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Zhou YW, Zheng JY, Shan CY, Yang HS, Su YS, Wang DB, Ni JX, Lan LJ, Lian XZ, Zhou ZM. Perceived stress and influencing factors for the people at high risk to COVID-19 in centralized quarantine camps in Wenzhou, China. J Public Health (Oxf) 2024; 46:e430-e438. [PMID: 38909990 DOI: 10.1093/pubmed/fdae110] [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: 12/20/2023] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND This study was designed to assess stress levels and related factors during the coronavirus disease 2019 (COVID-19) epidemic among individuals in centralized quarantine camps in Wenzhou, China. METHODS The survey was conducted using a questionnaire. The questionnaire included questions on sociodemographic characteristics, life events related to the COVID-19 and stressful situations, as well as Perceived Stress Scale-14. Participants included close contacts of patients with COVID-19 or at-risk individuals in quarantine camps. Multivariate logistic regression was used to analyze different factors affecting perceived stress. RESULTS The prevalence of high stress among quarantine camp participants was 37.45%. Of the 881 respondents, 51.99% were concerned about the difficulty of controlling the epidemic, 46.20% were concerned about the health of themselves and their family members and 39.61% were concerned about not being able to leave their homes. Multivariate logistic regression analysis revealed statistically significant differences in the prevalence of stress among different groups for certain variables, including occupation, education level and knowledge of COVID-19 (all P < 0.05). Our study found that at-risk individuals and close contacts experienced high levels of stress in quarantine camps during the COVID-19 pandemic. CONCLUSIONS These findings suggest that centralized quarantine policies should be adapted and optimized to minimize negative psychological effects on quarantined individuals.
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Affiliation(s)
- Yi-Wei Zhou
- Business School, University of Shanghai for Science and Technology, Shanghai 200093, China
- School of Intelligent Emergency Management, University of Shanghai for Science and Technology, Shanghai 200093, China
- Smart Urban Mobility Institute, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Jian-Yong Zheng
- Chronic Disease, Ouhai Center for Disease Control and Prevention, Wenzhou 325000, China
| | - Chun-Yan Shan
- International Collaborations, The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou 325007, China
| | - Hong-Sheng Yang
- International Collaborations, The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou 325007, China
| | - Yi-Suo Su
- Chronic Disease, Ouhai Center for Disease Control and Prevention, Wenzhou 325000, China
| | - Deborah Baofeng Wang
- International Collaborations, The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou 325007, China
| | - Jian-Xiao Ni
- Chronic Disease, Ouhai Center for Disease Control and Prevention, Wenzhou 325000, China
| | - Liu-Jie Lan
- Chronic Disease, Ouhai Center for Disease Control and Prevention, Wenzhou 325000, China
| | - Xin-Ze Lian
- School of Data Science and Artificial Intelligence, Wenzhou University of Technology, Wenzhou 325035, China
| | - Zu-Mu Zhou
- International Collaborations, The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou 325007, China
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Gutmanis I, Sanni A, McGeer A, Maunder R, Robertson N, Coleman BL. Level of patient contact and Impact of Event scores among Canadian healthcare providers during the COVID-19 pandemic. BMC Health Serv Res 2024; 24:947. [PMID: 39164701 PMCID: PMC11334392 DOI: 10.1186/s12913-024-11426-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 08/12/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Healthcare providers (HCP) continue to provide patient care during the COVID-19 pandemic despite the known risks for transmission. Studies conducted early in the pandemic showed that factors associated with higher levels of distress among HCP included being of younger age, female, in close contact with people with COVID-19, and lower levels of education. The goal of this study was to determine if level of patient contact was associated with concern for post-traumatic stress disorder (PTSD) as measured by the Impact of Event Scale-Revised (IES-R). METHODS This cross-sectional study, embedded within a prospective cohort study, recruited HCP working in hospitals in four Canadian provinces from June 2020 to June 2023. Data were collected at enrolment and annually from baseline surveys with the IES-R scale completed at withdrawal/study completion. Modified Poisson regression was used to determine the association between level of patient contact and concern for PTSD (i.e., IES-R scores ≥24). RESULTS The adjusted rate ratio (RR) associated with concern for PTSD among HCP with physical contact/direct patient care was 1.19 (95% confidence interval (CI) 1.03, 1.38) times higher than for HCP with no direct contact. In fully adjusted linear regression models, physical care/contact was associated with higher avoidance and hyperarousal scores, but not intrusion scores. CONCLUSIONS Administrators and planners need to consider the impact of heightened and ongoing stress among HCP by providing early screening for adverse emotional outcomes and delivery of tailored preventive strategies to ensure immediate and long-term HCP health.
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Affiliation(s)
- Iris Gutmanis
- Sinai Health System, 600 University Ave, Toronto, ON, M5G 1X5, Canada
| | - Ayodele Sanni
- Sinai Health System, 600 University Ave, Toronto, ON, M5G 1X5, Canada
| | - Allison McGeer
- Sinai Health System, 600 University Ave, Toronto, ON, M5G 1X5, Canada
- University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada
| | - Robert Maunder
- Sinai Health System, 600 University Ave, Toronto, ON, M5G 1X5, Canada
- University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada
| | - Nicole Robertson
- Sinai Health System, 600 University Ave, Toronto, ON, M5G 1X5, Canada
| | - Brenda L Coleman
- Sinai Health System, 600 University Ave, Toronto, ON, M5G 1X5, Canada.
- University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada.
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Silva MAXD, Santos MMA, Araújo AB, Galvão CRC, Barros MMMD, Silva ACDOE, Souza MBCAD, Barroso BIDL. Risk factors for healthcare professionals' mental health during the COVID-19 pandemic: a systematic review. CIENCIA & SAUDE COLETIVA 2023; 28:3033-3044. [PMID: 37878944 DOI: 10.1590/1413-812320232810.12102023] [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: 06/01/2022] [Accepted: 06/01/2023] [Indexed: 10/27/2023] Open
Abstract
The aim of the present study was to map the available evidence on the mental health risk factors of frontline health professionals during the COVID-19 pandemic. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was independently carried out by four researchers, following the selection criteria in the electronic databases: PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. The data processing used Zotero software, responsible for creating and importing items according to the criteria established by the research. A total of 18,733 articles were found, of which 2,722 were excluded by the Zotero software because they were in duplicate, and another 366 were manually excluded. After applying the selection criteria, 43 articles entered the final analysis of this review. It is recommended that new scientific research be carried out, especially focusing on the analysis of health workers' mental health, aiming at providing the basis to create and implement public mental health programs and policies for workers.
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Affiliation(s)
- Mariane Alexandra Xavier da Silva
- Departamento de Terapia Ocupacional, Universidade Federal da Paraíba. Brasil. Campus I, Cidade Universitária. 58051-900 João Pessoa PB Brasil.
| | - Mairana Maria Angélica Santos
- Departamento de Terapia Ocupacional, Universidade Federal da Paraíba. Brasil. Campus I, Cidade Universitária. 58051-900 João Pessoa PB Brasil.
| | - Angélica Barros Araújo
- Programa de Pós-Graduação em Enfermagem, Universidade Federal da Paraíba. João Pessoa PB Brasil
| | - Cláudia Regina Cabral Galvão
- Departamento de Terapia Ocupacional, Universidade Federal da Paraíba. Brasil. Campus I, Cidade Universitária. 58051-900 João Pessoa PB Brasil.
| | - Márcia Maria Mont'Alverne de Barros
- Departamento de Terapia Ocupacional, Universidade Federal da Paraíba. Brasil. Campus I, Cidade Universitária. 58051-900 João Pessoa PB Brasil.
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Robins-Browne K, Lewis M, Burchill LJ, Gilbert C, Johnson C, O'Donnell M, Kotevski A, Poonian J, Palmer VJ. Interventions to support the mental health and well-being of front-line healthcare workers in hospitals during pandemics: an evidence review and synthesis. BMJ Open 2022; 12:e061317. [PMID: 36344001 PMCID: PMC9644079 DOI: 10.1136/bmjopen-2022-061317] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Pandemics negatively impact healthcare workers' (HCW's) mental health and well-being causing additional feelings of anxiety, depression, moral distress and post-traumatic stress. A comprehensive review and evidence synthesis of HCW's mental health and well-being interventions through pandemics reporting mental health outcomes was conducted addressing two questions: (1) What mental health support interventions have been reported in recent pandemics, and have they been effective in improving the mental health and well-being of HCWs? (2) Have any mobile apps been designed and implemented to support HCWs' mental health and well-being during pandemics? DESIGN A narrative evidence synthesis was conducted using Cochrane criteria for synthesising and presenting findings when systematic review and pooling data for statistical analysis are not suitable due to the heterogeneity of the studies. DATA SOURCES Evidence summary resources, bibliographic databases, grey literature sources, clinical trial registries and protocol registries were searched. ELIGIBILITY CRITERIA Subject heading terms and keywords covering three key concepts were searched: SARS-CoV-2 coronavirus (or similar infectious diseases) epidemics, health workforce and mental health support interventions. Searches were limited to English-language items published from 1 January 2000 to 14 June 2022. No publication-type limit was used. DATA EXTRACTION AND SYNTHESIS Two authors determined eligibility and extracted data from identified manuscripts. Data was synthesised into tables and refined by coauthors. RESULTS 2694 studies were identified and 27 papers were included. Interventions were directed at individuals and/or organisations and most were COVID-19 focused. Interventions had some positive impacts on HCW's mental health and well-being, but variable study quality, low sample sizes and lack of control conditions were limitations. Two mobile apps were identified with mixed outcomes. CONCLUSION HCW interventions were rapidly designed and implemented with few comprehensively described or evaluated. Tailored interventions that respond to HCWs' needs using experience co-design for mental health and well-being are required with process and outcome evaluation.
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Affiliation(s)
- Kate Robins-Browne
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
| | - Matthew Lewis
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
- The ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
| | - Luke James Burchill
- The ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Department of Cardiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Cecily Gilbert
- The Centre for Digital Transformation of Health Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Vic, Australia
| | - Caroline Johnson
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
- The ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
| | - Meaghan O'Donnell
- The Department of Psychiatry, Melbourne Medical School, Facutly of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Vic, Australia
| | - Aneta Kotevski
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Jasmine Poonian
- Emergency Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Victoria J Palmer
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
- The ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
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Xiong NN, Fan TT, Leonhart R, Fritzsche K, Liu Q, Luo L, Stein B, Waller C, Huang M, Müller MM. Workplace factors can predict the stress levels of healthcare workers during the COVID-19 pandemic: First interim results of a multicenter follow-up study. Front Public Health 2022; 10:1002927. [PMID: 36388352 PMCID: PMC9663923 DOI: 10.3389/fpubh.2022.1002927] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022] Open
Abstract
Background Research is lacking on the long-term influence of workplace factors on the mental health of health care workers during the COVID-19 pandemic. Methods We distributed two online surveys to health care workers between May and October 2020 (T1) and between February and April 2021 (T2). Perceived stress, coronavirus-related risks, and workplace factors were measured via self-report questionnaires at both time points. We conducted hierarchical linear regression to investigate the predictive factors for high stress. Results A total of 2,110 participants from seven countries and 4,240 participants from nine countries were enrolled at T1 and T2, respectively. Among them, 612 participated in both surveys. We called this cohort T1 + T2. High stress was reported in 53.8 and 61.6% of participants at T1 and T2, respectively. In cohort T1 + T2, compared with the baseline, the level of stress rose significantly (6.0 ± 2.9 vs. 6.4 ± 3.1), as did health/safety in the workplace (3.9 ± 0.8 vs. 4.2 ± 0.7). Unfortunately, we did not detect any significant difference concerning support in the workplace. Among all factors at baseline, being older than 35 [β (95% CI) = -0.92 (-1.45, -0.40)], support [-0.80 (-1.29, -0.32)], and health/safety in the workplace [-0.33 (-0.65, -0.01)] were independent protective factors, while a positive history of mental disorders [0.81 (0.26, 1.37)] and rejection in private life [0.86 (0.48, 1.25)] were risk factors for high stress at T2. Conclusion To relieve the high stress of health care workers, organizational-level approaches should be implemented, especially measures designed to enhance support, health/safety in the workplace, and to reduce the rejection of the public.
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Affiliation(s)
- Na-na Xiong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Teng-teng Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China,*Correspondence: Teng-teng Fan
| | - Rainer Leonhart
- Department for Social Psychology and Methodology, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Freiburg, Freiburg, Germany
| | - Qi Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Lei Luo
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Mingjin Huang
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Markus M. Müller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany,Social and Organizational Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
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Andhavarapu S, Yardi I, Bzhilyanskaya V, Lurie T, Bhinder M, Patel P, Pourmand A, Tran QK. Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114890. [PMID: 36260970 PMCID: PMC9573911 DOI: 10.1016/j.psychres.2022.114890] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/02/2022] [Accepted: 10/06/2022] [Indexed: 01/05/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I2 >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I2 >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.
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Affiliation(s)
- Sanketh Andhavarapu
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Isha Yardi
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Vera Bzhilyanskaya
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Tucker Lurie
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mujtaba Bhinder
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Priya Patel
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, 22 South Greene Street, Suite T3N45, Baltimore, MD 21043, United States; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States.
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"Did You Bring It Home with You?" A Qualitative Investigation of the Impacts of the COVID-19 Pandemic on Victorian Frontline Healthcare Workers and Their Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084897. [PMID: 35457765 PMCID: PMC9027899 DOI: 10.3390/ijerph19084897] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/30/2022] [Accepted: 04/13/2022] [Indexed: 02/04/2023]
Abstract
Concerns regarding the physical and mental health impacts of frontline healthcare roles during the COVID-19 pandemic have been well documented, but the impacts on family functioning remain unclear. This study provides a unique contribution to the literature by considering the impacts of the COVID-19 pandemic on frontline healthcare workers and their families. Thirty-nine frontline healthcare workers from Victoria, Australia, who were parents to at least one child under 18 were interviewed. Data were analysed using reflexive thematic analysis. Five superordinate and 14 subordinate themes were identified. Themes included more family time during lockdowns, but at a cost; changes in family responsibilities and routines; managing increased demands; healthcare workers hypervigilance and fear of bringing COVID-19 home to their family members; ways in which families worked to “get through it”. While efforts have been made by many healthcare organisations to support their workers during this challenging time, the changes in family functioning observed by participants suggest that more could be done for this vulnerable cohort, particularly with respect to family support.
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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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Abstract
This review covers the thematic series of 22 papers selected from among manuscripts published by BJPsych Open concerning coronavirus disease 2019 (COVID-19) and healthcare. We report nine papers that cover concepts and epidemiology relating to the public and patients. We review 11 papers about the impact of COVID-19 on healthcare services and their staff in 15 countries. Two papers consider the psychosocial impact on staff working in mental health services in the UK. Most papers report cross-sectional analyses of data collected from convenience samples by self-reported surveys conducted at single times. They have limitations of generalisability, do not enable conclusions about diagnosis or causality, and many are likely to have attendant bias and noise. BJPsych Open published these papers to meet requirements for early indications of the mental health impact of COVID-19 on the public and on healthcare staff. They claim high prevalence of symptoms of anxiety, depression and post-traumatic stress. We contrast these findings with selected reports of studies with different methodologies published elsewhere. We emphasise the need for longitudinal clinical studies with refined sampling and methodological rigour. We identify several longitudinal research programmes; two in this series. We advocate tuning advice offered about caring for the public and healthcare staff to the realities of their circumstances and their perceptions of need in the context of findings from further longitudinal studies. We draw attention to the importance of the social, relationship and environmental circumstances of the public and healthcare staff in order to understand their distress and their risks of developing mental health disorders.
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Affiliation(s)
- Richard Williams
- Professor Emeritus of Mental Health Strategy, Welsh Institute for Health and Social Care, University of South Wales, UK; Presidential Lead for COVID-19, Emergency Preparedness and Mental Health to the Royal College of Psychiatrists, UK; and Director of the Psychosocial and Mental Health Programme for the Faculty of Pre-Hospital Care, Royal College of Surgeons of Edinburgh, UK
| | - Kenneth R Kaufman
- Professor of Psychiatry, Neurology and Anesthesiology, Rutgers Robert Wood Johnson Medical School, USA; and Visiting Professor, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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10
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Fernández-Ávalos MI, Pérez-Marfil MN, Fernández-Alcántara M, Ferrer-Cascales R, Cruz-Quintana F, Turnbull OH. Post-Traumatic Growth in Professionals Caring for People with Intellectual Disabilities during COVID-19: A Psychological Intervention. Healthcare (Basel) 2021; 10:healthcare10010048. [PMID: 35052212 PMCID: PMC8775061 DOI: 10.3390/healthcare10010048] [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: 11/16/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Health professionals present a greater vulnerability to the effects of COVID-19 on their mental health, especially those who work with vulnerable groups such as those who suffer from intellectual disability (ID). The objective of the present research was to develop and verify the effectiveness of a psychological intervention for professionals in the field of ID to improve their mental health during this health crisis. METHODS A total of 32 professionals participated. The variables measured were: post-traumatic growth, mental health, burnout, coping strategies, resilience, life satisfaction, optimism, and cognitive and affective empathy. RESULTS The results revealed statistically significant differences in the post-traumatic growth variable. In the rest of the variables (mental health, burnout, coping strategies, resilience, vital satisfaction, optimism, and empathy), no significant differences between groups were found. CONCLUSIONS An increase in the levels of post-traumatic growth was observed in the intervention group after a brief online psychological intervention. However, given the small sample size, these results should be taken with caution. Institutions should foster and promote interventions aimed at reducing the high emotional impact produced by COVID-19 in professionals that care for people diagnosed with ID.
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Affiliation(s)
- María Inmaculada Fernández-Ávalos
- Faculty of Health Sciences, Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (M.I.F.-Á.); (M.F.-A.); (R.F.-C.)
| | - María Nieves Pérez-Marfil
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain;
- End-of-Life Research Network (EOL), 18071 Granada, Spain
- Correspondence:
| | - Manuel Fernández-Alcántara
- Faculty of Health Sciences, Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (M.I.F.-Á.); (M.F.-A.); (R.F.-C.)
- End-of-Life Research Network (EOL), 18071 Granada, Spain
| | - Rosario Ferrer-Cascales
- Faculty of Health Sciences, Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (M.I.F.-Á.); (M.F.-A.); (R.F.-C.)
| | - Francisco Cruz-Quintana
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain;
- End-of-Life Research Network (EOL), 18071 Granada, Spain
| | - Oliver Hugh Turnbull
- School of Psychology Brigantia Building, Bangor University, Bangor LL57 2AS, UK;
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11
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Köse S, Gezginci E, Göktaş S, Murat M. The effectiveness of motivational messages to intensive care unit nurses during the COVID-19 pandemic. Intensive Crit Care Nurs 2021; 69:103161. [PMID: 34895798 PMCID: PMC8559765 DOI: 10.1016/j.iccn.2021.103161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/17/2021] [Accepted: 10/10/2021] [Indexed: 01/07/2023]
Abstract
Objectives To examine the effect of motivational
messages on optimism, hopelessness, and life satisfaction of intensive
care nurses during the COVID-19 pandemic. Study Design This is a multicenter, randomized
controlled, open-label study. Research
Methodology/Design The study was conducted with a total
of 87 nurses working in the COVID-19 intensive care units of three
hospitals in Istanbul. Motivational messages were sent via SMS to the
participants in the motivational group (n=41) for 21 days. The data were
obtained using a Personal Information Form, the Life Orientation Test,
Beck Hopelessness Scale, and the Satisfaction with Life
Scale. Results The nurses’ mean age in the
motivational and control groups was 28.4±7.6 and 26.9±3.7 years,
respectively. Before the messages, no statistically significant
difference was found between the two groups in terms of life orientation
(p=0.059), hopelessness (p=0.214), and satisfaction with life (p=0.898)
scores. After the messages, life orientation (p=0.042) and life
satisfaction (p=0.040) scores were significantly higher in the
motivational group compared with the control group, and the hopelessness
score was significantly lower (p=0.005). Conclusion According to our study, motivational
messages sent to intensive care nurses during the pandemic increased
their level of optimism and life satisfaction and decreased their level
of hopelessness. Trial registration:
blinded for review
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Affiliation(s)
- Selmin Köse
- Department of Nursing, Health Sciences Faculty, Biruni University, Istanbul, Turkey.
| | - Elif Gezginci
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey.
| | - Sonay Göktaş
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey.
| | - Merve Murat
- Department of Nursing, Health Sciences Faculty, Biruni University, Istanbul, Turkey.
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12
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Ahn J, Lee J, Hong Y, Park J, Chung S. Stress and Anxiety to Viral Epidemics-6 for Medical Students: Psychometric Properties of the Anxiety Measure for the COVID-19 Pandemic. Front Psychiatry 2021; 12:705805. [PMID: 34413799 PMCID: PMC8369005 DOI: 10.3389/fpsyt.2021.705805] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to explore the psychometric properties and validity of Stress and Anxiety to Viral Epidemics-6 items (SAVE-6) among medical students who are at high risk of coronavirus disease 2019 (COVID-19) infection. A total of 212 medical students participated in the online anonymous survey that used SAVE-6, Coronavirus Anxiety Scale (CAS), Generalized Anxiety Disorder-7 items (GAD-7), and Work and Social Adjustment Scale (WSAS). We observed that the single-factor structure model of the SAVE-6 scale showed good internal consistency (Cronbach's alpha = 0.756) and a good convergent validity with GAD-7 (rho = 0.320, p < 0.001), CAS (rho = 0.229, p < 0.001), and WSAS (rho = 0.278, p < 0.001). The appropriate cut-off score of the SAVE-6 scale was determined as 15 points in accordance with at least a mild degree of generalized anxiety (GAD-7 score of 5) among medical students. In conclusion, the SAVE-6 scale can be applied to medical students as a reliable and valid rating scale to assess anxiety response to the present viral pandemic.
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Affiliation(s)
- Junseok Ahn
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Jukab Lee
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Youjin Hong
- Department of Psychiatry, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
| | - Jangho Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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13
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Pollock A, Campbell P, Cheyne J, Cowie J, Davis B, McCallum J, McGill K, Elders A, Hagen S, McClurg D, Torrens C, Maxwell M. Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database Syst Rev 2020; 11:CD013779. [PMID: 33150970 PMCID: PMC8226433 DOI: 10.1002/14651858.cd013779] [Citation(s) in RCA: 207] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Evidence from disease epidemics shows that healthcare workers are at risk of developing short- and long-term mental health problems. The World Health Organization (WHO) has warned about the potential negative impact of the COVID-19 crisis on the mental well-being of health and social care professionals. Symptoms of mental health problems commonly include depression, anxiety, stress, and additional cognitive and social problems; these can impact on function in the workplace. The mental health and resilience (ability to cope with the negative effects of stress) of frontline health and social care professionals ('frontline workers' in this review) could be supported during disease epidemics by workplace interventions, interventions to support basic daily needs, psychological support interventions, pharmacological interventions, or a combination of any or all of these. OBJECTIVES Objective 1: to assess the effects of interventions aimed at supporting the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic. Objective 2: to identify barriers and facilitators that may impact on the implementation of interventions aimed at supporting the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic. SEARCH METHODS On 28 May 2020 we searched the Cochrane Database of Systematic Reviews, CENTRAL, MEDLINE, Embase, Web of Science, PsycINFO, CINAHL, Global Index Medicus databases and WHO Institutional Repository for Information Sharing. We also searched ongoing trials registers and Google Scholar. We ran all searches from the year 2002 onwards, with no language restrictions. SELECTION CRITERIA We included studies in which participants were health and social care professionals working at the front line during infectious disease outbreaks, categorised as epidemics or pandemics by WHO, from 2002 onwards. For objective 1 we included quantitative evidence from randomised trials, non-randomised trials, controlled before-after studies and interrupted time series studies, which investigated the effect of any intervention to support mental health or resilience, compared to no intervention, standard care, placebo or attention control intervention, or other active interventions. For objective 2 we included qualitative evidence from studies that described barriers and facilitators to the implementation of interventions. Outcomes critical to this review were general mental health and resilience. Additional outcomes included psychological symptoms of anxiety, depression or stress; burnout; other mental health disorders; workplace staffing; and adverse events arising from interventions. DATA COLLECTION AND ANALYSIS Pairs of review authors independently applied selection criteria to abstracts and full papers, with disagreements resolved through discussion. One review author systematically extracted data, cross-checked by a second review author. For objective 1, we assessed risk of bias of studies of effectiveness using the Cochrane 'Risk of bias' tool. For objective 2, we assessed methodological limitations using either the CASP (Critical Appraisal Skills Programme) qualitative study tool, for qualitative studies, or WEIRD (Ways of Evaluating Important and Relevant Data) tool, for descriptive studies. We planned meta-analyses of pairwise comparisons for outcomes if direct evidence were available. Two review authors extracted evidence relating to barriers and facilitators to implementation, organised these around the domains of the Consolidated Framework of Implementation Research, and used the GRADE-CERQual approach to assess confidence in each finding. We planned to produce an overarching synthesis, bringing quantitative and qualitative findings together. MAIN RESULTS We included 16 studies that reported implementation of an intervention aimed at supporting the resilience or mental health of frontline workers during disease outbreaks (severe acute respiratory syndrome (SARS): 2; Ebola: 9; Middle East respiratory syndrome (MERS): 1; COVID-19: 4). Interventions studied included workplace interventions, such as training, structure and communication (6 studies); psychological support interventions, such as counselling and psychology services (8 studies); and multifaceted interventions (2 studies). Objective 1: a mixed-methods study that incorporated a cluster-randomised trial, investigating the effect of a work-based intervention, provided very low-certainty evidence about the effect of training frontline healthcare workers to deliver psychological first aid on a measure of burnout. Objective 2: we included all 16 studies in our qualitative evidence synthesis; we classified seven as qualitative and nine as descriptive studies. We identified 17 key findings from multiple barriers and facilitators reported in studies. We did not have high confidence in any of the findings; we had moderate confidence in six findings and low to very low confidence in 11 findings. We are moderately confident that the following two factors were barriers to intervention implementation: frontline workers, or the organisations in which they worked, not being fully aware of what they needed to support their mental well-being; and a lack of equipment, staff time or skills needed for an intervention. We are moderately confident that the following three factors were facilitators of intervention implementation: interventions that could be adapted for local needs; having effective communication, both formally and socially; and having positive, safe and supportive learning environments for frontline workers. We are moderately confident that the knowledge or beliefs, or both, that people have about an intervention can act as either barriers or facilitators to implementation of the intervention. AUTHORS' CONCLUSIONS There is a lack of both quantitative and qualitative evidence from studies carried out during or after disease epidemics and pandemics that can inform the selection of interventions that are beneficial to the resilience and mental health of frontline workers. Alternative sources of evidence (e.g. from other healthcare crises, and general evidence about interventions that support mental well-being) could therefore be used to inform decision making. When selecting interventions aimed at supporting frontline workers' mental health, organisational, social, personal, and psychological factors may all be important. Research to determine the effectiveness of interventions is a high priority. The COVID-19 pandemic provides unique opportunities for robust evaluation of interventions. Future studies must be developed with appropriately rigorous planning, including development, peer review and transparent reporting of research protocols, following guidance and standards for best practice, and with appropriate length of follow-up. Factors that may act as barriers and facilitators to implementation of interventions should be considered during the planning of future research and when selecting interventions to deliver within local settings.
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Affiliation(s)
- Alex Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Joshua Cheyne
- Centre for Clinical Brain Sciences (CCBS), University of Edinburgh, Edinburgh, UK
| | - Julie Cowie
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Bridget Davis
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Jacqueline McCallum
- Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow, UK
| | - Kris McGill
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Andrew Elders
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Suzanne Hagen
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Doreen McClurg
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Claire Torrens
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Glasgow, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Glasgow, UK
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