Training to improve resilience and coping to monitor PTSD in rescue workers

Psychosocial model of burnout among humanitarian aid workers in Bangladesh: role of workplace stressors and emotion coping

BACKGROUND

While trauma exposure is an established predictor of poor mental health among humanitarian aid workers (HAWs), less is known about the role of psychosocial work-related factors. This study aims to establish a psychosocial model for burnout and psychological distress in HAWs that tests and compares the effects of adversity exposure and workplace stressors in combination, and explores the potential mediating role of individual coping styles.

METHODS

Path analysis and model comparison using cross-sectional online survey data were collected from full-time international and local HAWs in Bangladesh between December 2020 and February 2021. HAWs self-reported on exposure to adversities, workplace psychosocial stressors (Third Copenhagen Psychosocial Questionnaire), coping styles (Coping Inventory for Stressful Situations), burnout (Maslach Burnout Inventory-Human Services Survey), and psychological distress (Kessler-6).

RESULTS

Among N = 111 HAWs, 30.6%, 16.4%, 12.7%, and 8.2% screened positive for moderate psychological distress (8 ≤ Kessler-6 ≤ 12), emotional exhaustion (EE ≥ 27), depersonalization (DP ≥ 13), and severe psychological distress (K-6 ≥ 13), respectively. 28.8% reported a history of mental disorder. The preferred model showed distinct pathways from adversity exposure and workplace stressors to burnout, with negative emotion-focused coping and psychological distress as significant intervening variables. While greater exposure to both types of stressors were associated with higher levels of burnout and distress, workplace stressors had a stronger association with psychological outcomes than adversity exposure did (β = .52, p ≤ .001 vs. β = .20, p = .032). Workplace stressors, but not adversities, directly influenced psychological distress (β = .45, p ≤ .001 vs. β = -.01, p = .927). Demographic variables, task-focused and avoidance-focused coping were not significantly associated with psychological outcomes.

CONCLUSIONS

Compared to exposure to adversities, workplace stressors primarily influenced occupational stress syndromes. Reducing workplace stressors and enhancing adaptive coping may improve psychological outcomes in humanitarian staff.

Factors Associated with Knowledge of Evacuation Routes and Having an Emergency Backpack in Individuals Affected by a Major Earthquake in Piura, Peru

Information on the prevention of earthquakes in Peru, a high-risk country, is still emerging. We determined the frequency and factors associated with knowledge of evacuation routes and the use of emergency backpacks in people affected by a major earthquake. A cross-sectional study using secondary data was conducted from August-December 2021 on people that experienced the 6.1 magnitude earthquake that occurred in Piura, Peru on 30 July 2021. The outcome was self-reported knowledge of evacuation routes and the use of emergency backpacks. The association with self-reported earthquake preparation training, use of sources of information on earthquakes, and sociodemographic variables was investigated. A total of 69.5% of participants knew evacuation routes, and 46.3% had an emergency backpack. A higher frequency of knowledge of evacuation routes was associated with previous training (PR: 1.47; 95% CI: 1.15-1.87), use of the media (PR: 1.35; 95% CI: 1.06-1.72), having received information from the COEN (PR: 1.19; 95% CI: 1.02-1.40), and with a greater number of household members (PR: 1.03; 95% CI: 1.01-1.06). There is a high frequency of knowledge of evacuation routes among participants. However, basic notions of prevention culture are still needed. This research contributes to policy development on earthquake preparation at the community level.

Use of an Online Platform to Evaluate the Impact of Social Distancing Measures on Psycho-Physical Well-Being in the COVID-19 Era

Background: The SARS-CoV-2 pandemic (Severe Acute Respiratory Syndrome Coronavirus 2) and the worldwide health crisis have significantly changed both people's habits and lifestyles. Most of the studies found in the literature were carried out on specific professional categories in the socio-health sector, taking into consideration psychological disorders in relation to work. The purpose of this study was to analyze the psychological impact on a portion of the normal population subjected to lockdown. Methods: A questionnaire was distributed in the period between 23 March 2020 and 18 May 2020 (during Italian lockdown) using an online platform. The scales GAD-7, IES-r, PHQ-9 and MANSA were used to investigate the level of anxiety, the presence of post-traumatic stress disorder, the severity of depression and the perceived quality of life, respectively. Results: Four hundred and eight Italian subjects responded. Females and younger people were more affected by anxiety and depression. Post-traumatic stress disorder affected about 40% of the population sample, significantly young people and women, thus attesting to an important psychopathological response. About one-fifth of the sample population recorded an unsatisfactory quality of life. Conclusions: The results highlight the need to set up preventive interventions (primary and secondary), trying to focus on the most fragile group of subjects from a psychosocial point of view, in order to obtain a significant reduction in psychophysical damage in terms of relapses and outcomes.

"Hang in There!": Mental Health in a Sample of the Italian Civil Protection Volunteers during the COVID-19 Health Emergency

Few studies have been conducted on civil volunteers and their emotional conditions concerning the current COVID-19 pandemic. The present study aimed to evaluate the impact of the COVID-19 emergency on the mental health (general well-being, depression level, and post-traumatic distress), coping strategies, and training needs in an Italian sample of 331 Civil Protection volunteers of the L'Aquila province, during the first nationwide "lockdown" (8 March-3 June 2020). The rate of respondents to the online survey was limited (11.5%), presumably because displaying distress would be considered a sign of "weakness", making volunteers unable to do their jobs. More than 90% of the volunteers showed good mental health conditions and a wide utilization of positive coping strategies, with the less experienced displaying better emotional conditions compared to colleagues with 10 or more years of experience. The type of emergency, the relatively few cases of contagion and mortality in the territory compared to the rest of Italy, and the sense of helping the community, together with the awareness of their group identity, could have contributed to the reported well-being. These results may help to identify the needs of volunteers related to this new "urban" emergency to improve both their technical and emotional skills.

Association between habitual use of coping strategies and posttraumatic stress symptoms in a non-clinical sample of college students: A Bayesian approach

The present study investigated the influences of coping styles on posttraumatic stress symptoms (PTSS) among a sample of non-clinical college students who were exposed to traumatic events. Ninety-nine college students participated in the study. However, the sample used in the analyses consisted of only 37 participants who fulfilled the DSM-IV criterion A for Posttraumatic Stress Disorder (PTSD) diagnosis. The PTSD Checklist-Civilian Version (PCL-C) and the Brief COPE were used to assess the participants' PTSS and habitual use of coping strategies, respectively. Bayesian and frequentist correlations showed that emotion-focused coping style was negatively associated with PTSS, while dysfunctional coping style was positively related to PTSS. In the subsequent linear regression on both statistical framework, dysfunctional coping was the only consistent variable predicting more PTSD symptoms. The findings presented here show that lower use of adaptive coping (emotion-focused) and higher use of dysfunctional coping styles on a daily basis are associated to PTSS severity in a non-clinical sample of college students. According to the Bayesian approach, which permits more generalization of data, dysfunctional coping style is determinant to higher levels of PTSS. These findings add new data to the body of research that highlight the critical role of distinct coping strategies in the severity of PTSS.

Determinants of Hurricane Evacuation from a Large Representative Sample of the U.S. Gulf Coast

Exposure to natural disasters like hurricanes negatively impacts the mental and physical health of populations, and evacuation is an important step taken to prevent these adverse health events. This study uses data from a large representative sample of U.S. Gulf Coast residents to explore the determinants of hurricane evacuation. In December 2017, data were collected from 3030 residents of the U.S. Gulf Coast, including Texas, Louisiana, Mississippi, Alabama, and Florida—2557 of whom reported being impacted during the 2017 hurricane season. Bivariate analyses were conducted using prevalence differences and tested for statistical significance with chi-square tests. Multivariable logistic regression models were fitted to identify factors associated with hurricane evacuation. One-third of the respondents (919 of 2557; 35.9%) evacuated from a hurricane that impacted the U.S. Gulf Coast in 2017. The determinants of hurricane evacuation in this population were: residing in a mobile home, higher perception of storm surge risk, higher perception of wind risk, self-sufficiency, carrying flood insurance, and reliance on media and family for evacuation decisions. These findings may be relevant for reducing the adverse health effects of hurricanes by improving emergency planning and evacuation in this highly vulnerable region.

Hospitalization Rates for Respiratory Diseases After L'Aquila Earthquake

The study aims to investigate the impact of the earthquake on public health, in terms of hospitalizations for respiratory diseases in the Abruzzo region, focusing on the area damaged by the earthquake “Crater”. We collected data of hospitalizations of residents in Abruzzo between 2009 and 2015. Hospital Discharge Records (HDRs) with a primary diagnosis of respiratory disease were included and divided into pneumonia, Chronic Obstructive Pulmonary Disease (COPD), and respiratory insufficiency. Absolute frequencies and standardized hospitalization rates were calculated to perform both a short-term and a medium-long term analysis. A linear regression was performed using standardized hospitalization rates and the time. A total of 108.669 respiratory-related records were collected and the most frequent subgroup was respiratory insufficiency. Standardized Hospitalization Rates (SHRs) for respiratory diseases resulted higher in the non-Crater than Crater area, but the short-term analysis showed a significant increase in hospitalizations for pneumonia and respiratory insufficiency in the Crater area. The medium-long term analysis reported a significant difference on the slope decrease of hospitalizations for acute and chronic respiratory diseases in the Crater versus the non-Crater area. The earthquake may have played a triggering role in the increased detection of respiratory diseases. A temporal relationship between the quake and an increase in admissions was found although it is not yet possible to detect a direct cause-effect relationship.

Potentially traumatic experiences of seafarers

Background

The aim of the present study is to assess the extent to which seafarers had been affected by severe mental stress situations and what possible psychological effects they may have.

Methods

During the voyages of 22 German ships, a psychologically trained investigator interviewed 323 seafarers about severe mental stress or potentially traumatic events on board (participation rate 88.5%). Furthermore, a psychologist conducted semi-standardized interviews in 12 shipping companies and in 8 stations of the German Seafarers’ Mission on seafarers’ traumatic experiences.

Results

Of the seafarers surveyed on board, 116 (35.9%) experienced ship wrecks/severe accidents and 55 (17.0%) piracy on board. Experiences with stowaways were indicated by 126 seafarers (39.0%). Repeatedly having to unintentionally think about these events, being reminded of them by certain noises, smells, etc., or often dreaming of them were after-effects in 97 (83.6%) of the affected seafarers after ship wrecks/serious personal accidents on board and in 42 crew members (76.4%) after threats of piracy. Experiences of threat from stowaways had particularly affected non-European seafarers or ratings.

According to the interviews with the shipping companies, a total of 14 deaths occurred in the last 3 years in the 12 interviewed shipping companies (due to heart attacks (3), severe cancer (3), very serious accidents (3), suicides (2) and 3 with unknown causes of death). In relation to the container ships of the investigated shipping companies, these frequencies correspond to a mortality rate of 78.4 per 100,000 seafarer years.

According to the interviews in 8 Seafarers’ Missions, these organizations are in charge of emergency counselling in the form of crisis intervention when a seafarer has experienced serious psychological stress.

Discussion

A serious injury or even the death of a member is a serious psychological stress experience for the other crew members in the closed social system on board. These events are particularly distressing for Filipino seafarers with their strong sociocentric bonds and religious values. Priestly support is often required in order to stabilize the Filipino crew members.

Conclusion

As a preventive measure, psychoeducation for seafarers should be established for coping with extreme mental stress situations.