sciences, Graduate School of Public Health & Health Policy, The City University of New York, New York, NY, USA
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5
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DePierro JM, Marin DB, Sharma V, Katz CL, Pietrzak RH, Feder A, Murrough JW, Starkweather S, Marx BP, Southwick SM, Charney DS. Development and initial validation of the Mount Sinai Resilience Scale. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024; 16:407-415. [PMID: 37796549 PMCID: PMC10842183 DOI: 10.1037/tra0001590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE The construct of psychological resilience has received increasing attention in the mental health field. This article describes the development and initial validation of a novel self-report resilience scale, which addresses gaps in the resilience measurement literature by assessing thoughts and behaviors that help promote resilience rather than traits, and simultaneously evaluating multiple factors previously associated with resilience. METHOD Following consensus meetings focused on scale development, we conducted an online study (n = 1,864) of U.S. adults to develop and validate an initial version of the Mount Sinai Resilience Scale (MSRS). RESULTS An exploratory factor analysis in a random 50% of the sample suggested a seven-factor solution; this solution was then generally supported by a follow-up confirmatory factor analysis in the remaining 50% of the sample. After removing poor-fitting items, a revised 24-item scale correlated in the expected directions with established measures of perceived resilience and resilience-related constructs (e.g., social support and optimism). CONCLUSIONS Collectively, the results of this study provide initial support for the convergent and discriminant validity of the MSRS and describe its factor structure. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Deborah B. Marin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
| | - Vanshdeep Sharma
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
| | - Craig L. Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
- Department of Medical Education, Icahn School of Medicine at Mount Sinai
| | - Robert H. Pietrzak
- U.S. Department of Veterans Affairs, National Center for PTSD, West Haven, Connecticut, United States
- Department of Psychiatry, Yale School of Medicine
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
| | | | | | - Brian P. Marx
- U.S. Department of Veterans Affairs, National Center for PTSD, Boston, Massachusetts, United States
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine
| | | | - Dennis S. Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai
- Department of Pharmacology, Icahn School of Medicine at Mount Sinai
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6
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Doukas AM, Sharma V, DePierro JM, Ho S, Starkweather S, Marin DB. Effectiveness of CBT-Informed Behavioral Health Interventions for Health Care Workers in a Specialized Clinical Service During the COVID-19 Pandemic. Am J Public Health 2024; 114:167-170. [PMID: 38354342 PMCID: PMC10916725 DOI: 10.2105/ajph.2023.307435] [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] [Accepted: 08/26/2023] [Indexed: 02/16/2024]
Abstract
Objectives. To evaluate symptomatology and clinical outcomes among treatment-seeking health care workers (HCWs). We examined engagement, presenting symptomatology, and treatment outcomes among a diverse group of HCWs in a large urban health system. Methods. Demographic and pretreatment-posttreatment outcome data were available for 69 HCWs who sought cognitive behavioral therapy (CBT), with or without medication management, at a specialized clinical center from July 1, 2020, to April 25, 2022. Results. Treatment-seeking HWCs predominantly identified as female (78.3%) and non-White (53.6%) and had a mean age of 36.33 ± 10.72 years. Wilcoxon signed-rank tests showed significant reductions in all symptoms and increased well-being (P < .001), with effect sizes ranging from 0.59 to 0.71. Conclusions. Our findings replicate those of existing research on the prevalence of psychiatric distress among HCWs, uniquely focusing on those seeking care. Our outcome data suggest that short-term CBT is effective in reducing clinical symptoms and increasing HCW well-being. Public Health Implications. Given the elevated rates of distress found in HCW surveys, evidence-based interventions such as ours are essential to ensure workforce well-being. Providing mental health care to HCWs has both individual benefits and potential implications for improved patient care and workforce retention. (Am J Public Health. 2024;114(S2):S167-S170. https://doi.org/10.2105/AJPH.2023.307435).
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Affiliation(s)
- Ashley M Doukas
- The authors are with the Department of Psychiatry, Icahn School of Medicine, Mount Sinai Health System, New York, NY
| | - Vanshdeep Sharma
- The authors are with the Department of Psychiatry, Icahn School of Medicine, Mount Sinai Health System, New York, NY
| | - Jonathan M DePierro
- The authors are with the Department of Psychiatry, Icahn School of Medicine, Mount Sinai Health System, New York, NY
| | - Scarlett Ho
- The authors are with the Department of Psychiatry, Icahn School of Medicine, Mount Sinai Health System, New York, NY
| | - Sydney Starkweather
- The authors are with the Department of Psychiatry, Icahn School of Medicine, Mount Sinai Health System, New York, NY
| | - Deborah B Marin
- The authors are with the Department of Psychiatry, Icahn School of Medicine, Mount Sinai Health System, New York, NY
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7
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Tong M, Hurtado A, Deshpande R, Pietrzak RH, He C, Kaplan C, Kaplan S, Akhtar S, Feder A, Feingold JH, Ripp JA, Peccoralo LA. Psychological Burden of Systemic Racism-Related Distress in New York City Healthcare Workers During the COVID-19 Pandemic. J Gen Intern Med 2024; 39:450-459. [PMID: 37845586 PMCID: PMC10897117 DOI: 10.1007/s11606-023-08422-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/07/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Little is known about the relationship among systemic racism, psychological symptoms (depression, anxiety, and/or post-traumatic stress disorders), and burnout in healthcare workers (HCWs). OBJECTIVE To determine whether distress related to awareness of systemic racism contributes to psychological symptoms and/or burnout in HCWs. We explored whether this form of racism-related distress may moderate the relationship between race, ethnicity, psychological symptoms, and burnout. DESIGN A cross-sectional survey was conducted from November 19, 2020, through January 11, 2021. Statistical analysis was conducted from May 3, 2022, to June 15, 2022. PARTICIPANTS Frontline HCWs at an urban tertiary care hospital in New York City. MAIN MEASURES Distress related to awareness of systemic racism (SR) and racial disparities in COVID-19 outcomes (RD), psychological symptoms, and burnout. KEY RESULTS Two thousand one of 4654 HCWs completed the survey (response rate 43.0%). Most HCWs reported experiencing distress related to awareness of systemic racism (1329 [66.4%]) and to racial disparities in COVID-19 outcomes (1137 [56.8%]). Non-Hispanic Black participants (SR odds ratio (OR) 2.84, p < .001; RD OR 2.34, p < .001), women (SR OR 1.35, p = .01; RD OR 1.67, p < .001), and those with history of mental illness (SR OR 2.13, p < .001; RD OR 1.66, p < .001) were more likely to report SR- and RD-related distress, respectively. HCWs who experienced "quite-a-bit to extreme" SR-related distress were more likely to screen positive for psychological symptoms (OR 5.90, p < .001) and burnout (OR 2.26, p < .001). CONCLUSIONS Our findings suggest that distress related to awareness of systemic racism, not race/ethnicity, was associated with experiencing psychological symptoms and burnout in HCWs. As the medical community continues to critically examine the role of systemic racism in healthcare, our work is a first step in characterizing its toll on the psychological well-being of HCWs.
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Affiliation(s)
- Michelle Tong
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Alicia Hurtado
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Richa Deshpande
- Center for Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Celestine He
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Carly Kaplan
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Sabrina Kaplan
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Saadia Akhtar
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jordyn H Feingold
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan A Ripp
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lauren A Peccoralo
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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8
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Kakemam E, Maassoumi K, Azimi S, Abbasi M, Tahmasbi F, Alizadeh M. Prevalence of depression, anxiety, and stress and associated reasons among Iranian primary healthcare workers: a mixed method study. BMC PRIMARY CARE 2024; 25:40. [PMID: 38279098 PMCID: PMC10811870 DOI: 10.1186/s12875-024-02268-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/05/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Different mental disorders may be associated with many work-related factors to which primary health care workers (PHCWs) are exposed. The current research aims to measure the rates of depression, anxiety, and stress among PHCWs, and their associated causes in primary health care (PHC) settings. METHODS An explanatory sequential mixed methods design was employed in this research from January 2021 to January 2022 in Tabriz, Iran's PHC centers. First, this study followed an online-based cross-sectional survey using a self-reported questionnaire. The Depression, Anxiety and Stress Scale-21 Items (DASS-21) and questions on demographic and work-related characteristics were completed by 303 frontline PHCWs during the quantitative phase. In the qualitative phase, a semi-structured interview was held with 12 PHCWs who had the highest level of depression, anxiety, and stress to identify the reasons and sources of mental health prevalence. Quantitative data were analyzed using descriptive statistics via SPSS-26. A content analysis was performed to analyze qualitative data. RESULTS The results showed that self-reported stress, anxiety, and depression had a prevalence of 40.3%, 42.9%, and 42.6%, respectively. Symptoms of at least one mental disorder were experienced by 54% of respondents, while 28% had all three. Major sources of stress, anxiety, and depression among PHCWs were working environment conditions, organizational policies, job-related reasons, and interpersonal relations. CONCLUSIONS The results of current study indicated that PHCWs experienced high levels of depression, anxiety, and stress. The main factors and reasons that contributed to these mental health issues among PHCWs were work environment conditions, organizational policies, job-related reasons and interpersonal relations. Therefore, interventions should be implemented to promote mental health of PHCWs. This can include measures such as psychological screening, supportive care, workload management, flexible scheduling, and access to mental health resources. Additionally, training programs can be implemented to enhance resilience and coping skills among healthcare professionals.
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Affiliation(s)
- Edris Kakemam
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Katayoun Maassoumi
- Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Azimi
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Madineh Abbasi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Fateme Tahmasbi
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahasti Alizadeh
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
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9
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Dewhurst E, Ettman CK, Hare Bork R, Thornburg B, Abdalla SM, Galea S, Castrucci BC. Symptoms of Posttraumatic Stress During the COVID-19 Pandemic in the Governmental Public Health Workforce and General Population. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:E14-E20. [PMID: 37882760 PMCID: PMC10664775 DOI: 10.1097/phh.0000000000001837] [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] [Indexed: 10/27/2023]
Abstract
We aimed to estimate the prevalence of COVID-19-related posttraumatic stress symptoms (PTSS) in the governmental public health workforce and in US adults, assess differences in reporting PTSS within subgroups, and evaluate whether frontline workers reported higher levels of PTSS than persons in other jobs. We used data from 2 nationally representative studies: the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) and the COVID-19 and Life Stressors Impact on Mental Health and Well-being (CLIMB) study. Our study found that the state and local governmental public health workforce was more likely to report PTSS than the general adult population. Almost a quarter of public health agency employees (24.7%) and 21.1% of adults reported at least 3 symptoms of posttraumatic stress. Differences in levels of PTSS appeared within demographic groups for both samples. Personal care and service frontline workers had 4.3 times the odds of reporting symptoms of posttraumatic stress than non-frontline workers.
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Affiliation(s)
- Emma Dewhurst
- de Beaumont Foundation, Bethesda, Maryland (Ms Dewhurst and Drs Hare Bork and Castrucci); Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Ettman and Mr Thornburg); and Department of Global Health (Dr Abdalla) and Office of the Dean (Dr Galea), Boston University School of Public Health, Boston, Massachusetts
| | - Catherine K. Ettman
- de Beaumont Foundation, Bethesda, Maryland (Ms Dewhurst and Drs Hare Bork and Castrucci); Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Ettman and Mr Thornburg); and Department of Global Health (Dr Abdalla) and Office of the Dean (Dr Galea), Boston University School of Public Health, Boston, Massachusetts
| | - Rachel Hare Bork
- de Beaumont Foundation, Bethesda, Maryland (Ms Dewhurst and Drs Hare Bork and Castrucci); Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Ettman and Mr Thornburg); and Department of Global Health (Dr Abdalla) and Office of the Dean (Dr Galea), Boston University School of Public Health, Boston, Massachusetts
| | - Benjamin Thornburg
- de Beaumont Foundation, Bethesda, Maryland (Ms Dewhurst and Drs Hare Bork and Castrucci); Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Ettman and Mr Thornburg); and Department of Global Health (Dr Abdalla) and Office of the Dean (Dr Galea), Boston University School of Public Health, Boston, Massachusetts
| | - Salma M. Abdalla
- de Beaumont Foundation, Bethesda, Maryland (Ms Dewhurst and Drs Hare Bork and Castrucci); Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Ettman and Mr Thornburg); and Department of Global Health (Dr Abdalla) and Office of the Dean (Dr Galea), Boston University School of Public Health, Boston, Massachusetts
| | - Sandro Galea
- de Beaumont Foundation, Bethesda, Maryland (Ms Dewhurst and Drs Hare Bork and Castrucci); Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Ettman and Mr Thornburg); and Department of Global Health (Dr Abdalla) and Office of the Dean (Dr Galea), Boston University School of Public Health, Boston, Massachusetts
| | - Brian C. Castrucci
- de Beaumont Foundation, Bethesda, Maryland (Ms Dewhurst and Drs Hare Bork and Castrucci); Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Ettman and Mr Thornburg); and Department of Global Health (Dr Abdalla) and Office of the Dean (Dr Galea), Boston University School of Public Health, Boston, Massachusetts
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10
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Månsson Sandberg H, Landstad BJ, Tjulin Å, Brulin E. COVID-19- related work, managerial factors and exhaustion among general practitioners in Sweden: a cross-sectional study. BMC PRIMARY CARE 2023; 24:269. [PMID: 38087223 PMCID: PMC10717449 DOI: 10.1186/s12875-023-02228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION A significant number of international studies show that general practitioners (GPs) suffered from burnout when working during the COVID-19 pandemic. A Swedish study found that more than 16% of GPs had exhaustion in spring 2021. Exhaustion can be regarded as an initial stage of burnout. A knowledge gap remains on GPs´ working conditions, the impact of management during the pandemic and how it was associated with exhaustion. This study aims to explore the association between severe symptoms of exhaustion and COVID-19 pandemic-related work and managerial factors among Swedish GPs and whether managerial factors have an impact on the association between exhaustion and COVID-19-related work factors. METHODS Cross-sectional data was drawn from the Longitudinal Occupational Health survey in Health Care Sweden (LOHHCS), which included a representative sample of practicing doctors in Sweden. The sample consisted of 6699 doctors with a response rate of 41.2%. This study constitutes a sample of doctors who reported working in primary care facilities at the time of data collection, i.e. 1013 GPs. The Burnout Assessment Tool (BAT) was used to assess severe symptoms of exhaustion. Questions were also asked about pandemic-related work and managerial factors. The data was analysed using descriptive statistics and multivariate logistic regression to identify the association between exhaustion, work and managerial factors. RESULTS The multivariate analysis showed that GPs who managed COVID-19 patients were about twice as likely to report severe symptoms of exhaustion. Further, GPs who reported that management was unsupportive, provided unsatisfactory working conditions and unsatisfactory policies for patient prioritisation were between two and four times more likely to report severe symptoms of exhaustion. CONCLUSIONS COVID-19-related work and managerial factors had a significant impact on the mental health of GPs. Furthermore, the potentially protective effect that satisfactory management actions had on mental health was limited. In the aftermath of the COVID-19 pandemic and in preparation for future major crises that have a high impact on healthcare, there is a need to investigate the measures that can be taken to enable GPs to carry out their work, while maintaining their wellbeing.
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Affiliation(s)
- Helena Månsson Sandberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Bodil J Landstad
- Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
| | - Åsa Tjulin
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Emma Brulin
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden
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11
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Costello Z, Roberson-Miranda K, Ho S, DePierro JM, Starkweather S, Katz CL, Sharma V, Marin DB. A Resilience Program for Hospital Security Officers During the COVID-19 Pandemic Using a Community Engagement Model. J Community Health 2023; 48:963-969. [PMID: 37728723 PMCID: PMC10623110 DOI: 10.1007/s10900-023-01282-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/21/2023]
Abstract
Security officers in health systems are subject to high levels of stress and current support interventions do not necessarily target their needs. To address this gap, a resilience center at a major urban tertiary care hospital utilized community engagement principles to adapt and implement resilience and mental health awareness workshops, which were informed by initial piloting. The program consisted of twelve short briefings in which officers were provided psychoeducation on psychological first aid and adaptive coping. The program reached 107 security officers (89.5% men, 95.2% people of color); both qualitative and quantitative feedback indicated a generally positive reception. Further efforts to support security officers are warranted given their high exposure to patient crises and under-acknowledgement as frontline workers in healthcare.
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Affiliation(s)
- Zorina Costello
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katheryn Roberson-Miranda
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Psychological and Educational Services, Fordham University, New York, NY, USA.
| | - Scarlett Ho
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan M DePierro
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sydney Starkweather
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Craig L Katz
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Health System Design & Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vanshdeep Sharma
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah B Marin
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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12
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Sinsky CA, Trockel M, Carlasare LE, West CP, Wang H, Tutty M, Dyrbye LN, Shanafelt TD. Politicization of Medical Care, Burnout, and Professionally Conflicting Emotions Among Physicians During COVID-19. Mayo Clin Proc 2023; 98:1613-1628. [PMID: 37923520 DOI: 10.1016/j.mayocp.2023.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To evaluate the association of politicization of medical care with burnout, professional fulfillment, and professionally conflicting emotions (eg, less empathy, compassion; more anger, frustration, resentment). PARTICIPANTS AND METHODS Physicians in select specialties were surveyed between December 2021 and January 2022 using methods similar to our prior studies, with additional assessment of politicization of medical care; moral distress; and having had to compromise professional integrity, workload, and professionally conflicting emotions. RESULTS In a sample of 2780 physicians in emergency medicine, critical care, noncritical care hospital medicine, and ambulatory care, stress related to politicization of medical care was reported by 91.8% of physicians. On multivariable analysis, compromised integrity (odds ratio [OR], 3.64; 95% CI, 2.31 to 5.98), moral distress (OR, 2.82; 95% CI, 2.16 to 3.68), and feeling more exhausted taking care of patients with coronavirus disease 2019 (COVID-19) (OR, 3.46; 95% CI, 2.63 to 4.54) were associated with burnout. Compromised integrity, moral distress, and feeling more exhausted taking care of patients with COVID-19 were also statistically significantly associated with lower odds of professional fulfillment and professionally conflicting emotions. Stress related to conversations about non-approved COVID-19 therapies (OR, 1.74; 95% CI, 1.08 to 2.89), patient resistance to mask wearing (OR, 1.84; 95% CI, 1.35 to 2.55), and working more hours due to COVID (OR, 0.66; 95% CI, 0.49 to 0.89) were associated with professionally conflicting emotions. CONCLUSION Most physicians experienced intrusion of politics into medical care during the pandemic. These experiences are associated with professionally conflicting emotions, including less compassion and empathy, greater frustration, and resentment. COVID-19-related moral distress and compromised integrity were also associated with less professional fulfillment and greater occupational burnout.
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Affiliation(s)
| | | | | | | | - Hanhan Wang
- American Medical Association, Chicago, IL, USA
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13
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Boitet LM, Meese KA, Colón-López A, Sweeney KL, Rogers DA. Feeling safe versus being safe: Perceptions of safety versus actual disease exposure across the entire health care team. J Healthc Risk Manag 2023; 43:10-18. [PMID: 37208959 DOI: 10.1002/jhrm.21542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/14/2023] [Indexed: 05/21/2023]
Abstract
As supply chains experienced disruptions early in the COVID-19 pandemic, personal protective equipment (PPE) quickly became scarce. The purpose of this study was to examine the impact of perceptions of inadequate PPE, fear of COVID-19 infection, and self-reported direct COVID-19 exposure on health care workers. Data to assess distress, resilience, social-ecological factors, and work and nonwork-related stressors were collected from June to July 2020 at a large medical center. Stressors were analyzed by role using descriptive statistics and multivariate regression analysis. Our data indicate that job role influenced fear of infection and perceptions of inadequate PPE in the early phase of the COVID-19 pandemic. Perceived organizational support was also related to perceptions of inadequate PPE supply. Interestingly, work location, rather than job role, was predictive of direct COVID-19 exposure. Our data highlight a disconnect between the perception of safety in the health care setting with real risk of exposure to infectious disease. This study suggests that leaders in health care should focus on cultivating supportive organizational cultures, assessing both perceived and actual safety, and provide adequate training in safety practices may improve preparedness and organizational trust during times of both certainty and crisis particularly for clinical workers with less education and training.
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Affiliation(s)
- Laurence M Boitet
- Department of Health Services Administration, UAB Medicine Office of Wellness, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Department of Health Services Administration and Director of Wellness Research, University of Alabama at Birmingham (UAB), UAB Medicine Office of Wellness, UAB, Birmingham, Alabama, USA
| | - Katherine A Meese
- Department of Health Services Administration, UAB Medicine Office of Wellness, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Department of Health Services Administration and Director of Wellness Research, University of Alabama at Birmingham (UAB), UAB Medicine Office of Wellness, UAB, Birmingham, Alabama, USA
| | - Alejandra Colón-López
- Department of Medical Education, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Katherine L Sweeney
- Department of Health Services Administration and Director of Wellness Research, University of Alabama at Birmingham (UAB), UAB Medicine Office of Wellness, UAB, Birmingham, Alabama, USA
- Department of Sociology, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - David A Rogers
- Department of Health Services Administration and Director of Wellness Research, University of Alabama at Birmingham (UAB), UAB Medicine Office of Wellness, UAB, Birmingham, Alabama, USA
- Department of Surgery and Chief Wellness Officer, UAB Medicine Office of Wellness, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
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14
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Burrowes SAB, Casey SM, Pierre-Joseph N, Talbot SG, Hall T, Christian-Brathwaite N, Del-Carmen M, Garofalo C, Lundberg B, Mehta PK, Mottl-Santiago J, Schechter-Perkins EM, Weber A, Yarrington CD, Perkins RB. COVID-19 pandemic impacts on mental health, burnout, and longevity in the workplace among healthcare workers: A mixed methods study. JOURNAL OF INTERPROFESSIONAL EDUCATION & PRACTICE 2023; 32:100661. [PMID: 37305404 PMCID: PMC10248469 DOI: 10.1016/j.xjep.2023.100661] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/07/2023] [Indexed: 06/13/2023]
Abstract
To explore the mental health impacts of the COVID-19 pandemic on healthcare workers in Massachusetts and identify potential strategies to maintain the healthcare workforce we conducted a sequential exploratory mixed methods study. Fifty-two individuals completed interviews from April 22nd - September 7th, 2021; 209 individuals completed an online survey from February 17th - March 23rd, 2022. Interviews and surveys asked about the mental health impacts of working in healthcare during the COVID-19 pandemic, burnout, longevity in the workplace, and strategies for reducing attrition. Interview and survey participants were predominantly White (56%; 73%, respectively), female (79%; 81%) and worked as physicians (37%; 34%). Interviewees indicated high stress and anxiety levels due to frequent exposure to patient deaths from COVID-19. Among survey respondents, 55% reported worse mental health than before the pandemic, 29% reported a new/worsening mental health condition for themselves or their family, 59% reported feeling burned out at least weekly, and 37% intended to leave healthcare in less than 5 years. To decrease attrition, respondents suggested higher salaries (91%), flexible schedules (90%), and increased support to care for patients (89%). Healthcare workers' experiences with death, feeling unvalued, and overworked resulted in unprecedented rates of burnout and intention to leave healthcare.
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Affiliation(s)
- Shana A B Burrowes
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Sharon M Casey
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Natalie Pierre-Joseph
- Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Simon G Talbot
- Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Taylor Hall
- Graduate Medical Sciences, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | | | - Marcela Del-Carmen
- Division of Gynecologic Oncology, Vincent Department of Obstetrics & Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher Garofalo
- Department of Family Medicine and Department of Obstetrics and Gynecology at Sturdy Memorial Hospital, Attleboro, MA, USA
- Family Medicine Associates of South Attleboro, South Attleboro, Massachusetts, USA
| | | | - Pooja K Mehta
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
- Cityblock Health, Brooklyn, NY, USA
| | - Julie Mottl-Santiago
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Elissa M Schechter-Perkins
- Department of Emergency Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Ariana Weber
- Department of Emergency Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Christina D Yarrington
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Rebecca B Perkins
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
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15
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Lee BEC, Ling M, Boyd L, Olsson CA, Sheen J. Key predictors of psychological distress and wellbeing in Australian frontline healthcare workers during COVID-19 (Omicron wave). Front Psychol 2023; 14:1200839. [PMID: 37484084 PMCID: PMC10361570 DOI: 10.3389/fpsyg.2023.1200839] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The COVID-19 pandemic has led to significant challenges for frontline healthcare workers' (FHW), raising many mental health and wellbeing concerns for this cohort. To facilitate identification of risk and protective factors to inform treatment and interventions, this study investigated key predictors of psychological distress and subjective wellbeing in FHWs. Methods During the Omicron wave of the COVID-19 pandemic (January 2022), Victorian (Australia) doctors, nurses, allied health and non-medical staff from Emergency Departments, Intensive Care units, Aged Care, Hospital In The Home, and COVID Wards completed a cross-sectional survey consisting of the Kessler 6 item (Psychological Distress), Personal Wellbeing Index (Subjective Wellbeing), Coronavirus Health Impact Survey tool (COVID-19 related factors) and occupational factors. Multivariable linear regressions were used to evaluate unadjusted and adjusted associations. Relative weight analysis was used to compare and identify key predictors. Results Out of 167 participants, 18.1% screened positive for a probable mental illness and a further 15.3% screened positive for low wellbeing. Key risk factors for greater psychological distress included COVID infection worries, relationship stress and younger age. For both psychological distress and lower wellbeing, health status and supervisor support were key protective factors, while infection risks were key risk factors. Only positive changes in relationship quality was protective of lower wellbeing. Conclusion This study highlights the significance of social determinants and individual level factors alongside work related factors, in influencing FHWs' mental health and wellbeing during public health crises, such as the COVID-19 pandemic. Findings suggest that future interventions and supports should take a more holistic approach that considers work, social and individual level factors when supporting FHWs' mental health and wellbeing.
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Affiliation(s)
- Brian En Chyi Lee
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Mathew Ling
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Neami National, Preston, VIC, Australia
| | | | - Craig A. Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Jade Sheen
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
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16
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Doukas A, DePierro J, Starkweather S, Sharma V, Marin DB, Charney DS. Symptom characteristics of health care workers seeking outpatient psychiatric care during the COVID-19 pandemic. Am J Ind Med 2023; 66:500-509. [PMID: 36960643 PMCID: PMC10636598 DOI: 10.1002/ajim.23478] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/08/2023] [Accepted: 03/22/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Though there is a growing body of research establishing a broad negative psychological impact of COVID-19 among healthcare workers (HCWs), there are comparably fewer studies evaluating symptom presentation and clinical diagnoses among treatment-seeking HCWs. The present report seeks to fill this gap in the literature by establishing the prevalence of anxiety, depression, post-traumatic stress, alcohol misuse, and well-being among treatment-seeking HCWs. METHOD Data were collected from 421 treatment-seeking HCWs in an outpatient hospital-based mental health setting. Both self-report measures and semi-structured interviews were utilized to assess symptom severity and render psychiatric diagnosis at intake. RESULTS Adjustment disorders were the most prevalent diagnosis at 44.2%. Of the 347 who completed self-report measures, over 47% endorsed moderate-to-severe depressive symptoms, with 13% endorsing suicidal ideation (SI). Fifty-eight percent scored in the moderate-to-severe range for anxiety, and 19% screened positive for COVID-related post-traumatic stress disorder. Further analyses revealed that those in medical support roles endorsed significantly greater depression symptoms relative to other groups and also reported SI at greater frequency. Medical trainees also endorsed SI at higher frequencies. CONCLUSIONS These findings are consistent with previous research on the adverse impact of COVID-19 stressors on HCWs' mental health. We further identified vulnerable groups that are underrepresented in the literature. These findings highlight the need for targeted outreach and intervention among overlooked HCWs populations.
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Affiliation(s)
- Ashley Doukas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jonathan DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sydney Starkweather
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vanshdeep Sharma
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Deborah B. Marin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dennis S. Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Pharmacology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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17
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Caldichoury N, García-Roncallo P, Saldías C, Zurita B, Castellanos C, Herrera-Pino J, Soto-Añari M, Porto MF, Quispe-Rodríguez I, Florez Y, Castillo-Tamara E, Díaz MC, Coronado-López J, Gaitan-Quintero G, Pabón-Moreno A, Ocampo-Barba N, Martínez-Pérez J, Gargiulo PA, Quispe-Ayala C, Camposano-Córdova A, Escorcia-Villarreal J, Ripoll-Cordoba D, Camargo L, López N. [Psychological Impact of COVID-19 on Health Workers During the Second Year of the Pandemic in Latin America: Cross-Sectional Survey Study]. REVISTA COLOMBIANA DE PSIQUIATRIA 2023:S0034-7450(23)00035-5. [PMID: 37360790 PMCID: PMC10103623 DOI: 10.1016/j.rcp.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/04/2023] [Indexed: 06/28/2023]
Abstract
Introduction The coronavirus pandemic continues to affect the mental health of healthcare personnel in Latin America (LA). Objective To estimate the prevalence of psychological disturbances and associated risk factors for mental health in healthcare personnel in LA during the second year of the COVID-19 pandemic. Method This multicenter cross-sectional study included a total sample of 5437 healthcare professionals from Argentina, Bolivia, Chile, Colombia, Ecuador, and Peru. The PHQ-9, GAD-7, and a brief demographic questionnaire were used. The prevalence of anxiety and depression was estimated based on the cut-off points of the instruments. Two multivariate logistic regressions were performed. Results A population burden of anxiety (40.1%) and depression (62.2%) was found in healthcare personnel in LA. Among professionals in Argentina (OR = 1.374; P<.001), those working in state hospitals (OR = 1.536; P<.003), frontline healthcare workers for COVID patients (OR = 1.848; P<.001), general practitioners (OR = 1.335; P<.001), and specialists (OR = 1.298; P<.001), a higher risk of experiencing mental disorders was observed. Among women, younger personnel, and administrative staff, a higher probability of experiencing anxiety and depression was identified. Conclusions The burden of mental disorders on healthcare personnel in Latin America is alarming. Psychological support services are necessary, aimed at providing measures for professionals to develop healthy coping mechanisms that mitigate the impact of the pandemic on their well-being and facilitate post-crisis adjustment.
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Affiliation(s)
| | | | | | - Boris Zurita
- Departamento de Neurocirugía, Hospital de Omni, Guayaquil, Ecuador
| | - Cesar Castellanos
- Instituto Dominicano para el Estudio de la Salud Integral y la Psicología Aplicada (IDESIP), Santo Domingo, República Dominicana
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18
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El-Mohandes A, Wyka K, White TM, El-Sadr WM, Rauh L, Vasan A, Greene D, Rabin K, Ratzan SC, Chaudhri S, Kimball S, Lazarus JV. Comparison of Current Attitudes Toward COVID-19 Vaccination in New York City and the US Nationally. JOURNAL OF HEALTH COMMUNICATION 2023; 28:34-44. [PMID: 37390011 DOI: 10.1080/10810730.2023.2208071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
COVID-19 vaccination has resulted in decreased hospitalization and mortality, particularly among those who have received a booster. As new effective pharmaceutical treatments are now available and requirements for non-pharmaceutical interventions (e.g. masking) are relaxed, perceptions of the risk and health consequences of SARS-CoV-2 infection have decreased, risking potential resurgence. This June 2022 cross-sectional comparative study of representative samples in New York City (NYC, n = 2500) and the United States (US, n = 1000) aimed to assess differences in reported vaccine acceptance as well as attitudes toward vaccination mandates and new COVID-19 information and treatments. NYC respondents reported higher COVID-19 vaccine acceptance and support for vaccine mandate than U.S. respondents, yet lower acceptance for the booster dose. Nearly one-third of both NYC and U.S. respondents reported paying less attention to COVID-19 vaccine information than a year earlier, suggesting health communicators may need innovation and creativity to reach those with waning attention to COVID-19-related information.
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Affiliation(s)
- Ayman El-Mohandes
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Katarzyna Wyka
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Trenton M White
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | - Lauren Rauh
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Ashwin Vasan
- Office of the Commissioner of Health, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Danielle Greene
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Kenneth Rabin
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Scott C Ratzan
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Simran Chaudhri
- Office of the Commissioner of Health, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Spencer Kimball
- Emerson Polling, Emerson College, Boston, Massachusetts, USA
| | - Jeffrey V Lazarus
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
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19
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Starkweather S, DePierro JM, Akhtar S, de Guillebon E, Kaplan C, Kaplan S, Ripp J, Peccoralo L, Feingold J, Feder A, Murrough JW, Pietrzak RH. Predictors of Mental Health Service Utilization among Frontline Healthcare Workers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5326. [PMID: 37047942 PMCID: PMC10094311 DOI: 10.3390/ijerph20075326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
(1) Background: This study examined the prevalence and correlates of factors associated with self-reported mental health service use in a longitudinal cohort of frontline health care workers (FHCWs) providing care to patients with COVID-19 throughout 2020. (2) Methods: The study comprised a two-wave survey (n = 780) administered in April-May 2020 (T1) and November 2020-January 2021 (T2) to faculty, staff, and trainees in a large urban medical center. Factors associated with initiation, cessation, or continuation of mental health care over time were examined. (3) Results: A total of 19.1% of FHCWs endorsed currently utilizing mental health services, with 11.4% continuing, 4.2% initiating, and 3.5% ceasing services between T1 and T2. Predisposing and need-related factors, most notably a history of a mental health diagnosis and distress related to systemic racism, predicted service initiation and continuation. Among FHCWs with a prior mental health history, those with greater perceived resilience were less likely to initiate treatment at T2. Descriptive data highlighted the importance of services around basic and safety needs (e.g., reliable access to personal protective equipment) relative to mental health support in the acute phase of the pandemic. (4) Conclusions: Results may be helpful in identifying FHCWs who may benefit from mental health services.
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Affiliation(s)
- Sydney Starkweather
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Jonathan M. DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Saadia Akhtar
- Departments of Emergency Medicine and Graduate Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Eleanore de Guillebon
- Office of Well-Being and Resilience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Carly Kaplan
- Departments of Emergency Medicine and Graduate Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Sabrina Kaplan
- Office of Well-Being and Resilience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Jonathan Ripp
- Office of Well-Being and Resilience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Lauren Peccoralo
- Office of Well-Being and Resilience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Jordyn Feingold
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - James W. Murrough
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Robert H. Pietrzak
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
- U.S. Department of Veterans Affairs National Center for PTSD, West Haven, CT 06516, USA
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA
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20
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Hruska B, Patterson PD, Doshi AA, Guyette MK, Wong AH, Chang BP, Suffoletto BP, Pacella-LaBarbara ML. Examining the prevalence and health impairment associated with subthreshold PTSD symptoms (PTSS) among frontline healthcare workers during the COVID-19 pandemic. J Psychiatr Res 2023; 158:202-208. [PMID: 36592534 PMCID: PMC9796598 DOI: 10.1016/j.jpsychires.2022.12.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/15/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
Abstract
The COVID-19 pandemic has increased healthcare workers' (HCWs) risk for posttraumatic stress disorder (PTSD). Although subthreshold PTSD symptoms (PTSS) are common and increase vulnerability for health impairments, they have received little attention. We examined the prevalence of subthreshold PTSS and their relationship to physical health symptoms and sleep problems among HCWs during the pandemic's second wave (01/21-02/21). Participants (N = 852; 63.1% male; Mage = 38.34) completed the Short-Form PTSD Checklist (SF-PCL), the Cohen-Hoberman Inventory of Physical Symptoms, and the PROMIS Sleep-Related Impairment-Short-Form 4a. We created three groups with the SF-PCL: scores ≥11 = probable PTSD (5.5%); scores between 1 and 10 = subthreshold PTSS (55.3%); scores of 0 = no PTSS (39.2%). After controlling for demographics, occupational characteristics, and COVID-19 status, HCWs with subthreshold PTSS experienced greater physical health symptoms and sleep problems than HCWs with no PTSS. While HCWs with PTSD reported the greatest health impairment, HCWs with subthreshold PTSS reported 88% more physical health symptoms and 36% more sleep problems than HCWs with no PTSS. Subthreshold PTSS are common and increase risk for health impairment. Interventions addressing HCWs' mental health in response to the COVID-19 pandemic must include subthreshold PTSS to ensure their effectiveness.
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Affiliation(s)
- Bryce Hruska
- Department of Public Health, Syracuse University, Syracuse, NY, USA
| | - P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ankur A Doshi
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Ambrose H Wong
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Medical Center, New York, NY, USA
| | - Brian P Suffoletto
- Department of Emergency Medicine, Stanford University, Palo Alto, CA, USA
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21
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Sanky C. Safe and Sound: An Improvisational Theater-Based Curriculum and Behavioral Intervention to Address Violence in the Emergency Department. J Emerg Med 2023; 64:236-245. [PMID: 36806429 DOI: 10.1016/j.jemermed.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/29/2022] [Accepted: 11/06/2022] [Indexed: 02/20/2023]
Abstract
BACKGROUND Emergency department (ED) workplace violence has become increasingly prevalent in the United States, warranting the development of legislation, policy, and advocacy to protect health care workers. Solutions to address ED violence remain limited, and staff-oriented trainings often exist as short, one-time didactic sessions, which are not practical nor often applicable to the ED setting. There is a paucity of evidence-based interventions that incorporate behavioral-based training to adequately prepare staff for the complicated, multifactorial presentation of violence in the ED. OBJECTIVE This pilot study sought to assess the feasibility of an improvisational theater-based, simulation intervention for health care professionals to address ED violence. METHODS A longitudinal curriculum for ED violence was developed in collaboration with a committee of emergency medicine (EM) faculty, EM simulation experts, hospital security and police personnel, professional theater and improvisational performers, resident physicians, and medical students. This pilot intervention was tailored to new EM residents (n = 25) at a large, urban, academic medical center. Sessions were led by facilitators trained in group facilitation, simulation, and improvisation. RESULTS Participants felt the curriculum was helpful (82.6%), engaging (91.3%), applicable (73.9%), and enjoyable (82.6%). Participation primarily by residents identifying as female and people of color suggested the efficacy of creative expression and nontraditional modalities in engaging diverse learners. Ninety-five percent of participants expressed interest in future sessions. CONCLUSIONS A multidisciplinary workplace violence intervention leveraging principles of improvisational theater, health equity, organizational psychology, and EM simulation may prove useful in preparing health care professionals for violence in the ED.
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Affiliation(s)
- Charles Sanky
- Departments of Emergency Medicine and Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York
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22
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Harris ML, McLeod A, Titler MG. Health Experiences of Nurses during the COVID-19 Pandemic: A Mixed Methods Study. West J Nurs Res 2023; 45:443-454. [PMID: 36625341 PMCID: PMC9834626 DOI: 10.1177/01939459221148825] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This study characterizes the impact of the COVID-19 pandemic on the mental and physical health of nurses. Qualitative data (collected using semi-structured interviews) were integrated with quantitative data (collected concurrently using the SF-12 Health Survey). Nurses (N = 30) compared their health prior to and during the first pandemic wave (March-May 2020). Interviews were analyzed thematically; descriptive statistics and t-tests compared pre-pandemic to current SF-12 scores. Qualitative findings demonstrated an impact on nurses' mental health expressed as isolation, loss, intense emotions, and feelings of being expendable. Impact on nurses' physical health included exhaustion, personal protective equipment skin breakdown, limited breaks from work, and virus exposure. Quantitative results show nurses' experienced declines in overall mental health (p < .001), and multiple physical health domains: role limitations due to physical problems (p < .0001), bodily pain (p < .0001), and general health (p < .0001). Promotion of nurses' well-being and safety, as well as education in emergency preparedness, must be given precedence to protect nurses' health.
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Affiliation(s)
- Melissa L. Harris
- Center of Innovation to Accelerate
Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham,
NC, USA,Clinical and Translational Science
Institute, Duke University, Durham, NC, USA,University of Michigan School of
Nursing, Ann Arbor, MI, USA,Melissa L. Harris, Clinical and
Translational Science Institute, Duke University, 710 W. Main St. Durham NC
27701, USA.
| | - Anne McLeod
- University of Michigan School of
Nursing, Ann Arbor, MI, USA,University of Michigan, Michigan
Medicine, Transplant Center, Ann Arbor, MI, USA
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23
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Skogsberg M, Jarl G, Matérne M. Health care workers' need for support from managers during the initial phase of the COVID-19 pandemic. BMC Health Serv Res 2022; 22:1563. [PMID: 36544137 PMCID: PMC9768758 DOI: 10.1186/s12913-022-08937-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic placed great pressure on health care workers and increased the risk of these workers developing mental illness. Effective leadership is essential to prevent mental illness from developing. The study aim was to investigate health care workers' perceptions of the support given by their managers, their need for such support, and their levels of anxiety during the initial phase of the COVID-19 pandemic. METHODS An electronic study-specific questionnaire was sent to health care workers. A convergent mixed-methods design was used, in which data were analyzed with descriptive statistics, t-tests, and qualitative content analysis. RESULTS The majority of the 1074 participants experienced support from a manager who was physically present, caring, and sensitive to their needs, who provided information, and listened to their opinions. Those who did not receive this support experienced more anxiety, and the majority of them expressed a need for this support. A minority of the participants had a manager who scheduled reflection time; few asked for this support, and it was not found to be associated with lower anxiety levels. The qualitative analysis resulted in four themes: 1) A physically present and responsive manager who provides support based on the workers' needs, 2) The workers understand their manager's tough work situation and lack of resources, 3) There is a need for clear dissemination of information and participation in organizing the work, and 4) The care of patients is carried out with good cooperation. CONCLUSIONS The majority of the health care workers received adequate support from their managers. A manager has to be physically present, caring, and supportive to meet the workers' needs and potentially reduce anxiety levels.
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Affiliation(s)
| | - Gustav Jarl
- grid.15895.300000 0001 0738 8966University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden ,grid.15895.300000 0001 0738 8966Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Marie Matérne
- grid.15895.300000 0001 0738 8966University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden ,grid.15895.300000 0001 0738 8966School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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24
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Baxter SL, Saseendrakumar BR, Cheung M, Savides TJ, Longhurst CA, Sinsky CA, Millen M, Tai-Seale M. Association of Electronic Health Record Inbasket Message Characteristics With Physician Burnout. JAMA Netw Open 2022; 5:e2244363. [PMID: 36449288 PMCID: PMC9713605 DOI: 10.1001/jamanetworkopen.2022.44363] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
IMPORTANCE Physician burnout is an ongoing epidemic; electronic health record (EHR) use has been associated with burnout, and the burden of EHR inbasket messages has grown in the context of the COVID-19 pandemic. Understanding how EHR inbasket messages are associated with physician burnout may uncover new insights for intervention strategies. OBJECTIVE To evaluate associations between EHR inbasket message characteristics and physician burnout. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study in a single academic medical center involving physicians from multiple specialties. Data collection took place April to September 2020, and data were analyzed September to December 2020. EXPOSURES Physicians responded to a survey including the validated Mini-Z 5-point burnout scale. MAIN OUTCOMES AND MEASURES Physician burnout according to the self-reported burnout scale. A sentiment analysis model was used to calculate sentiment scores for EHR inbasket messages extracted for participating physicians. Multivariable modeling was used to model risk of physician burnout using factors such as message characteristics, physician demographics, and clinical practice characteristics. RESULTS Of 609 physicians who responded to the survey, 297 (48.8%) were women, 343 (56.3%) were White, 391 (64.2%) practiced in outpatient settings, and 428 (70.28%) had been in medical practice for 15 years or less. Half (307 [50.4%]) reported burnout (score of 3 or higher). A total of 1 453 245 inbasket messages were extracted, of which 630 828 (43.4%) were patient messages. Among negative messages, common words included medical conditions, expletives and/or profanity, and words related to violence. There were no significant associations between message characteristics (including sentiment scores) and burnout. Odds of burnout were significantly higher among Hispanic/Latino physicians (odds ratio [OR], 3.44; 95% CI, 1.18-10.61; P = .03) and women (OR, 1.60; 95% CI, 1.13-2.27; P = .01), and significantly lower among physicians in clinical practice for more than 15 years (OR, 0.46; 95% CI, 0.30-0.68; P < .001). CONCLUSIONS AND RELEVANCE In this cross-sectional study, message characteristics were not associated with physician burnout, but the presence of expletives and violent words represents an opportunity for improving patient engagement, EHR portal design, or filters. Natural language processing represents a novel approach to understanding potential associations between EHR inbasket messages and physician burnout and may also help inform quality improvement initiatives aimed at improving patient experience.
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Affiliation(s)
- Sally L Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, La Jolla
- Department of Medicine, University of California, San Diego, La Jolla
| | - Bharanidharan Radha Saseendrakumar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, La Jolla
| | - Michael Cheung
- Department of Family Medicine, University of California, San Diego, La Jolla
| | - Thomas J Savides
- Department of Medicine, University of California, San Diego, La Jolla
| | - Christopher A Longhurst
- Department of Medicine, University of California, San Diego, La Jolla
- Department of Pediatrics, University of California, San Diego, La Jolla
| | | | - Marlene Millen
- Department of Medicine, University of California, San Diego, La Jolla
| | - Ming Tai-Seale
- Department of Medicine, University of California, San Diego, La Jolla
- Department of Family Medicine, University of California, San Diego, La Jolla
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25
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Chan CP, Li KK, Tang A, Wong SYS, Wei WI, Lee SS, Kwok KO. Effect of prior outbreak work experience to future outbreak responses for nurses in Hong Kong: A cross-sectional study. Collegian 2022; 29:612-620. [PMID: 35221754 PMCID: PMC8858083 DOI: 10.1016/j.colegn.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/24/2022] [Accepted: 02/05/2022] [Indexed: 11/25/2022]
Abstract
Background During the early phase of the Coronavirus Disease 2019 (COVID-19) epidemic, health care workers had elevated levels of psychological distress. Historical exposure to disease outbreak may shape different pandemic responses among experienced health care workers. Aim Considering the unique experience of the 2003 SARS outbreak in Hong Kong, this study examined the association between prior epidemic work experience and anxiety levels, and the mediating role of perceived severity of COVID-19 and SARS in nurses. Methods In March 2020, a cross-sectional survey targeting practising nurses in Hong Kong was conducted during the early phase of the COVID-19 epidemic. The interrelationships among participants' work experience during the SARS outbreak, perceived severity of SARS and COVID-19, and anxiety level were elucidated using structural equation model (SEM). Findings Of 1,061 eligible nurses, a majority were female (90%) with a median age of 39 years (IQR = 32-49). A significant and negative indirect association was identified between SARS experience and anxiety levels (B=-0.04, p=0.04) in the SEM with a satisfactory fitness (CFI=0.95; RMSEA=0.06). SARS-experienced nurses perceived SARS to be less severe (B=-0.17, p=0.01), translated an equivalent perception to COVID-19 (B=1.29, p<0.001) and resulted in a lower level of anxiety (B=0.19, p<0.001). Conclusions The less vigorous perception towards the severity of SARS and COVID-19 may explain SARS-experienced nurses' less initial epidemic-induced anxiety. The possible role of outbreak-experienced nurses in supporting outbreak-inexperienced nurses, both emotionally and technically, should be considered when an epidemic commences. Interventions aiming to facilitate the understanding of emerging virus should also be in place.
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Affiliation(s)
- Chin Pok Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kin Kit Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, China
| | - Arthur Tang
- Sungkyunkwan University College of Software, Seoul, South Korea
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shui Shan Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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26
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Sims H, Alvarez C, Grant K, Walczak J, Cooper LA, Ibe CA. Frontline healthcare workers experiences and challenges with in-person and remote work during the COVID-19 pandemic: A qualitative study. Front Public Health 2022; 10:983414. [PMID: 36203659 PMCID: PMC9531651 DOI: 10.3389/fpubh.2022.983414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/29/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction The COVID-19 pandemic created new and exacerbated existing stressors for frontline healthcare workers. Despite being disproportionately affected by COVID-19, little is known about the experiences of frontline healthcare workers serving marginalized populations in community settings. Design We used qualitative descriptive methods to understand the experiences of 12 frontline healthcare workers (HCWs) supporting primarily underserved populations in outpatient settings during COVID-19. Interviews were conducted from March to April 2021. Methods Interviews were held virtually via Zoom using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and uploaded into NVivo 12 qualitative data analysis software. The transcripts were dually coded by members of the research team and a thematic analysis was conducted. Results Four major themes from the interviews were identified: stressors and burnout, coping strategies, organizational support, and recommendations. HCWs described how the early adjustment period to the pandemic created new challenges as they attempted to navigate changes in the workplace and altered responsibilities at home. HCWs felt largely unsupported by their organizations as they attempted to cope with stressors. Organizational support programs and resources often did not meet frontline workers' needs, and sentiments of unappreciation from leadership contributed to feelings of burnout and frustration as pandemic-related challenges persisted and evolved. Conclusion Despite encountering numerous stressors at work and home, resulting from pandemic-related disruptions, frontline HCWs continued to provide care for their clients while navigating emerging challenges. Health organizations should include HCWs in decision-making processes when implementing support systems for workers during times of crisis.
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Affiliation(s)
- Holly Sims
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Carmen Alvarez
- University of Pennsylvania School of Nursing, Philadelphia, PA, United States
| | - Kimesha Grant
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Jessica Walczak
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Lisa A. Cooper
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Division of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Chidinma A. Ibe
- Division of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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27
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Karanikola M, Mpouzika M, Papathanassoglou E, Kaikoushi K, Hatzioannou A, Leontiou I, Livadiotis C, Christophorou N, Chatzittofis A. Work-Related Traumatic Stress Response in Nurses Employed in COVID-19 Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191711049. [PMID: 36078761 PMCID: PMC9518142 DOI: 10.3390/ijerph191711049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 05/27/2023]
Abstract
Nurses may be at a higher risk of experiencing work-related traumatic stress response during the COVID-19 pandemic compared to other clinicians. This study aimed to investigate the correlations between work-related trauma symptoms and demographic factors, psychosocial hazards and stress response in a census sample of nurses working in COVID-19 settings in Cyprus. In this nationwide descriptive and cross-sectional study, data were collected between April and May 2020 using a questionnaire that included sociodemographic, educational and employment and work-related variables, as well as a modified version of the Secondary Traumatic Stress Scale (STSS) for the assessment of work-related trauma symptoms during the pandemic. Overall, 233 nurses participated (with a response rate of 61.3%) and 25.7% of them reported clinical work-related trauma symptoms (STSS-M > 55; actual scale range: 17-85). The mean value for emotional exhaustion was 7.3 (SD: 2.29; visual scale range: 1-10), while the value for distress that was caused by being avoided due to work in COVID-19 units was 6.98 (SD: 2.69; visual scale range: 1-10). Positive associations were noted between trauma symptoms and both emotional exhaustion and distress from being avoided by others due to work in a COVID-19 setting and a negative association was also found between trauma symptoms and satisfaction from organizational support variables (all p < 0.002). Working in COVID-19 settings during the pandemic is a stressful experience that has been linked to psychologically traumatic symptoms Thus, supportive measures are proposed for healthcare personnel, even in countries with low COVID-19 burden.
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Affiliation(s)
- Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Meropi Mpouzika
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | | | | | - Anna Hatzioannou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Ioannis Leontiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Chris Livadiotis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | | | - Andreas Chatzittofis
- Medical School, University of Cyprus, Nicosia 1065, Cyprus
- Department of Clinical Sciences/Psychiatry, Umeå University, 901 85 Umeå, Sweden
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28
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Schiff M, Chow A, Noi GS. Riding the waves of the pandemic from West to East: The social workers' experience an International collaboration on study of social workers during COVID-19. SOCIAL WORK IN HEALTH CARE 2022; 61:185-198. [PMID: 35929856 DOI: 10.1080/00981389.2022.2108569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Miriam Schiff
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University, Israel
| | - Amy Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Goh Soon Noi
- Medical Social Services, Changi General Hospital, Singapore
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29
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Gómez-Durán EL, Fumadó CM, Gassó AM, Díaz S, Miranda-Mendizabal A, Forero CG, Virumbrales M. COVID-19 Pandemic Psychological Impact and Volunteering Experience Perceptions of Medical Students after 2 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127532. [PMID: 35742780 PMCID: PMC9223586 DOI: 10.3390/ijerph19127532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 02/07/2023]
Abstract
Undergraduate healthcare students were mobilized to support healthcare systems during the COVID-19 pandemic, but we have scarce information regarding their experience and its impact on their wellbeing. An anonymous online survey was conducted among undergraduate students and recently graduated physicians of a medical university in Spain, regarding their symptoms and volunteering experience during the initial months of the Spanish COVID-19 pandemic. Respondents showed a high prevalence of perceived stress, anxiety, and depressive symptoms, measured by the PHQ-9 and GAD-7. 14.5% reported healthcare-related volunteering tasks. Volunteering was a satisfactory experience for most of the respondents and the majority felt ready to do volunteering tasks (66.6%). Yet, 16.6% acknowledged not getting appropriate specific-task education before starting, 20.8% reported not having appropriate supervision, and 33.3% feel they did not have proper protective equipment. More than half of volunteers feared getting infected, more than 70% feared infecting their relatives or friends, and 54.2% reported stigmatization. Volunteers showed significantly higher stress, anxiety, and depression scores than the rest of the respondents, and 32% reported a highly traumatic event during volunteering, with high scores on the IES-R in the 16% of volunteers. Our results should help guide future potential volunteering processes in emergencies, enhance academic programs at medical schools and provide valuable data for psychological support services.
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Affiliation(s)
- Esperanza L. Gómez-Durán
- School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (E.L.G.-D.); (A.M.G.); (S.D.); (A.M.-M.); (C.G.F.); (M.V.)
- Integral Care Program for Sick Health Professionals, Galatea Clinic, Galatea Foundation, 08017 Barcelona, Spain
| | - Carles Martin Fumadó
- School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (E.L.G.-D.); (A.M.G.); (S.D.); (A.M.-M.); (C.G.F.); (M.V.)
- Professional Liability and Legal Medicine, Universitat Autònoma de Barcelona, 08017 Barcelona, Spain
- Correspondence:
| | - Aina M. Gassó
- School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (E.L.G.-D.); (A.M.G.); (S.D.); (A.M.-M.); (C.G.F.); (M.V.)
| | - Sandra Díaz
- School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (E.L.G.-D.); (A.M.G.); (S.D.); (A.M.-M.); (C.G.F.); (M.V.)
| | - Andrea Miranda-Mendizabal
- School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (E.L.G.-D.); (A.M.G.); (S.D.); (A.M.-M.); (C.G.F.); (M.V.)
| | - Carlos G. Forero
- School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (E.L.G.-D.); (A.M.G.); (S.D.); (A.M.-M.); (C.G.F.); (M.V.)
| | - Montserrat Virumbrales
- School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (E.L.G.-D.); (A.M.G.); (S.D.); (A.M.-M.); (C.G.F.); (M.V.)
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"It's All COVID's Fault!": Symptoms of Distress among Workers in an Italian General Hospital during the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127313. [PMID: 35742555 PMCID: PMC9223842 DOI: 10.3390/ijerph19127313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic, healthcare workers (HCWs) have been faced with specific stressors endangering their physical and mental health and their functioning. This study aimed to assess the short-term psychological health of a sample of Italian HCWs and the related influencing factors. In particular, the study focused on the differences related to HCWs' gender and to having been directly in charge of COVID-19 patients or not. METHODS An online survey was administered to the whole staff of the Modena General University Hospital three months after the onset of the pandemic, in 2020. Demographic data and changes in working and living conditions related to COVID-19 were collected; mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale-Revised (IES-R). RESULTS 1172 out of 4788 members returned the survey (response rate = 24.5%), the male/female ratio was 30/70%. Clinically significant symptoms assessed according to the DASS-21 emerged among 21.0% of the respondents for depression, 22.5% for anxiety and 27.0% for stress. Symptoms suggestive of a traumatic reaction were reported by 19.0% of the sample. Symptoms of psychological distress were statistically associated with female gender, job role, ward, changes in lifestyle, whereas first-line work with COVID-19 patients was statistically associated with more stress symptoms. HCWs reported a significant level of psychological distress that could reach severe clinical significance and impact dramatically their quality of life and functioning. CONCLUSIONS Considering the persistence of the international emergency, effective strategies to anticipate, recognize and address distress in HCWs are essential, also because they may impact the organization and effectiveness of healthcare systems.
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Luo C, Santos-Malave G, Taku K, Katz C, Yanagisawa R. Post-traumatic Growth and Resilience among American Medical Students during the COVID-19 Pandemic. Psychiatr Q 2022; 93:599-612. [PMID: 35211827 PMCID: PMC8870080 DOI: 10.1007/s11126-022-09981-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 01/20/2023]
Abstract
The ongoing COVID-19 pandemic has caused significant psychological impact on medical professionals, including medical students, many who have been caring for patients on the frontlines. Understanding how medical students perceive their stressful life experiences is important as the mental health of these future physicians directly impacts their ability to care for patients. We assessed for post-traumatic growth and resilience in the face of traumatic events among a cohort of medical students that attended a medical school located in an early epicenter of the COVID-19 pandemic. Between October 29, 2020 and December 1, 2020, medical students at the Icahn School of Medicine at Mount Sinai in New York City were surveyed on various stressful life events, including COVID-19. We identified specific resilience behaviors, including establishing a supportive social network, relying on a moral compass, and using cognitive flexibility, that medical students commonly used to cope with traumatic experiences. Compared with students who perceived COVID-19 as their most stressful life event, students who perceived other events, such as family issues or serious illness, as most stressful experienced less COVID-related stress (t = -2.2, p = .03), greater posttraumatic growth (t = 4.3, p < .001), and demonstrated more resilient behaviors including establishing and nurturing a supportive social network (t = 2.2, p = .03), developing brain fitness (t = 2.2, p = .03), and finding meaning and purpose in things (t = 2.9, p = .006). This suggests that stressful experiences prior to or in parallel with COVID-19 encouraged posttraumatic growth and development of resilience behaviors that were protective to COVID-19-related stress.
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Affiliation(s)
- Cynthia Luo
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
| | - Gabriel Santos-Malave
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Kanako Taku
- Department of Psychology, Oakland University, 318 Meadow Brook Rd, Rochester, MI, 48309, USA
| | - Craig Katz
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Robert Yanagisawa
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
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Saali A, Stanislawski ER, Kumar V, Chan C, Hurtado A, Pietrzak RH, Charney DS, Ripp J, Katz CL. The Psychiatric Burden on Medical Students in New York City Entering Clinical Clerkships During the COVID-19 Pandemic. Psychiatr Q 2022; 93:419-434. [PMID: 34618278 PMCID: PMC8495188 DOI: 10.1007/s11126-021-09955-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2021] [Indexed: 01/20/2023]
Abstract
For medical students first entering the clinical space in July 2020, the unique challenges related to the coronavirus pandemic threatened to amplify the psychological distress associated with clerkship rotations. This study aimed to characterize the mental health of third-year medical students starting clinical clerkships in the midst of a pandemic by assessing symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) as well as risk, coping, and protective factors associated with psychological outcomes. Of 147 third-year medical students at the Icahn School of Medicine at Mount Sinai in New York City, 110 (75%) participated in this prospective survey-based study with 108 included in the final analysis. 43 (39.8%) respondents screened positive for symptoms of either MDD, GAD, or PTSD. Multiple regression analyses revealed that greater overall symptom severity was associated with more avoidant coping, more traumatic events witnessed, poorer student and leisure functioning, lower trait emotional stability, and lower social support. Worries related to COVID-19 did not significantly influence outcome variables. To better understand the role of the pandemic on psychological outcomes in third-year medical students, additional research should focus on the trajectory of these outcomes over the year during the coronavirus pandemic.
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Affiliation(s)
- Alexandra Saali
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emma R Stanislawski
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Maine Medical Center, Portland, ME, USA.
| | - Vedika Kumar
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital, New York, NY, USA
| | - Chi Chan
- Mental Illness Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alicia Hurtado
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Dennis S Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Ripp
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Craig L Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Esteban-Sepúlveda S, Terradas-Robledo R, Castro-Ribeiro T, García-Pagès E, Sobregrau-Sangrà P, Lacueva-Pérez L. [COVID-19 pandemic on health professionals in a third level hospital in Spain: job changes during the first wave, mental health at 4 months, and follow-up at 9 months]. ENFERMERIA CLINICA 2022; 32:143-151. [PMID: 35125862 PMCID: PMC8808694 DOI: 10.1016/j.enfcli.2021.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/10/2021] [Indexed: 11/21/2022]
Abstract
Objective To determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health. Method 1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires. Results In the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n = 64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time. Conclusions The structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.
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Affiliation(s)
- Silvia Esteban-Sepúlveda
- Methodology, Quallity and Nursing Research Department, Consorci Parc de Salut MAR de Barcelona , Barcelona, España
- Research group in nursing care (GRECI), Hospital del Mar Institute of Medical Research (IMIM) , Barcelona, España
| | - Roser Terradas-Robledo
- Methodology, Quallity and Nursing Research Department, Consorci Parc de Salut MAR de Barcelona , Barcelona, España
| | - Thaís Castro-Ribeiro
- Department of Microelectronics and Electronic Systems, Escola d'Enginyeria, Campus de la UAB, Bellaterra, Barcelona, España
| | - Esther García-Pagès
- Department of Microelectronics and Electronic Systems, Escola d'Enginyeria, Campus de la UAB, Bellaterra, Barcelona, España
| | | | - Laia Lacueva-Pérez
- Methodology, Quallity and Nursing Research Department, Consorci Parc de Salut MAR de Barcelona , Barcelona, España
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Kotini-Shah P, Man B, Pobee R, Hirshfield LE, Risman BJ, Buhimschi IA, Weinreich HM. Work-Life Balance and Productivity Among Academic Faculty During the COVID-19 Pandemic: A Latent Class Analysis. J Womens Health (Larchmt) 2022; 31:321-330. [PMID: 34846927 PMCID: PMC8972018 DOI: 10.1089/jwh.2021.0277] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: For faculty in academic health sciences, the balance between research, education, and patient care has been impeded by the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify personal and professional characteristics of faculty to understand the impact of the pandemic on faculty and consequent policy implications. Methods: A 93-question survey was sent to faculty at a large urban public university and medical center. Demographic, family, and academic characteristics, work distribution and productivity before and during the pandemic, stress, and self-care data information were collected. Latent class analysis (LCA) was performed to identify classes of faculty sharing similar characteristics. Comparisons between latent classes were performed using analysis of variance and chi-square analyses. Results: Of 497 respondents, 60% were women. Four latent classes of faculty emerged based on six significant indicator variables. Class 1 individuals were more likely women, assistant professors, nontenured with high work and home stress; Class 2 faculty were more likely associate professors, women, tenured, who reported high home and work stress; Class 3 faculty were more likely men, professors, tenured with moderate work, but low home stress; and Class 4 faculty were more likely adjunct professors, nontenured, and had low home and work stress. Class 2 reported significantly increased administrative and clinical duties, decreased scholarly productivity, and deferred self-care. Conclusions: The pandemic has not affected faculty equally. Early and mid-career individuals were impacted negatively from increased workloads, stress, and decreased self-care. Academic leaders need to acknowledge these differences and be inclusive of faculty with different experiences when adjusting workplace or promotion policies.
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Affiliation(s)
- Pavitra Kotini-Shah
- Department of Emergency Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Bernice Man
- Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Ruth Pobee
- Department of Emergency Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Laura E. Hirshfield
- Department of Medical Education, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Barbara J. Risman
- Department of Sociology, College of Liberal Arts and Sciences, University of Illinois at Chicago, Illinois, USA
| | - Irina A. Buhimschi
- Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Heather M. Weinreich
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA.,Address correspondence to: Heather M. Weinreich, MD, MPH, Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago College of Medicine, 1855 West Taylor Street, Chicago, IL 60612, USA
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David E, DePierro JM, Marin DB, Sharma V, Charney DS, Katz CL. COVID-19 Pandemic Support Programs for Healthcare Workers and Implications for Occupational Mental Health: A Narrative Review. Psychiatr Q 2022; 93:227-247. [PMID: 34606067 PMCID: PMC8488324 DOI: 10.1007/s11126-021-09952-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2021] [Indexed: 02/08/2023]
Abstract
This narrative review aims to summarize initiatives developed during the COVID-19 pandemic to support healthcare workers' emotional well-being within the context of a pre-existing framework of occupational mental health guidelines. This occupational mental health framework integrates principles from multiple disciplines to optimize prevention and management of mental health issues among employees. We conducted an online search on Medline/PubMed, Cochrane Library, and Embase for studies that reported on design or execution of medical institution-based interventions, aiming to support healthcare worker mental health during the COVID-19 pandemic. Inclusion criteria was intentionally broad in order to incorporate as many types of interventions at varying stages of development or evaluation. We included 31 studies in our review that reported on newly designed psychological support interventions for healthcare workers (HCW) during the COVID-19 pandemic. We found that most programs commonly supported HCW mental health through offering one or more of the following initiatives: expanded basic need resources/services, additional workplace training programs that bolstered professional preparedness while also indirectly boosting HCW emotional health, and/or expanded psychological support programs, such as peer support programs, psychoeducational or counseling services. Most programs, however, did not consider methods to ensure program longevity or sustainability. The COVID-19 pandemic has underscored the acuity of HCW mental health issues and is likely to leave long lasting mental health strains among HCW. This pandemic is a critical point in time to catalyze much needed progress in reducing stigma and expanding HCW mental health care access.
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Affiliation(s)
- Eden David
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Jonathan M DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah B Marin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vanshdeep Sharma
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dennis S Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Craig L Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Liu S, Han L, Li J, Li H. Electrochemical detection of ACE2 as a biomarker for diagnosis of COVID-19 and potential male infertility. Biosens Bioelectron 2022; 198:113788. [PMID: 34861523 PMCID: PMC8603219 DOI: 10.1016/j.bios.2021.113788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 12/28/2022]
Abstract
Knowing how heavily the body is burdened by SARS-CoV-2 infection is all important to avoid tragic outcomes. This demands fast and convenient assays with minimum requirement for instruments and reagents. Therefore, a short synthetic peptide is developed to perform direct serum assay, using portable hand-held potentiostat, in a reagent-less manner. The target is angiotensin converting enzyme 2 (ACE2), a protein secreted by the body into the blood to restrict viral invasion. Specifically, under electrochemical potential scanning, the peptide can covalently capture ACE2 from the serum, and then form a covalent gel-like 2D protein network with the serum proteins, in an ACE2-specific fashion. This formation of a covalent biosensing complex enables sensitive detection in serum samples of SARS-CoV-2 infected patients. The detected serum level of ACE2 can not only serve as an index of viral load, but may also hint at the associated risk of potential male infertility. These results may point to field application of this simple design in the clinical practice in treating COVID-19 in the near future.
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Affiliation(s)
- Shuai Liu
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Liping Han
- Department of Neurology, Shandong Police Hospital, Jinan, Shandong, 250002, China
| | - Jinlong Li
- Department of Laboratory Medicine, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.
| | - Hao Li
- School of Biological Science and Technology, University of Jinan, Jinan, 250024, China.
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Aggar C, Samios C, Penman O, Whiteing N, Massey D, Rafferty R, Bowen K, Stephens A. The impact of COVID-19 pandemic-related stress experienced by Australian nurses. Int J Ment Health Nurs 2022; 31:91-103. [PMID: 34636134 PMCID: PMC8653281 DOI: 10.1111/inm.12938] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/12/2021] [Accepted: 09/26/2021] [Indexed: 12/29/2022]
Abstract
Globally, the impact of COVID-19 on healthcare workers' mental health has been a major focus of recent research. However, Australian research involving nurses, particularly across the acute care sector, is limited. This cross-sectional research aimed to explore the impact of pandemic-related stress on psychological adjustment outcomes and potential protective factors for nurses (n = 767) working in the Australian acute care sector during the COVID-19 pandemic. Nurses completed an online questionnaire with psychometrically validated measures of pandemic-related stress, psychological adjustment outcomes (depression, anxiety, and subjective well-being), and protective factors (posttraumatic growth and self-compassion). Descriptive analyses revealed that pandemic-related stress was reported by 17.7% of the participants. Psychological adjustment outcome scores above normal for depression (27.5%) and anxiety (22.0%) were found, and 36.4% of the participants reported poor subjective well-being. Regression analyses suggest that pandemic-related stress predicted greater depression (B = 0.32, SE = 0.02, 95% confidence interval [0.28, 0.35]) and anxiety (B = 0.26, SE = 0.01, 95% confidence interval [0.24, 0.29]) and less subjective well-being (B = -0.14, SE = 0.01, 95% confidence interval [-0.16, -0.12]). Self-compassion weakened the relationship between pandemic-related stress and greater depression, however, exacerbated the relationship between pandemic-related stress and less subjective well-being. Posttraumatic growth reduced the negative relationship between pandemic-related stress and psychological adjustment outcomes. These findings will inform strategies to facilitate psychological resources that support nurses' psychological adjustment, enabling better pandemic preparedness at both an individual and organizational level.
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Affiliation(s)
- Christina Aggar
- School of Health & Human Sciences, Southern Cross University, Bilinga, Queensland, Australia.,Northern New South, Wales Local Health District, Ballina, New South Wales, Australia
| | - Christina Samios
- School of Health & Human Sciences, Southern Cross University, Bilinga, Queensland, Australia
| | - Olivia Penman
- School of Health & Human Sciences, Southern Cross University, Bilinga, Queensland, Australia
| | - Nicola Whiteing
- School of Health & Human Sciences, Southern Cross University, Bilinga, Queensland, Australia
| | - Deb Massey
- School of Health & Human Sciences, Southern Cross University, Bilinga, Queensland, Australia
| | - Rae Rafferty
- Northern New South, Wales Local Health District, Ballina, New South Wales, Australia
| | - Karen Bowen
- Northern New South, Wales Local Health District, Ballina, New South Wales, Australia
| | - Alexandre Stephens
- Northern New South, Wales Local Health District, Ballina, New South Wales, Australia
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Peccoralo LA, Pietrzak RH, Feingold JH, Syed S, Chan CC, Murrough JW, Kaplan C, Verity J, Feder A, Charney DS, Southwick SM, Ripp JA. A prospective cohort study of the psychological consequences of the COVID-19 pandemic on frontline healthcare workers in New York City. Int Arch Occup Environ Health 2022; 95:1279-1291. [PMID: 35064838 PMCID: PMC8783588 DOI: 10.1007/s00420-022-01832-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/06/2022] [Indexed: 12/20/2022]
Abstract
Objectives We sought to describe the course and correlates of psychological distress in frontline healthcare workers (FHCWs) during the COVID-19 pandemic in New York City (NYC). Methods A prospective cohort study of FHCWs at the Mount Sinai Hospital was conducted during the initial 2020 surge (T1) and 7 months later (T2). Psychological distress [i.e., positive screen for pandemic-related post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and/or generalized anxiety disorder (GAD)], occupational and personal exposures to COVID-19, coping strategies, and psychosocial characteristics were assessed. Four courses of psychological distress response were identified: no/minimal, remitted, persistent, and new-onset. Multinomial logistic regression and relative importance analyses were conducted to identify factors associated with courses of distress. Results Of 786 FHCWs, 126 (16.0%) FHCWs had persistent distress; 150 (19.1%) remitted distress; 35 (4.5%) new-onset distress; and 475 (60.4%) no/minimal distress. Relative to FHCWs with no/minimal distress, those with persistent distress reported greater relationship worries [19.8% relative variance explained (RVE)], pre-pandemic burnout (18.7% RVE), lower dispositional optimism (9.8% RVE), less emotional support (8.6% RVE), and feeling less valued by hospital leadership (8.4% RVE). Relative to FHCWs with remitted symptoms, those with persistent distress reported less emotional support (29.7% RVE), fewer years in practice (28.3% RVE), and psychiatric history (23.6% RVE). Conclusions One-fifth of FHCWs in our study experienced psychological distress 7 months following the COVID-19 surge in NYC. Pandemic-related worries, pre-pandemic burnout, emotional support, and feeling valued by leaders were linked to persistent distress. Implications for prevention, treatment, and organizational efforts to mitigate distress in FHCWs are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-022-01832-0.
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Affiliation(s)
- Lauren A Peccoralo
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jordyn H Feingold
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shumayl Syed
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chi C Chan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA
| | - James W Murrough
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Depression and Anxiety Center for Discovery and Treatment, New York, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Carly Kaplan
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jaclyn Verity
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dennis S Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Jonathan A Ripp
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Mota N, Bolton SL, Sippel LM. Editorial: Mental health services for occupational trauma: Decreasing stigma and increasing access. FRONTIERS IN HEALTH SERVICES 2022; 2:1041953. [PMID: 36925781 PMCID: PMC10012684 DOI: 10.3389/frhs.2022.1041953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Shay-Lee Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Lauren M Sippel
- Department of Veterans Affairs Northeast Program Evaluation Center, West Haven, CT, United States.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.,Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder (PTSD), Washington, DC, United States
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Grailey K, Lound A, Brett S. Lived experiences of healthcare workers on the front line during the COVID-19 pandemic: a qualitative interview study. BMJ Open 2021; 11:e053680. [PMID: 35258477 PMCID: PMC8719006 DOI: 10.1136/bmjopen-2021-053680] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the presence of perceived stressors, psychological safety and teamwork in healthcare professionals. As the timeframe for this study spanned the first wave of the COVID-19 pandemic, data were captured demonstrating the impact of the pandemic on these factors. DESIGN Qualitative interview study. SETTING All staff working within the emergency and critical care departments of one National Health Service Trust in London, UK. PARTICIPANTS Forty-nine participants were recruited using a purposive sampling technique and interviewed when the first wave of the COVID-19 pandemic had subsided. MAIN OUTCOME MEASURES Evaluation of changes in perceived stressors, psychological safety and teamwork in individuals working during the COVID-19 pandemic. RESULTS The thematic analysis relating to a participant's lived experiences while working during COVID-19 led to the construction of five key themes, including 'psychological effects' and 'changes in team dynamics'. Several psychological effects were described, including the presence of psychological distress and insights into the aetiology of moral injury. There was marked heterogeneity in participants' response to COVID-19, particularly with respect to changes in team dynamics and the perception of a psychologically safe environment. Descriptions of improved team cohesiveness and camaraderie contrasted with stories of new barriers, notably due to the high workload and the impact of personal protective equipment. Building on these themes, a map of key changes arising due to the pandemic was developed, highlighting potential opportunities to provide targeted support. CONCLUSIONS Working on the front line of a pandemic can have significant implications for healthcare workers, putting them at risk of psychological distress and moral injury, as well as affecting team dynamics. There is striking heterogeneity in the manifestation of these challenges. Team leaders can use the themes and qualitative data from this study to help identify areas for management focus and individual and team support.
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Affiliation(s)
- Kate Grailey
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Adam Lound
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Stephen Brett
- Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK
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Effects of Sleep, Exercise, and Leadership Support on Resilience in Frontline Healthcare Workers During the COVID-19 Pandemic. J Occup Environ Med 2021; 64:416-420. [PMID: 34935678 DOI: 10.1097/jom.0000000000002460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the direct and interacting effects of personal and systemic factors that contribute to psychological distress among frontline healthcare workers (FHCWs) during the COVID-19 pandemic. METHODS Data were collected using a hospital-wide, cross-sectional survey. A multivariable binary logistic regression and relative importance analysis was conducted to identify factors associated with screening positive for C19-distress. RESULTS A total of 1,005 (39.0%, 95%CI = 37.1-40.9%) out of 2,579 FHCWs met the pre-specified cutoff values for significant symptoms of C19-distress. Fewer sleep hours and lower perceptions of leadership support explained the majority of variance (19.4% relative variance explained [RVE]) in C19-distress, followed by team camaraderie (6.4% RVE), physical exercise (4.9% RVE), and engagement in hobbies (3.2% RVE). CONCLUSION These results underscore the importance of restorative behaviors as potential targets to help decrease distress and promote resilience in FHCWs.
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Sinsky CA, Brown RL, Stillman MJ, Linzer M. COVID-Related Stress and Work Intentions in a Sample of US Health Care Workers. Mayo Clin Proc Innov Qual Outcomes 2021; 5:1165-1173. [PMID: 34901752 PMCID: PMC8651505 DOI: 10.1016/j.mayocpiqo.2021.08.007] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
OBJECTIVE To evaluate relationships between coronavirus disease 2019 (COVID-19)-related stress and work intentions in a sample of US health care workers. PATIENTS AND METHODS Between July 1 and December 31, 2020, health care workers were surveyed for fear of viral exposure or transmission, COVID-19-related anxiety or depression, work overload, burnout, and intentions to reduce hours or leave their jobs. RESULTS Among 20,665 respondents at 124 institutions (median organizational response rate, 34%), intention to reduce hours was highest among nurses (33.7%; n=776), physicians (31.4%; n=2914), and advanced practice providers (APPs; 28.9%; n=608) while lowest among clerical staff (13.6%; n=242) and administrators (6.8%; n=50; all P<.001). Burnout (odds ratio [OR], 2.15; 95% CI, 1.93 to 2.38), fear of exposure, COVID-19-related anxiety/depression, and workload were independently related to intent to reduce work hours within 12 months (all P<.01). Intention to leave one's practice within 2 years was highest among nurses (40.0%; n=921), APPs (33.0%; n=694), other clinical staff (29.4%; n=718), and physicians (23.8%; n=2204) while lowest among administrators (12.6%; n=93; all P<.001). Burnout (OR, 2.57; 95% CI, 2.29 to 2.88), fear of exposure, COVID-19-related anxiety/depression, and workload were predictors of intent to leave. Feeling valued by one's organization was protective of reducing hours (OR, 0.65; 95% CI, 0.59 to 0.72) and intending to leave (OR, 0.40; 95% CI, 0.36 to 0.45; all P<.01). CONCLUSION Approximately 1 in 3 physicians, APPs, and nurses surveyed intend to reduce work hours. One in 5 physicians and 2 in 5 nurses intend to leave their practice altogether. Reducing burnout and improving a sense of feeling valued may allow health care organizations to better maintain their workforces postpandemic.
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Affiliation(s)
| | | | - Martin J. Stillman
- Department of Medicine, Hennepin Health System and University of Minnesota, Minneapolis
| | - Mark Linzer
- Department of Medicine, Hennepin Health System and University of Minnesota, Minneapolis
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DePierro J, Marin DB, Sharma V, Costello Z, Starkweather S, Katz CL, Lim S, Charney DS. Developments in the first year of a resilience-focused program for health care workers. Psychiatry Res 2021; 306:114280. [PMID: 34800784 PMCID: PMC10754208 DOI: 10.1016/j.psychres.2021.114280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/15/2022]
Abstract
The present article comprises a one-year retrospective review of the efforts of the Mount Sinai Center for Stress, Resilience and Personal Growth, an initiative to support the resilience and well-being of health care workers that was founded amid the first peak of the pandemic in New York in 2020. Specific offerings to date have included evidence-backed resilience workshops, a digital health platform, and a specialty screening and treatment service. All services have been modified or expanded in response to changing needs and are subject to ongoing research. Robust evidence-based programming that addressing health care worker well-being, regardless of role, may prove beneficial to institutions well beyond the pandemic.
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Affiliation(s)
- Jonathan DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
| | - Deborah B Marin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Vansh Sharma
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Zorina Costello
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Sydney Starkweather
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Craig L Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Global Health and Health Systems Design, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Sabina Lim
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Dennis S Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Pharmacology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
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Blanchard AK, Podczerwinski J, Twiss MF, Norcott C, Lee R, Pincavage AT. Resident Well-Being Before and During the COVID-19 Pandemic. J Grad Med Educ 2021; 13:858-862. [PMID: 35070099 PMCID: PMC8672847 DOI: 10.4300/jgme-d-21-00325.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/30/2021] [Accepted: 08/16/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Preliminary studies reveal challenges posed by the COVID-19 pandemic to the well-being of health care workers. Little is known about the effects of the pandemic on the well-being of graduate medical education (GME) residents or about protective factors and post-traumatic growth. Through deeper examination of resident well-being during this unique crisis, we can identify trends and associated lessons to apply broadly to resident well-being. OBJECTIVE To characterize resident burnout, resilience, and loneliness before and during the COVID-19 pandemic. METHODS All residents in any specialty at a single institution were anonymously surveyed semiannually for 2 years (2019-2020), including the time period of the COVID-19 pandemic. Surveys included demographics, the 10-item Connor-Davidson Resilience Scale, the Maslach Burnout Inventory, and the UCLA Loneliness Scale. RESULTS Overall response rates were 53% (508 of 964) in spring 2019, 55% (538 of 982) in fall 2019, 51% (498 of 984) in spring 2020, and 57% (563 of 985) in fall 2020. The overall rates of burnout were stable across all time periods and did not change during the COVID-19 pandemic. Among frontline residents, burnout rates were higher than other resident populations in both the pre- and post-COVID-19 pandemic time periods. Resilience and loneliness measures were similar for frontline and non-frontline residents and remained stable during the pandemic. CONCLUSIONS Initial data from this single institution survey of all GME residents in the first 8 months of the COVID-19 pandemic demonstrated burnout and loneliness did not increase and resilience was preserved.
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Affiliation(s)
- Anita K. Blanchard
- All authors are with The University of Chicago
- Anita K. Blanchard, MD, is Professor of Obstetrics and Gynecology, Associate Dean of Graduate Medical Education, Department of Obstetrics and Gynecology Biological Sciences Division, and Designated Institutional Official
| | - Jeremy Podczerwinski
- All authors are with The University of Chicago
- Jeremy Podczerwinski, BS, is Data Integrity Analyst, Office of Graduate Medical Education
| | - Megham Freytag Twiss
- All authors are with The University of Chicago
- Megham Freytag Twiss, MA, MDiv, is Director of GME Operations, Accreditation and Innovation, Office of Graduate Medical Education
| | - Candice Norcott
- All authors are with The University of Chicago
- Candice Norcott, PhD, is Assistant Professor and Director of GME Wellness, Department of Psychiatry and Behavioral Neuroscience
| | - Royce Lee
- All authors are with The University of Chicago
- Royce Lee, MD, is Associate Professor, Department of Psychiatry and Behavioral Neuroscience
| | - Amber T. Pincavage
- All authors are with The University of Chicago
- Amber T. Pincavage, MD, is Associate Professor, Department of Medicine
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45
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Scales SE, Patrick E, Stone KW, Kintziger KW, Jagger MA, Horney JA. A Qualitative Study of the COVID-19 Response Experiences of Public Health Workers in the United States. Health Secur 2021; 19:573-581. [PMID: 34756111 DOI: 10.1089/hs.2021.0132] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The mental health impacts of the COVID-19 pandemic on frontline, patient-facing healthcare staff have been described in several studies, but the effects of the COVID-19 response on the US public health workforce have not been well characterized. In early 2021, we conducted interviews with a subset of public health practitioners in the United States who participated in a cross-sectional survey and indicated their willingness to participate in a follow-up interview. An interview guide was developed to collect information about professional roles since the start of the pandemic, aspects of the individual COVID-19 response that impacted mental health, and aspects of the organizational/institutional COVID-19 response that impacted mental health, as well as the strengths and weaknesses of, opportunities for, and threats to public health professionals and organizations going forward. Interviews were transcribed and inductively coded to identify themes. Of the 48 people invited to participate, 24 completed an interview between January 28 and February 23, 2021. Five key themes were identified through inductive coding of interview transcripts: (1) teamwork and workplace camaraderie, (2) potential for growth in the field of public health, (3) considerations for adaptive work environments (eg, remote work, work out of jurisdiction, transition to telework), (4) politicization of response, and (5) constrained hiring capacity and burnout. After more than a year of public health emergency response to the COVID-19 pandemic, it is critically important to understand the detrimental and supportive factors of good mental health among the public health workforce.
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Affiliation(s)
- Sarah E Scales
- Sarah E. Scales, MPH, is a Doctoral Student, Epidemiology Department, College of Health Sciences, University of Delaware, Newark, DE
| | - Elizabeth Patrick
- Elizabeth Patrick is an Undergraduate Research Assistant, Behavioral Health and Nutrition Department, College of Health Sciences, University of Delaware, Newark, DE
| | - Kahler W Stone
- Kahler W. Stone, DrPH, MPH, is an Assistant Professor, Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, TN
| | - Kristina W Kintziger
- Kristina W. Kintziger, PhD, MPH, is an Assistant Professor, Department of Public Health, University of Tennessee, Knoxville, TN
| | | | - Jennifer A Horney
- Jennifer A. Horney, PhD, MPH, is a Professor, Epidemiology Department, College of Health Sciences, University of Delaware, Newark, DE
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Fisher E, Cárdenas L, Kieffer E, Larson E. Reflections from the "Forgotten Front Line": A qualitative study of factors affecting wellbeing among long-term care workers in New York City during the COVID-19 pandemic. Geriatr Nurs 2021; 42:1408-1414. [PMID: 34624698 DOI: 10.1016/j.gerinurse.2021.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/28/2022]
Abstract
While long-term care (LTC)1 facilities serving older adults have long struggled with low employee morale and high rates of staff turnover, the COVID-19 pandemic brought unprecedented challenges to these facilities and the frontline staff working in them. This study aimed to explore factors that influenced the personal and professional wellbeing of care providers working in LTC facilities across New York City (NYC) during the pandemic. Fourteen semi-structured qualitative interviews were conducted with frontline care providers working in LTC facilities across NYC. Interviews were audio-recorded, transcribed, and systematically coded according to both pre-existing and emergent topics. Four main themes emerged from the data: the toll of the virus; home and work-life balance stressors; workplace stressors; and participants' recommendations for facility leadership. Findings from this study may inform strategies for supporting the wellbeing of frontline care providers in LTC environments, especially during future public health emergencies.
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Affiliation(s)
- Elisa Fisher
- The New York Academy of Medicine, 1216 5th Ave, New York, NY 10029, USA.
| | - Luisa Cárdenas
- The New York Academy of Medicine, 1216 5th Ave, New York, NY 10029, USA
| | - Elana Kieffer
- The New York Academy of Medicine, 1216 5th Ave, New York, NY 10029, USA
| | - Elaine Larson
- The New York Academy of Medicine, 1216 5th Ave, New York, NY 10029, USA; Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, USA
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Norman SB, Feingold JH, Kaye‐Kauderer H, Kaplan CA, Hurtado A, Kachadourian L, Feder A, Murrough JW, Charney D, Southwick SM, Ripp J, Peccoralo L, Pietrzak RH. Moral distress in frontline healthcare workers in the initial epicenter of the COVID-19 pandemic in the United States: Relationship to PTSD symptoms, burnout, and psychosocial functioning. Depress Anxiety 2021; 38:1007-1017. [PMID: 34293236 PMCID: PMC8426909 DOI: 10.1002/da.23205] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 04/21/2021] [Accepted: 06/11/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Little is known about the relationship between moral distress and mental health problems. We examined moral distress in 2579 frontline healthcare workers (FHCWs) caring for coronavirus disease 2019 (COVID-19) patients during the height of the spring 2020 pandemic surge in New York City. The goals of the study were to identify common dimensions of COVID-19 moral distress; and to examine the relationship between moral distress, and positive screen for COVID-19-related posttraumatic stress disorder (PTSD) symptoms, burnout, and work and interpersonal functional difficulties. METHOD Data were collected in spring 2020, through an anonymous survey delivered to a purposively-selected sample of 6026 FHCWs at Mount Sinai Hospital; 2579 endorsed treating COVID-19 patients and provided complete survey responses. Physicians, house staff, nurses, physician assistants, social workers, chaplains, and clinical dietitians comprised the sample. RESULTS The majority of the sample (52.7%-87.8%) endorsed moral distress. Factor analyses revealed three dimensions of COVID-19 moral distress: negative impact on family, fear of infecting others, and work-related concerns. All three factors were significantly associated with severity and positive screen for COVID-19-related PTSD symptoms, burnout, and work and interpersonal difficulties. Relative importance analyses revealed that concerns about work competencies and personal relationships were most strongly related to all outcomes. CONCLUSION Moral distress is prevalent in FHCWs and includes family-, infection-, and work-related concerns. Prevention and treatment efforts to address moral distress during the acute phase of potentially morally injurious events may help mitigate risk for PTSD, burnout, and functional difficulties.
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Affiliation(s)
- Sonya B. Norman
- Executive DivisionU.S. Department of Veterans Affairs National Center for PTSDWasington, D.C.USA,Department of PsychiatryUniversity of California San Diego School of MedicineSan DiegoCaliforniaUSA
| | - Jordyn H. Feingold
- Department of Medical EducationIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Halley Kaye‐Kauderer
- Department of Medical EducationIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Carly A. Kaplan
- Department of Well‐Being and ResilienceIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Alicia Hurtado
- Department of Well‐Being and ResilienceIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Lorig Kachadourian
- Executive DivisionU.S. Department of Veterans Affairs National Center for PTSDWasington, D.C.USA,Department of PsychiatryYale School of MedicineNew HavenConnecticutUSA
| | - Adriana Feder
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - James W. Murrough
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of NeuroscienceIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Dennis Charney
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of NeuroscienceIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of Pharmacological SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Steven M. Southwick
- Executive DivisionU.S. Department of Veterans Affairs National Center for PTSDWasington, D.C.USA
| | - Jonathan Ripp
- Department of Well‐Being and ResilienceIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Lauren Peccoralo
- Department of Medical EducationIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of Well‐Being and ResilienceIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Robert H. Pietrzak
- Executive DivisionU.S. Department of Veterans Affairs National Center for PTSDWasington, D.C.USA,Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of PsychiatryYale School of MedicineNew HavenConnecticutUSA,Department of Social and Behavioral SciencesYale School of Public HealthNew HavenConnecticutUSA
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Norrholm SD, Zalta A, Zoellner L, Powers A, Tull MT, Reist C, Schnurr PP, Weathers F, Friedman MJ. Does COVID-19 count?: Defining Criterion A trauma for diagnosing PTSD during a global crisis. Depress Anxiety 2021; 38:882-885. [PMID: 34469042 PMCID: PMC8652625 DOI: 10.1002/da.23209] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The ongoing coronavirus disease 2019 (COVID-19) pandemic is a globally significant crisis with a rapid spread worldwide, high rates of illness and mortality, a high degree of uncertainty, and a disruption of daily life across the sociodemographic spectrum. The clinically relevant psychological consequences of this catastrophe will be long-lasting and far-reaching. There is an emerging body of empirical literature related to the mental health aspects of this pandemic and this body will likely expand exponentially. The COVID-19 pandemic is an example of a historic catastrophe from which we can learn much and from which the field will need to archive, interpret, and synthesize a multitude of clinical and research observations. METHODS In this commentary, we discuss situations and contexts in which a diagnosis of posttraumatic stress disorder (PTSD) may or may not apply within the context of diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria. RESULTS Our consensus is that a COVID-related event cannot be considered traumatic unless key aspects of DSM-5's PTSD Criterion A have been established for a specific type of COVID-19 event (e.g., acute, life-threatening, and catastrophic). CONCLUSION The application of a more liberal interpretation of Criterion A will dilute the PTSD diagnosis, increase heterogeneity, confound case-control research, and create an overall sample pool with varying degrees of risk and vulnerability factors.
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Affiliation(s)
- Seth D. Norrholm
- Neuroscience Center for Anxiety, Stress, and Trauma, Department of Psychiatry and Behavioral NeurosciencesWayne State University School of MedicineDetroitMichiganUSA
| | - Alyson Zalta
- Department of Psychological ScienceUniversity of CaliforniaIrvineCaliforniaUSA
| | - Lori Zoellner
- Department of PsychologyUniversity of WashingtonSeattleWashingtonUSA
| | - Abigail Powers
- Department of Psychiatry and Behavioral SciencesEmory University School of MedicineAtlantaGeorgiaUSA
| | | | - Christopher Reist
- Long Beach VA Healthcare SystemLong BeachCaliforniaUSA,Science 37Culver CityCaliforniaUSA
| | - Paula P. Schnurr
- National Center for PTSD, U.S. Department of Veterans AffairsWhite River JunctionUSA,Department of PsychiatryGeisel School of Medicine at DartmouthHanoverNew HampshireUSA
| | - Frank Weathers
- Department of Psychological SciencesAuburn UniversityAuburnAlabamaUSA
| | - Matthew J. Friedman
- National Center for PTSD, U.S. Department of Veterans AffairsWhite River JunctionUSA,Department of PsychiatryGeisel School of Medicine at DartmouthHanoverNew HampshireUSA
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Chan SL, Takemura N, Chau PH, Lin CC, Wang MP. Psychological Impact of the COVID-19 Pandemic on Licensed Full-Time Practicing Nurses Undertaking Part-Time Studies in Higher Education: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168569. [PMID: 34444322 PMCID: PMC8391214 DOI: 10.3390/ijerph18168569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/02/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
Frontline nurses face an unpreceded situation with the coronavirus disease (COVID-19) pandemic, and many report suffering from physical and psychological stress. This online, cross-sectional survey used questionnaires, such as the Generalized Anxiety Disorder (GAD-7) questionnaire, the Patient Health Questionnaire (PHQ-2), the Connor–Davidson Resilience Scale, stress-related questions, and Brief Coping Orientation to Problems Experienced (Brief-COPE), to determine the psychological impact of COVID-19 on licensed full-time practicing nurses undertaking part-time studies in higher education. Recruitment commenced from August to September 2020; 385 students were approached, and 124 completed the survey (response rate: 32%). Most of the respondents were frontline nurses working in public sectors (89.5%), 29% of whom reported symptoms of depression, and 61.3% reported mild to severe levels of anxiety. The GAD-7 was significantly associated with the resilience score (β = −0.188; p = 0.008) and exhaustion (β = 0.612; p < 0.001). The PHQ-2 was significantly associated with ‘anxiety about infection’ (β = 0.071; p = 0.048). A lower anxiety level was significantly associated with a higher resilience level and a lower level of exhaustion, and a lower depression level was significantly associated with a lower anxiety about infection. Nursing programs incorporating resilience building may mitigate psychological distress of the study population.
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Affiliation(s)
- Siu-Ling Chan
- Correspondence: (S.-L.C.); (C.-C.L.); Tel.: +852-001-3917-6680 (S.-L.C.); +852-001-3917-6633 (C.-C.L.)
| | | | | | - Chia-Chin Lin
- Correspondence: (S.-L.C.); (C.-C.L.); Tel.: +852-001-3917-6680 (S.-L.C.); +852-001-3917-6633 (C.-C.L.)
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Stöcker A, Demirer I, Gunkel S, Hoffmann J, Mause L, Ohnhäuser T, Scholten N. Stockpiled personal protective equipment and knowledge of pandemic plans as predictors of perceived pandemic preparedness among German general practitioners. PLoS One 2021; 16:e0255986. [PMID: 34383827 PMCID: PMC8360569 DOI: 10.1371/journal.pone.0255986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly changed the work of general practitioners (GPs). At the onset of the pandemic in March 2020, German outpatient practices had to adapt quickly. Pandemic preparedness (PP) of GPs may play a vital role in their management of a pandemic. OBJECTIVES The study aimed to examine the association in the stock of seven personal protective equipment (PPE) items and knowledge of pandemic plans on perceived PP among GPs. METHODS Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March-April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age. RESULTS In total, 508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP; the association of the knowledge of a pandemic plan was significant but small. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP. CONCLUSION The stock of PPE seems to be the determining factor for PP among German GPs; for COVID-19, sufficient masks are the determining factor. Knowledge of a pandemic plans play a secondary role in PP.
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Affiliation(s)
- Arno Stöcker
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Ibrahim Demirer
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Sophie Gunkel
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Jan Hoffmann
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Laura Mause
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Tim Ohnhäuser
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nadine Scholten
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
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