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Abdo M, Schlösser A. A systematic review of post-traumatic growth in ambulance personnel: facilitators and prevalence rates. Br Paramed J 2024; 9:34-46. [PMID: 38946734 PMCID: PMC11210585 DOI: 10.29045/14784726.2024.6.9.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Introduction Ambulance personnel are exposed to traumatic and stressful situations, which can increase the risk of mental health conditions, such as post-traumatic stress disorder (PTSD). High rates of PTSD have been found in ambulance personnel (Petrie et al., 2018), but no review is available to examine post-traumatic growth (PTG - positive psychological change following a trauma) in this population. This literature review provides an overview of the prevalence rates and facilitators that may contribute to PTG in ambulance personnel. Methods A systematic search was conducted on EBSCOhost in January 2024 across the following six databases: Academic Search Ultimate, PsycINFO, PsycARTICLES, MEDLINE, ERIC and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ultimate. Results Eleven papers were identified for this review. Pooled prevalence of PTG was moderate (52%), and facilitators for PTG were grouped into five categories: coping style/strategies, resilience, personality traits, gender and incident characteristics. Conclusions Numerous facilitators contributed to the development of PTG, although these did not arise in all papers. The quality of research ranged from satisfactory to excellent. Evidence suggested that adaptive coping style, high levels of resilience, the absence of a personality trait (neuroticism) and being female may facilitate PTG. Further research is needed to support the reliability of findings.
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Affiliation(s)
- Molly Abdo
- Humber Teaching NHS Foundation Trust ORCID iD: https://orcid.org/0009-0004-7662-9363
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Liu N, Zhang L, Liu Y, Ding X, Li Q, Lixia G, Zhang X. Relationship between self-psychological adjustment and post-traumatic growth in patients with lung cancer undergoing chemotherapy: a cross-sectional study. BMJ Open 2024; 14:e081940. [PMID: 38719309 PMCID: PMC11086470 DOI: 10.1136/bmjopen-2023-081940] [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: 11/10/2023] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES This study aimed to determine the potential profiles of self-psychological adjustment in patients with lung cancer undergoing chemotherapy, including sense of coherence (SOC) and positive cognitive emotion regulation (PCER). The relationship between these profiles with post-traumatic growth (PTG) and the relevant factors of self-psychological adjustment in different profiles was analysed. DESIGN Cross-sectional study. SETTING Patients with lung cancer undergoing chemotherapy in China. PARTICIPANTS A total of 330 patients with lung cancer undergoing chemotherapy were recruited out of which 321 completed the questionnaires effectively. METHODS Latent profile analysis was used to identify self-psychological adjustment classes based on the two subscales of the Sense of Coherence Scale and Cognitive Emotion Regulation Questionnaire. One-way analysis of variance and multinomial logistic regression were performed to examine the subgroup association with characteristics and PTG. RESULTS Three latent profiles of self-psychological adjustment were identified: low level (54.5%), high SOC-low PCER (15.6%) and high PCER (29.9%). The results of univariate analysis showed a significant difference in PTG scores among different self-psychological adjustment subgroups (F=11.55, p<0.001). Patients in the high-PCER group were more likely living in urban areas (OR=2.41, 95% CI 1.17 to 4.97, p=0.02), and time since cancer diagnosis was ≥6 months and <1 year (OR=3.54, 95% CI 1.3 to 9.64, p<0.001). CONCLUSION This study revealed that most patients with lung cancer undergoing chemotherapy belonged to the low-level group. Three profiles are associated with PTG. There were differences in characteristics between patients treated with chemotherapy for lung cancer in the high-PCER and low-PCER groups. Thus, these profiles provide useful information for developing targeted individualised interventions based on demographic characteristics that would assist PTG in patients with lung cancer undergoing chemotherapy.
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Affiliation(s)
- Na Liu
- Binzhou Medical University, Yantai, China
| | - Lei Zhang
- Yan Tai Affiliated Hospital of Bin Zhou Medical University(The Second School clinical Medicine), Yantai, China
| | - Yaxin Liu
- Binzhou Medical University, Yantai, China
| | | | - Qing Li
- The Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Gao Lixia
- The Affiliated Hospital of Binzhou Medical University, Binzhou, China
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Mantas-Jiménez S, Reig-García G, Roqueta-Vall-Llosera M, Camara-Liebana D, Masià-Plana A, Lluch-Canut MT, Juvinya-Canal D. Positive mental health and sense of coherence among emergency medical service professionals. Front Public Health 2024; 12:1344872. [PMID: 38444442 PMCID: PMC10912187 DOI: 10.3389/fpubh.2024.1344872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/01/2024] [Indexed: 03/07/2024] Open
Abstract
Background Positive mental health (PMH) is a construct used to define and evaluate health from a positive perspective. Healthcare professionals in the emergency ambulance service are more likely to experience mental health disorders than the overall population. The demographic and occupational variables and Sense of Coherence (SOC) can act as predictors of PMH and can serve as protective elements against stress and demanding situations in the work environment. Objective This study aimed to evaluate PMH and its relationship with demographic and occupational variables and determine if SOC is a predictive variable for PMH in health professionals working in the emergency ambulance service. Methods A descriptive, cross-sectional, and correlational study was conducted with a sample of 406 healthcare professionals from the emergency ambulance service in eight health regions of Catalonia, Spain. The following variables were analyzed: Age, biological sex, household members, dependents family members, professional category, type of contract, job satisfaction and sense of collaboration with other institutions. The following assessment instruments were used: Positive Mental Health Questionnaire and Sense of Coherence scale. Results High scores were obtained in Positive Mental Health (PMH). Study participants who reported feeling completely satisfied in their work also showed a significant relationship with all PMH factors: greater satisfaction with their personal life, in their helpful prosocial attitude toward others, in their capability to deal effectively with stress and navigate conflict scenarios, in their ability to solve problems and self-realization, greater empathy and ability to understand the feelings of others, greater ability to establish interpersonal relationships. Comprehensibility, as a dimension of SOC, was identified as a predictor for some factors of PMH: a greater personal satisfaction, self-control, autonomy, interpersonal skills and total PMHQ. More than 43% of positive mental health in health professionals is explained by higher Meaningfulness and Comprehensibility values of the SOC, the absence of dependent family members and having a non-graduate background. Conclusion Healthcare workers in the emergency ambulance service had high PMH. Meaningfulness (ME) and Comprehensibility (C), dimensions of SOC, were identified as model predictors of greater PMH, showing higher scores in most of PMH factors. To enhance SOC as a mental health promotion measure, resilience programs should be implemented to help professionals develop skills to face and overcome adverse situations. Educating in stress management thought networks are key elements to strengthen SOC. Managers in emergency medical services play a key role in transforming healthcare work environments to promote positive outcomes in the mental health of their healthcare workers.
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Affiliation(s)
- Susana Mantas-Jiménez
- Department of Nursing, University of Girona, Girona, Spain
- Research Group Health and Healthcare, University of Girona, Girona, Spain
| | - Glòria Reig-García
- Department of Nursing, University of Girona, Girona, Spain
- Research Group Health and Healthcare, University of Girona, Girona, Spain
| | - Marta Roqueta-Vall-Llosera
- Department of Nursing, University of Girona, Girona, Spain
- Health Gender and Aging Research Group, Girona, Spain
| | - David Camara-Liebana
- Department of Nursing, University of Girona, Girona, Spain
- Department of Psychology, Quality of Life Research Institute, Universitat de Girona, Girona, Spain
| | - Afra Masià-Plana
- Department of Nursing, University of Girona, Girona, Spain
- Research Group Health and Healthcare, University of Girona, Girona, Spain
| | | | - Dolors Juvinya-Canal
- Department of Nursing, University of Girona, Girona, Spain
- Research Group Health and Healthcare, University of Girona, Girona, Spain
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Hikichi H, Shiba K, Aida J, Kondo K, Kawachi I. Association between sense of coherence and health and well-being among older survivors of a natural disaster: a prospective outcome-wide study. Sci Rep 2023; 13:16385. [PMID: 37773258 PMCID: PMC10542327 DOI: 10.1038/s41598-023-43672-z] [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] [Received: 07/08/2023] [Accepted: 09/27/2023] [Indexed: 10/01/2023] Open
Abstract
We examined whether pre-disaster Sense of Coherence (SOC) mitigated the impact of housing damage on health and well-being of older survivors after the 2011 Japan Earthquake and Tsunami. A panel survey was conducted in a city located 80 km west of the epicenter seven months before and three years after the disaster (3594 respondents). Among respondents with lighter property damage, higher SOC was inversely associated with mental distress (coefficient - 0.29, 95% CI (confidence interval) - 0.39, - 0.19, p < .01), unhappiness (coefficient - 0.33, 95% CI - 0.43, - 0.23, p < .01), low expectation of mutual help (coefficient - 0.17, 95% CI - 0.27, - 0.07, p < .01), and weak community attachment (coefficient - 0.20, 95% CI - 0.30, - 0.11, p < .01). Conversely, among those who experienced housing loss, higher SOC was no longer protectively associated with health and well-being. Loss of generalized resistance resources due to serious damage led to difficulties in stress coping.
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Affiliation(s)
- Hiroyuki Hikichi
- Kitasato University School of Medicine, 1-15-1 Kitazato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Koichiro Shiba
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8510, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo, Chiba, Chiba, 260-8670, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Russell B, Mussap AJ. Rumination and threat-biased interpretation mediate posttraumatic stress and growth responses to military stressors. MILITARY PSYCHOLOGY 2023; 35:451-466. [PMID: 37615560 PMCID: PMC10453989 DOI: 10.1080/08995605.2022.2127618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/14/2022] [Indexed: 10/14/2022]
Abstract
We examined the role of rumination and threat-biased interpretation in stress and growth responses to military stressors. Two online surveys were completed by 183 (survey 1) and 393 (survey 2) currently serving or retired military personnel. The surveys measured exposure to potential military stressors (exposure to combat, witnessing the consequences of war, and perceived moral injury), posttraumatic stress symptomatology (PTSS), posttraumatic growth (PTG), and personal wellbeing, with survey 1 including measures of rumination, and survey 2 including a measure of threat-biased interpretation. Path analyses revealed that indirect paths from both witnessing the consequences of war and experiencing betrayal to PTSS were mediated by intrusive rumination and threat-biased interpretation, and that indirect paths from both betrayal and transgressions by others to PTG were mediated by deliberate rumination and threat-biased interpretation. The results reveal the idiosyncratic nature of military stressors, their differential involvement with cognitions that underpin rumination about past events and interpretation of current events, and their relevance to posttraumatic stress and growth in military personnel.
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Affiliation(s)
- Brenton Russell
- School of Psychology, Deakin University, Melbourne, Australia
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Boals A, Griffith EL, Park CL. Can respondents accurately self-report posttraumatic growth when coached through the required cognitive steps? ANXIETY, STRESS, AND COPING 2023; 36:184-198. [PMID: 35266842 DOI: 10.1080/10615806.2022.2047949] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Coyne and Tennen [(2010). Positive psychology in cancer care: Bad science, exaggerated claims, and unproven medicine. Annals of Behavioral Medicine, 39(1), 16-26. https://doi.org/10.1007/s12160-009-9154-z] argue that completing self-reports of posttraumatic growth (PTG) requires four complicated cognitive steps. DESIGN We conducted two experiments designed to (1) use mental chronometry (i.e., reaction times on cognitive tasks) to test whether respondents engage in multiple cognitive steps when completing self-reports of PTG, and (2) determine whether coaching participants to take these steps results in a more valid assessment. METHOD In Experiment 1, 310 undergraduates were randomly assigned to complete either the Posttraumatic Growth Inventory (PTGI) or Stress-Related Growth Scale (SRGS), and its corresponding current version that requires only one cognitive step. In Experiment 2, 306 undergraduates were randomly assigned to complete either a guided-steps version of the SRGS or the original SRGS. RESULTS Experiment 1 indicated a very small difference in completion time for the PTGI, but not the SRGS, in comparison to the current versions, suggesting respondents do not engage in the four required cognitive steps. In Experiment 2, participants reported less PTG when coached to go through the four cognitive steps, but the resulting scores were generally unrelated to measures of convergent and predictive validity. CONCLUSION We conclude that individuals cannot accurately report PTG, even when explicitly coached.
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Affiliation(s)
- Adriel Boals
- Department of Psychology, University of North Texas, Denton, TX, USA
| | | | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Sandrin É, Brun JP, Nguyen C, Biron C, Ivers H. Psychological distress and post-traumatic growth in France during the COVID-19 pandemic: A mediation model of psychosocial safety climate as a determinant of work performance. Front Psychol 2022; 13:993458. [PMID: 36329744 PMCID: PMC9623118 DOI: 10.3389/fpsyg.2022.993458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
The psychosocial safety climate (PSC) reflects workers’ perceptions of senior management’s concern for mental health. Because the COVID-19 pandemic has exacerbated organizational issues, PSC could be a target for interventions attempting to preserve both the psychological health of employees and the economic health of companies. This study examines the direct and indirect relationships between PSC and work performance through two indicators of psychological health, psychological distress and post-traumatic growth, during a health crisis, i.e., prior to the second confinement in France. To this end, 2,004 participants from the French workforce completed a survey in October 2020. The results of mediation analyses indicate that PSC has a direct and positive influence on post-traumatic growth (PTG) and performance, as well as a direct negative influence on psychological distress. PSC also has an indirect positive influence on performance via psychological distress. Organizations that wish to jointly address mental health and performance at work would benefit from optimizing PSC.
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Affiliation(s)
- Émilie Sandrin
- Empreinte Humaine, Paris, France
- *Correspondence: Émilie Sandrin,
| | - Jean-Pierre Brun
- Empreinte Humaine, Paris, France
- Department of Management, Faculty of Business and Administration, Université Laval, Quebec, QC, Canada
- Jean-Pierre Brun,
| | | | - Caroline Biron
- Department of Management, Faculty of Business and Administration, Université Laval, Quebec, QC, Canada
- VITAM Research Centre on Sustainable Health, Quebec, QC, Canada
| | - Hans Ivers
- Department of Management, Faculty of Business and Administration, Université Laval, Quebec, QC, Canada
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Zonp Z, Saint Arnault D. The Reliability and Predictive Validity of Sense of Coherence Scale for American Survivors of Gender-Based Violence. Violence Against Women 2022:10778012221120445. [DOI: 10.1177/10778012221120445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the reliability and predictive validity of the Sense of Coherence (SOC) scale for 299 American survivors of gender-based violence (GBV). First, confirmatory factor analysis examined the construct validity of the SOC-13. Then, relationships between SOC and clinical scales were examined. Confirmatory factor analysis supported the 3-factor solution, and Cronbach's alpha reliability values for comprehensibility, manageability, and meaningfulness subscales and total score of SOC-13 were: .62, .53, .65, and .81, respectively. Multiple regression revealed that age, posttraumatic growth, depression, and posttraumatic stress scores explained 53% of the variance of SOC scores. We interpret this to suggest that SOC is a protective factor in GBV, especially in younger women. Clinical implications are suggested.
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Affiliation(s)
- Zeynep Zonp
- University of Michigan, School of Nursing, Ann Arbor, MI, USA
- TUBITAK, Turkey
- Multicultural Study of Trauma Recovery (MiStory), Ann Arbor, MI, USA
| | - Denise Saint Arnault
- University of Michigan, School of Nursing, Ann Arbor, MI, USA
- Multicultural Study of Trauma Recovery (MiStory), Ann Arbor, MI, USA
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Reid BO, Næss-Pleym LE, Haugland H, Dale J, Uleberg O, Nordstrand AE. Posttraumatic Stress Responses and Psychological Well-being in Norwegian Medical Helicopter Personnel. Air Med J 2022; 41:292-297. [PMID: 35595337 DOI: 10.1016/j.amj.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Emergency medical personnel are exposed to multiple stressors, including those of psychological etiologies. The aim of this study was to report the prevalence of anxiety, depression, and posttraumatic stress symptoms in Norwegian medical helicopter personnel and to determine to what degree they report personal growth or deprecation due to exposure to work-related events. METHODS This was a web-based, cross-sectional survey performed among rescue paramedics and physicians staffing helicopter emergency medical services and search and rescue helicopters between May 5, 2021, and July 5, 2021. Questions included demographic data, the traumatic events exposure index, the Generalized Anxiety Disorder 7 scale, the Patient Health Questionnaire 9 (Depression), the posttraumatic change scale, and the posttraumatic symptom scale. RESULTS Of the 245 eligible participants, 10 declined to take part and 74 failed to answer, producing a response rate of 66% (72 rescue paramedics and 89 physicians). Of the study population, 3.9 % reported manifest posttraumatic stress disorder symptoms, and 1.9% described moderate to severe depression and anxiety. The majority (76%) described posttraumatic emotional growth because of their work experience. CONCLUSION Despite exposure to several traumatic stressors, participants reported a lower prevalence of posttraumatic stress symptoms, depression, and anxiety compared with a Norwegian adult population.
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Affiliation(s)
- Bjørn Ole Reid
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway; Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.
| | - Lars Eide Næss-Pleym
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway; Department of Research and Development, Norwegian Air Ambulance Foundation, Oslo, Norway
| | - Helge Haugland
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway
| | - Jostein Dale
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway
| | - Oddvar Uleberg
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway
| | - Andreas Espetvedt Nordstrand
- Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Sun Y, Lam CB, Chung KKH. Being Hopeful and Mindful During Adversity: A Longitudinal Study on College Students’ Adjustment During COVID-19. Mindfulness (N Y) 2022; 13:1499-1509. [PMID: 35463480 PMCID: PMC9016695 DOI: 10.1007/s12671-022-01892-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/25/2022]
Abstract
Objectives The current study examined whether hope and mindfulness were associated with changes in two maladjustment measures, internalizing and externalizing behaviors, during the COVID-19 pandemic and tested sense of coherence as a mediator. The salutogenic theory of health, which posits that sense of coherence is central to individuals’ well-being in stressful situations and that individuals derive their sense of coherence from their generalized resistance resources (GRRs), was used to guide the analyses. Methods On two occasions separated by about 6 months, 253 Hong Kong college students (mean age = 21.0 years at time 1; 86% of them were women) filled in online questionnaires during the COVID-19 outbreaks. Path analysis was conducted to examine the interrelationships among hope and mindfulness, sense of coherence, and internalizing and externalizing behaviors. Results Results indicated that hope and mindfulness at time 1 were associated with internalizing and externalizing behaviors at time 2, even after controlling for confounding variables and prior levels of internalizing and externalizing behaviors. Moreover, sense of coherence at time 1 significantly mediated these associations. Conclusions Findings pointed to the potential roles of hope, mindfulness, and sense of coherence in understanding Chinese college students’ adjustment during the COVID-19 pandemic. Future research is needed to test whether sense of coherence and behavioral adjustment can be promoted through hope- and mindfulness-based intervention programs. Future research is also needed to examine the interrelationships among health-promoting assets, sense of coherence, and individual adjustment in samples of diverse cultural backgrounds.
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Affiliation(s)
- Yao Sun
- Centre for Child and Family Science, The Education University of Hong Kong, Taipo, Hong Kong
| | - Chun Bun Lam
- Centre for Child and Family Science, The Education University of Hong Kong, Taipo, Hong Kong
- Department of Early Childhood Education, The Education University of Hong Kong, 10, Lo Ping Road, Taipo, New Territories Hong Kong
| | - Kevin Kien Hoa Chung
- Centre for Child and Family Science, The Education University of Hong Kong, Taipo, Hong Kong
- Department of Early Childhood Education, The Education University of Hong Kong, 10, Lo Ping Road, Taipo, New Territories Hong Kong
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Hong E, Jung A, Woo K. A cross-sectional study on public health nurses' disaster competencies and influencing factors during the COVID-19 pandemic in Korea. BMC Public Health 2022; 22:731. [PMID: 35413863 PMCID: PMC9005315 DOI: 10.1186/s12889-022-13091-2] [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: 10/24/2021] [Accepted: 03/17/2022] [Indexed: 12/24/2022] Open
Abstract
Public health nurses are performing various roles during the COVID-19 pandemic: counseling, surveillance, specimen collection, epidemiological investigation, education, and vaccination. This study investigated their disaster competencies in the context of emerging infectious diseases, and identified their influencing factors based on Deci and Ryan's self-determination theory. A convenience sample of 242 was selected from public health nurses working in a metropolitan city of South Korea. Data were collected using a structured questionnaire and analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and multiple regression analysis using the SPSS Statistics ver. 23.0. Results showed that the significant factors influencing disaster competencies included "willingness to respond to a disaster," "preventive behavior," "experience of receiving education on emerging infectious diseases response," "public health center experience," "job satisfaction," and "education." This regression model explained 33.2% of the variance in disaster competencies. "Willingness to respond to a disaster" was the strongest factor affecting disaster competencies. Based on these results, it is concluded that interventions to improve disaster competencies and psychological well-being of public health nurses are needed. Additionally, strategies such as creating a supportive work environment, deploying experienced nurses primarily on the front line, and reducing the tasks of permanent public health nurses should be implemented.
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Affiliation(s)
- Eunjoo Hong
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Aeri Jung
- College of Nursing, Eulji University, 712 Dongil-ro, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Kyungmi Woo
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
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Donovan N. Peer support facilitates post-traumatic growth in first responders: A literature review. TRAUMA-ENGLAND 2022. [DOI: 10.1177/14604086221079441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction First responders are routinely exposed to traumatic workplace incidents that can result in post-traumatic stress disorder (PTSD). First responder organizations utilize different types of peer led programs to support first responders following a critical incident including the Critical Incident Stress Management Program (CISM) and stand-alone peer support programs. Little research has been done to determine the benefits or limitations of stand-alone peer support programs on the mental health of first responders. The aim of this project was to understand what characteristics of peer support facilitate post-traumatic growth (PTG) in first responders. Methods A literature search was completed using the City University of Seattle library database, ResearchGate and Google Scholar. The studies used in this review were found on EBCSOhost, ProQuest, PubMed and Wiley Online. This review includes literature published since 2006 that references post-traumatic growth in first responders, and/or their preferences for support, their coping styles and organizational impacts on growth. Thematic analysis was conducted to identify the themes and patterns in the final 10 research papers. Results This literature review identified five themes of formal and informal peer interactions that support PTG in first responders. (1) Peer support assists first responders with the processing of traumatic events and (2) managing organizational stressors. (3) Peer support alone may not lead to PTG and requires the use of adaptive coping behaviours. (4) First responders who actively engage with peer support experience increased well-being and (5) relational safety with peers encourages disclosure that leads to post-traumatic growth. Conclusion Formal and informal peer support contribute to post-traumatic growth (PTG) in first responders. Further research needs to be done to differentiate between the effects of trained peer support and support from colleagues.
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Montoro-Fernández E, Cárdenas-Gutiérrez AR, Bernal-Guerrero A. Entrepreneurial Resilience: A Case Study on University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2589. [PMID: 35270281 PMCID: PMC8910058 DOI: 10.3390/ijerph19052589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022]
Abstract
Entrepreneurial resilience refers to the capacity to face, overcome and project oneself after suffering life events with a negative impact. Emerging adulthood and the characteristics of university life facilitate the occurrence of stressful situations that can affect well-being. The aim of this phenomenological research is to explore the strategic components of entrepreneurial resilience and how young university students have shaped their entrepreneurial resilience after experiencing negative life events. The present research is a multiple case study that was developed through a mixed methodology. The methodological sequence was quantitative and qualitative, with priority given to the qualitative phase of the research. Ten university students with high levels of resilience were interviewed. The data were analysed using thematic analysis. The results indicate that resilience is built through intrapersonal and exopersonal processes. These processes make up a set of strategic dimensions related to entrepreneurial behaviour that are used for the construction of personal projects.
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Affiliation(s)
- Elisabet Montoro-Fernández
- Department of Communication and Education, Faculty of Social and Human Sciences, University Loyola Andalucía, 41704 Seville, Spain
| | - Antonio Ramón Cárdenas-Gutiérrez
- Department of Theory and History of Education and Social Pedagogy, Faculty of Education Sciences, Seville University, 41013 Seville, Spain; (A.R.C.-G.); (A.B.-G.)
| | - Antonio Bernal-Guerrero
- Department of Theory and History of Education and Social Pedagogy, Faculty of Education Sciences, Seville University, 41013 Seville, Spain; (A.R.C.-G.); (A.B.-G.)
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Reid BO, Næss-Pleym LE, Bakkelund KE, Dale J, Uleberg O, Nordstrand AE. A cross-sectional study of mental health-, posttraumatic stress symptoms and post exposure changes in Norwegian ambulance personnel. Scand J Trauma Resusc Emerg Med 2022; 30:3. [PMID: 35016708 PMCID: PMC8749923 DOI: 10.1186/s13049-021-00991-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background Posttraumatic stress disorder (PTSD) has been shown to be elevated among first responders (Emergency Medical Services, fire service, police force) compared to the general population. Examining the prevalence of mental health issues in a work force with an elevated occupational risk is fundamental towards ensuring their wellbeing and implementing safeguard measures. The goal of this study is therefore to report the prevalence of depression, anxiety, posttraumatic development, and PTSD in Norwegian ambulance personnel. Methods This study is a cross-sectional, anonymous, web-based survey (Questback®), performed among operative personnel employed in the Emergency Medical Services in the Regional Health Trust of Central Norway between 18. February and 9. April 2021. The study was sent to 1052 eligible participants. Questions reported demographic data, a traumatic events exposure index, Patient Health Questionnaire-9 (Depression), Generalized Anxiety Disorder-7 scale, Posttraumatic symptom scale (PTSD) and Posttraumatic change scale. Results The response rate in this study was 45.5% (n = 479/1052). The mean age of respondents was 37.1 years (std. 11.1) and 52.8% (n = 253) were male. Of the respondents, 80.6% (n = 386) were married or had a partner, and 91.6% (n = 439) reported having access to a peer support programme, with 34.9% (n = 167) reporting that they had utilized peer support. In this study, 5% (n = 24) showed a prevalence of manifest posttraumatic stress disorder symptoms, while 8.6% (n = 41) reported moderate to severe depression and 2.9% (n = 14) presented moderate to severe symptoms of general anxiety. Of the respondents, 77.2% (n = 370) reported personal growth because of their work experiences. Conclusions This study indicates that Norwegian ambulance personnel report a prevalence of posttraumatic stress symptoms and depression, which is slightly higher for men, and lower for the female proportion in this study, when compared to an adult Norwegian population. The vast majority of respondents reported personal growth because of their work experience, and both the degree of peer support and having a partner seem to influence levels of posttraumatic stress and -development. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00991-2.
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Affiliation(s)
- Bjørn Ole Reid
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway. .,Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.
| | - Lars Eide Næss-Pleym
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway
| | - Karin Elvenes Bakkelund
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway
| | - Jostein Dale
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway
| | - Oddvar Uleberg
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Espetvedt Nordstrand
- Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.,Department of Psychology, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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15
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Yeung NCY, Wong ELY, Cheung AWL, Leung CSY, Yeoh EK, Wong SYS. Finding the positives from the COVID-19 pandemic: factors associated with posttraumatic growth among nurses in Hong Kong. Eur J Psychotraumatol 2022; 13:2005346. [PMID: 35145608 PMCID: PMC8823681 DOI: 10.1080/20008198.2021.2005346] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Due to active involvement with patients for COVID-19 treatments, nurses are susceptible to adverse psychological outcomes amid the COVID-19 pandemic. Despite the distress, studies have suggested that nurses are able to experience positive changes (i.e. posttraumatic growth; PTG) during the pandemic. Research on other populations has also indicated that COVID-19-specific worries and work-related coping resources are associated with people's positive changes during the pandemic. OBJECTIVE This study examined how socio-demographic characteristics, COVID-19-related worries, and work-related variables (satisfaction with work and workplace pandemic guidelines) were associated with PTG among nurses in Hong Kong. METHODS Nurses (N = 1510) working in hospitals and community settings were recruited through nursing associations in Hong Kong between 8 August 2020 and 22 September 2020. They were invited to complete a cross-sectional survey measuring their sociodemographic characteristics, COVID-19 worries, and satisfaction with work and workplace pandemic-control measures. RESULTS Results from hierarchical regressions found that those working non-full-time (β = -0.06), affiliating with a religion (β = 0.24), having higher COVID-19-related worries and psychological distress (βs ranging from 0.12-0.15), and having higher work satisfaction (β = 0.14) were associated with higher PTG (ps < .05). Moreover, a significant interaction between psychological distress and satisfaction with workplace pandemic control guidelines emerged in explaining PTG (β = 0.08, p < .05), such that guideline satisfaction was only associated with higher PTG among those with higher distress (β = 0.09, p = .03), but not those with lower distress (β = -0.05, p > .05). CONCLUSIONS Nurses in Hong Kong did report positive changes amid the COVID-19 pandemic. Future studies could focus on the contributing factors of PTG to design for effective strategies to enhance resources for nurses to promote positive psychosocial outcomes.
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Affiliation(s)
- Nelson Chun-Yiu Yeung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cecilia Shih-Ya Leung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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16
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Mikutta C, Schmid JJ, Ehlert U. Resilience and Post-traumatic Stress Disorder in the Swiss Alpine Rescue Association. Front Psychiatry 2022; 13:780498. [PMID: 35401258 PMCID: PMC8985199 DOI: 10.3389/fpsyt.2022.780498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The present study aimed to assess the frequency of trauma exposure, the prevalence of possible post-traumatic stress disorder (PTSD), the extent of resilience, and sense of coherence among personnel of the Swiss alpine rescue association (ARS). METHODS Using a trilingual online survey approach, 465 mountain rescuers of the ARS were surveyed using the Posttraumatic Diagnostic Scale (PDS), the PTSD Checklist 5 (PCL-5), the Resilience Scale 13 and 14 (RS-13/-14), the Perceived Stress Scale 10 (PSS-10), the General Health Questionnaire 12 (GHQ-12), the Pittsburg Sleep Quality Index (PSQI), the Sense of Coherence Scale 13 (SOC-13), and the Berlin Social Support Scales (BSSS). RESULTS Although the rate of mountain rescuers having witnessed or experienced a traumatic event was high (71%), the prevalence of possible PTSD was low (0.9%). The sample showed high resilience and high sense of coherence. Resilience was positively correlated with work experience. Low perceived stress and high sense of coherence predicted resilience. The severity of PTSD symptoms was mainly predicted by low sense of coherence. Sense of coherence mediated the interaction between resilience and severity of PTSD symptoms. CONCLUSION The findings suggest that resilience and sense of coherence are indicative for the low prevalence of possible PTSD among mountain rescuers, and may therefore represent valuable screening and training parameters for mountain rescue personnel.
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Affiliation(s)
- Christian Mikutta
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Privatklinik Meiringen, Meiringen, Switzerland
| | - Julia J Schmid
- Department of Clinical Psychology, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Department of Clinical Psychology, University of Zurich, Zurich, Switzerland
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17
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Steel C, Tehrani N, Lewis G, Billings J. Risk factors for complex posttraumatic stress disorder in UK police. Occup Med (Lond) 2021; 71:351-357. [PMID: 34415342 PMCID: PMC8849141 DOI: 10.1093/occmed/kqab114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Police officers are frequently exposed to distressing and dangerous situations, increasing their risk of posttraumatic stress disorder (PTSD) and complex PTSD (C-PTSD). Research examining C-PTSD in police officers is sparse, particularly examination of the occupational risk factors for trauma symptoms. Aims This study aimed to examine the prevalence and risk factors for PTSD and C-PTSD in UK police officers. Methods A cross-sectional study was conducted using psychological health surveillance data from the UK National Police Wellbeing Service. Police officers were either from high-risk areas of work or had been referred for screening by occupational health practitioners regarding psychological distress. The primary outcome for this study was a positive screening of either PTSD or C-PTSD, measured using the International Trauma Questionnaire. A range of occupational, clinical and lifestyle factors was examined to establish their role as potential risk factors for PTSD and C-PTSD. Results In total, 2444 UK police officers were included, with 89% from high-risk areas of work. A prevalence of 3% for PTSD and 2% for C-PTSD was found in police officers from high-risk areas of work. Higher work stress and lower manager support were found to increase the odds of C-PTSD but not PTSD. Higher personal trauma history increased the risk for PTSD and C-PTSD equally. Conclusions Work-related occupational factors increased the odds of PTSD and C-PTSD in police officers, which could be important risk factors for trauma symptoms within police officers. Efforts should be made to improve the working environment of police officers to help improve their psychological well-being.
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Affiliation(s)
- C Steel
- Division of Psychiatry, University College London, London, UK
| | | | - G Lewis
- Division of Psychiatry, University College London, London, UK
| | - J Billings
- Division of Psychiatry, University College London, London, UK
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18
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Loef J, Vloet LCM, Vierhoven PH, van der Schans L, Neyman-Lubbers Y, de Vries-de Winter C, Ebben RHA. Starting ambulance care professionals and critical incidents: a qualitative study on experiences, consequences and coping strategies. BMC Emerg Med 2021; 21:110. [PMID: 34620095 PMCID: PMC8495434 DOI: 10.1186/s12873-021-00500-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ambulance care professionals are regularly confronted with critical incidents that increase risks for mental health disorders. To minimize these risks, it is important that ambulance care professionals adequately cope with critical incidents. Especially from the perspective of starting ambulance care professionals it is unknown which coping styles they use when experiencing a critical incident and how they are trained to cope with critical incidents. The aim of this study was to gain insight in (a) what starting ambulance care professionals describe as critical incidents, (b) how they experience these critical incidents and their consequences, (c) how they cope with these incidents, and (d) how they are trained and guided to cope with these incidents. METHODS A qualitative design with individual, semi-structured interviews was used. The data was analyzed by using inductive thematic analysis. RESULTS Twenty-two starting ambulance care professionals were interviewed of which, 11 were male. The age ranged from 23 to 31 years, with 11 participants being 27 years or younger. Three key-themes emerged that make an incident critical: (1) emotional connection versus emotional detachment, (2) feeling loss of control, and (3) incomprehension. All participants experienced several short to middle term physical, psychological and social consequences after encountering a critical incident. Starting ambulance care professionals applied different coping strategies during different phases of the ambulance care process: a mix of depersonification, focus on the medical task, support from colleagues and their own network, seeking confirmation, and distraction. Most starting ambulance care professionals don't actively remember they received education about coping with critical incidents during their initial educational program. During and after traineeships, the workplace preceptor has a crucial role for starting ambulance care professionals to learn them how to cope with critical incidents. CONCLUSIONS Three key-themes interact to make an incident more critical for starting ambulance care professionals. To cope with these critical incidents, starting ambulance care professionals use a variety of coping strategies. These results can be used to develop training and coaching for starting ambulance care professionals so they can adequately cope with critical incidents.
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Affiliation(s)
- Jorik Loef
- Emergency Medical Service Brabant Midden-West-Noord, 's Hertogenbosch, The Netherlands. .,Research Department of Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands.
| | - Lilian C M Vloet
- Research Department of Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands.,IQ healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Peter-Hans Vierhoven
- Research Department of Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands.,, Dutch platform of Bachelor of Medical Health, Utrecht, The Netherlands
| | - Leonie van der Schans
- Dutch Society of Bachelor of Medical Health, Utrecht, The Netherlands.,Emergency Medical Service Amsterdam, Amsterdam, The Netherlands
| | - Yvonne Neyman-Lubbers
- Emergency Medical Service Brabant Midden-West-Noord, 's Hertogenbosch, The Netherlands
| | - Christine de Vries-de Winter
- Research Department of Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands.,, Dutch platform of Bachelor of Medical Health, Utrecht, The Netherlands
| | - Remco H A Ebben
- Research Department of Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands
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19
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Lau BHP, Chan CLW, Ng SM. Post-traumatic Growth in the First COVID Outbreak in Hong Kong. Front Psychol 2021; 12:675132. [PMID: 34603120 PMCID: PMC8481897 DOI: 10.3389/fpsyg.2021.675132] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022] Open
Abstract
Post-traumatic growth (PTG) emerges from highly stressful situations. The coronavirus (COVID) pandemic may qualify as one. This study investigated the PTG among Hong Kong citizens during the first outbreak in spring 2020, shortly after a large-scale social movement subsided. A longitudinal online survey was launched during the peak (Time 1) and the palliation (Time 2) of the outbreak. Among the 327 participants who completed both waves, 28.4% exhibited probable post-traumatic stress disorder (PTSD) in Time 1, while 18.0% reported significant PTG in at least one domain in Time 2. The interaction between the sense of coherence (SOC) and post-traumatic stress mediated the relationship between Time 1 perceived outbreak severity and Time 2 PTG, such that PTG was more likely among participants with higher post-traumatic stress and SOC. PTG was also associated with a weaker contingency between Time 1 and Time 2 perceived outbreak severity. Echoing the transformational model, our findings show that both experienced stress and coping resources are essential for PTG to emerge. We also demonstrated how PTG might lead to more flexible risk perceptions according to the development of the outbreak.
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Affiliation(s)
- Bobo Hi Po Lau
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong, SAR China.,Wan Chow Yuk Fan Centre for Interdisciplinary Evidence-Based Practice & Research, Hong Kong Shue Yan University, Hong Kong, Hong Kong, SAR China
| | - Cecilia Lai Wan Chan
- Centre on Behavioral Health, University of Hong Kong, Hong Kong, Hong Kong, SAR China.,Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Siu Man Ng
- Centre on Behavioral Health, University of Hong Kong, Hong Kong, Hong Kong, SAR China.,Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Hong Kong, SAR China
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20
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Ord AS, Stranahan KR, Hurley RA, Taber KH. Stress-Related Growth: Building a More Resilient Brain. J Neuropsychiatry Clin Neurosci 2021; 32:A4-212. [PMID: 32729793 DOI: 10.1176/appi.neuropsych.20050111] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anna S Ord
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Ord, Hurley, Taber); the Mental Health Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Stranahan); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Kathryn R Stranahan
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Ord, Hurley, Taber); the Mental Health Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Stranahan); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Robin A Hurley
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Ord, Hurley, Taber); the Mental Health Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Stranahan); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Katherine H Taber
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Ord, Hurley, Taber); the Mental Health Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Stranahan); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
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21
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Karrasch S, Hitzler M, Behnke A, Tumani V, Kolassa IT, Rojas R. Chronic and Traumatic Stress Among Emergency Medical Services Personnel. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2020. [DOI: 10.1026/1616-3443/a000600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Abstract. Background: Emergency medical services (EMS) personnel are frequently confronted with multiple stressful and potentially traumatic events as well as adverse working conditions. Objective: This narrative review provides an overview of the impact of adverse mission experiences and working conditions on the mental and physical health of EMS personnel. Methods: We summarize the empirical findings on prevalence rates as well as individual vulnerability factors and resilience. Results: EMS personnel show the highest prevalence rates of stress-related health problems among first responders. The article outlines prevention and intervention approaches that contribute to maintaining and improving the mental and physical health of EMS personnel. Conclusion: In the future, further evidence-based intervention measures should be developed to adequately support this professional group.
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Affiliation(s)
- Sarah Karrasch
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - Melissa Hitzler
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - Alexander Behnke
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - Visal Tumani
- Department of Psychiatry and Psychotherapy III, Ulm University, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - Roberto Rojas
- University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Germany
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22
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Sense of Coherence and Psychological Distress Among Healthcare Workers During the COVID-19 Pandemic in Spain. SUSTAINABILITY 2020. [DOI: 10.3390/su12176855] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The health crisis triggered by COVID-19 and the preventive measures taken to control it have caused a strong psychological impact on the population, especially on healthcare professionals. Risk exposure, uncertainty about how to approach the disease, care and emotional overburden, lack of resources, or unclear ever-changing protocols are, among others, psychological distress risk factors for the healthcare professionals who have faced this dramatic scenario on the front line. On the other hand, the Sense of Coherence (SOC) is a competence that could help these professionals perceive the situation as understandable, manageable, and meaningful, facilitating the activation of their resilience. This work aims to describe the levels of psychological distress and SOC of healthcare professionals during the crisis caused by COVID-19, the relationship between both variables, and their health status. A cross-sectional descriptive study with a sample of 1459 currently active healthcare workers was developed. GHQ-12 and SOC-13 were used for data collection. Bivariate analyses were performed, including Chi-Squared Test, Student’s T-Test, Analysis of Variance—ANOVA (with Bonferroni test for multiple comparisons), and correlations. Cohen’s d or Cramer’s V effect size measurements were also provided. The results showed that 80.6% of healthcare professionals had psychological distress, and the mean score on the SOC-13 scale was 62.8 points (SD = 12.02). Both psychological distress and SOC were related to the presence of COVID-19 symptoms, as well as with contact history. Professionals with psychological distress showed a lower SOC. Taking care of the mental health of healthcare professionals is essential to effectively cope with the COVID-19 pandemic. Given the psychological impact of working in the current menacing scenario, people on the front line against the disease should be protected, minimizing risks, providing them with resources and support, and fostering their coping skills.
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23
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Schäfer SK, Sopp MR, Staginnus M, Lass-Hennemann J, Michael T. Correlates of mental health in occupations at risk for traumatization: a cross-sectional study. BMC Psychiatry 2020; 20:335. [PMID: 32586338 PMCID: PMC7318450 DOI: 10.1186/s12888-020-02704-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hospitals, police stations, and fire departments are highly demanding workplaces. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff members manage to sustain their mental health. The current study is the first to investigate three health-promoting factors simultaneously among three different, highly demanding occupations. METHODS The present cross-sectional survey investigated health-promoting factors (sense of coherence - SOC, trait-resilience, locus of control - LOC) and mental health outcomes (general psychopathological symptom burden, posttraumatic stress, burnout) in medical staff (n = 223), police officers (n = 257), and firefighters (n = 100). RESULTS Among all occupations, SOC, trait-resilience, and an internal LOC were negatively associated with general psychopathological symptoms, posttraumatic stress, and burnout symptoms. By contrast, all these outcome measures were positively correlated with an external LOC. Multiple regression models including all health-promoting factors explained 56% of the variance in general psychopathological symptoms and 27% in posttraumatic stress symptoms. Among all occupations, SOC was the strongest predictor of both general psychopathological symptom burden and posttraumatic stress symptoms. Multigroup path analyses revealed minor differences across occupations, mainly driven by a stronger influence of LOC in police officers. CONCLUSION Across all occupations, SOC was identified as the most important health-promoting factor. Future longitudinal studies should further examine the causal link between health-promoting factors and mental distress in different workplaces. Such studies will also allow for further development and evaluation of resilience promoting programs.
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Affiliation(s)
- Sarah K. Schäfer
- Department of Psychology, Saarland University, Building A1 3, 66123 Saarbruecken, Germany
| | - M. Roxanne Sopp
- Department of Psychology, Saarland University, Building A1 3, 66123 Saarbruecken, Germany
| | - Marlene Staginnus
- Department of Psychology, Saarland University, Building A1 3, 66123 Saarbruecken, Germany
| | - Johanna Lass-Hennemann
- Department of Psychology, Saarland University, Building A1 3, 66123 Saarbruecken, Germany
| | - Tanja Michael
- Department of Psychology, Saarland University, Building A1 3, 66123 Saarbruecken, Germany
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24
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Taube LN, Mussap AJ. Growth from adversity in trans and gender diverse people of color. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 23:194-213. [PMID: 35403108 PMCID: PMC8986204 DOI: 10.1080/26895269.2020.1777615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Trans-negativity and gender-based discrimination negatively impact on the wellbeing and mental health in transgender (trans) and gender diverse people (TGD). There is limited research on TGD people thriving under adversity, and no research to date has considered TGD people of color in this context. METHOD We used the Post-Traumatic Growth Inventory (PTGI-X) to survey 125 TGD people of color and 625 white TGD adults (18 to 68 years old, M = 26.0, SD = 9.2) about their experiences of growth from adversity. Confirmatory factor analysis (CFA), using sub-sampling to compensate for our unequal sample sizes, supported a five-factor structure of the PTGI-X consisting of growth in relating to others, finding new possibilities, personal strength, greater appreciation of life, and spiritual/existential change. Measurement invariance tests confirmed configural, metric, and scalar invariance of this structure across the two TGD subgroups. RESULTS A MANOVA revealed that growth from adversity in TGD participants was generally greater than that reported by people who have recently been exposed to a traumatic event. T-tests revealed that TGD people of color experienced more growth in terms of relating to others and more personal strength than white TGD participants. Subsequent hierarchical regressions revealed that race moderated associations between PTGI-X scores and personal well-being, with TGD people of color reporting more benefits (more well-being) at high levels of growth but also more deficits (less well-being) at low levels of growth than the white TGD subgroup. CONCLUSION The results support the use of the PTGI-X with TGD populations and across racial TGD subgroups and indicate that growth from adversity is not only prevalent in TGD people but also relevant to positive outcomes, particularly in TGD people of color.
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Affiliation(s)
- Lee N. Taube
- School of Psychology, Deakin University, Melbourne, VIC, Australia
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Sharma SR, Gonda X, Dome P, Tarazi FI. What's Love Got to do with it: Role of oxytocin in trauma, attachment and resilience. Pharmacol Ther 2020; 214:107602. [PMID: 32512017 DOI: 10.1016/j.pharmthera.2020.107602] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/27/2020] [Indexed: 02/06/2023]
Abstract
Oxytocin (OT) is a neurohypophysial hormone and neuropeptide produced by the hypothalamus and released by the pituitary gland. It has multiple physiological roles including stimulation of parturition and lactation, and promotion of pro-adaptive social behaviors necessary for mammalian survival. OT interacts with one receptor subtype: the OT receptor (OTR) which, upon stimulation, triggers different intracellular signal transduction cascades to mediate its physiological actions. Preclinical studies show that OT regulates social behaviors such as pair bonding, recognition and social interaction. It also coordinates the activation of the hypothalamic-pituitary-adrenal (HPA) axis and the release of corticotrophin-releasing hormone. Further evidence suggests that OT plays an important role in regulating caloric intake and metabolism, and in maintaining electrolyte and cardiovascular homeostasis. OT is also involved in attenuating the neurophysiological and neurochemical effects of trauma on the brain and body by facilitating both physical attachment such as wound healing, and psychological/social attachment, thereby increasing resilience to subsequent traumatic events. Clinical trials have reported that intranasal administration of OT provides therapeutic benefits for patients diagnosed with traumatic stress-related diseases such as major depressive disorders and post-traumatic stress disorder. OT's therapeutic benefits may result from context-dependent interactions with key neural pathways (social, cognitive, and reward), neurotransmitters (dopamine, norepinephrine, serotonin, and endogenous opioids), and biomarkers (adrenocorticotropic hormone, cortisol, and dehydroepiandrosterone sulfate), that lead to a decrease in stress -associated behaviors, and facilitate post-traumatic growth, ultimately leading to increased resilience, through improved social cohesion and attachment. OT induced-augmentation of physical and cognitive resilience may play a significant role in both the prevention of, and improved clinical outcomes for, traumatic stress-related disorders following either acute or enduring traumatic experiences.
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Affiliation(s)
- Samata R Sharma
- Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE Neurochemistry and Neuropsychopharmacology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary; NAP-2-SE New Antidepressant Target Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary; Laboratory of Suicide Prevention and Research, National Institute for Psychiatry and Addictions, Budapest, Hungary
| | - Peter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; Laboratory of Suicide Prevention and Research, National Institute for Psychiatry and Addictions, Budapest, Hungary
| | - Frank I Tarazi
- Department of Psychiatry and Neuroscience Program, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA
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Behnke A, Rojas R, Karrasch S, Hitzler M, Kolassa IT. Deconstructing Traumatic Mission Experiences: Identifying Critical Incidents and Their Relevance for the Mental and Physical Health Among Emergency Medical Service Personnel. Front Psychol 2019; 10:2305. [PMID: 31695639 PMCID: PMC6817588 DOI: 10.3389/fpsyg.2019.02305] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/27/2019] [Indexed: 12/11/2022] Open
Abstract
Emergency medical service (EMS) personnel frequently encounter emotionally stressful or even traumatic incidents in their line of duty. In this study, a checklist of emotionally stressful events for the German EMS was introduced. A mixed-method approach was used to identify mission events that were critical for the development of mental and physical stress symptoms. Data were collected in a cross-sectional sample of 102 EMS employees. A quantitative content analysis of the participants' worst experiences on duty indicated, traumatic missions to be a concatenation of two to five emotionally stressful events. Rescue missions were experienced as traumatic if (i) EMS personnel became victims of attacks or threats; (ii) certain circumstances caused them to give up their professional detachment from patients; (iii) EMS personnel perceived the overall mission as exceptionally tragic. In subsequent correlation analyses, the corresponding checklist items showed consistent positive associations with the post-traumatic, depressive and physical stress symptoms among the study cohort. Within the exploratory regressions, the sum score of critical on-duty exposures contributed incrementally to the prediction of mental and physical stress symptoms when non-work-related trauma exposure and perceived social support were also considered. Findings point toward the importance of considering the cumulative burden of critical incidents for the long-term health of EMS personnel. Future research is needed to investigate, how on-duty trauma affects the social support EMS personnel received from their work and personal relationships.
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Affiliation(s)
- Alexander Behnke
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Roberto Rojas
- University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Sarah Karrasch
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Melissa Hitzler
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Iris-Tatjana Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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