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Turliuc MN, Balcan AD. Psychological intervention programme for developing resilience in the military personnel. A randomized controlled trial. Stress Health 2024:e3399. [PMID: 38619082 DOI: 10.1002/smi.3399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
Military gendarmes are frequently exposed to events with traumatic impact, with negative effects on emotional and physical health. The present research aims to analyse the effectiveness of Military Resilience Training (MRTR), a psychological intervention programme developed to reduce perceived stress, increase the perception of adaptive resources and strengthen resilience. Ninety-eight participants who met the inclusion criteria were enroled in a single-blind randomized controlled trial. The psychological training programme was implemented in the intervention group (n = 48) for a duration of 5 months. The participants in the control group (n = 50) were scheduled to start the training later. The levels of perceived stress, adaptive resources and resilience were measured in all participants, from the intervention and the control group, before and after the intervention, and at a 3-month follow-up. The effects of the intervention (Cohen's d) were very high for adaptive resources (d = 0.99), self-schemes (d = 1.33), family support (d = 0.70), and partner support (d = 0.66), average for resilience (d = 0.53) and stress (d = 0.49), with very high effects on military task demands (d = 1.19) and averages for friction with authority (d = 0.51). The effects were obtained only in the intervention group, and all gains were maintained at follow-up. This study provides evidence of the effectiveness of MRTR, a psychological intervention implemented in the military gendarmerie population. In the short and long term, MRTR has significant effects in reducing perceived stress, increasing the perception of adaptive resources and strengthening the resilience of military gendarmes.
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Affiliation(s)
| | - Ana-Diana Balcan
- Department of Psychology, Alexandru Ioan Cuza University of Iaşi, Iaşi, Romania
- The Group of Mobile Gendarmes of "Matei Basarab" Ploiești, Ploieşti, Prahova
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Ali B, Shamblen S, Scarbrough W, Atwood K, Sangpukdee UA, Andrews E, Markowitz J, Wensel A. Opioid overdose prevention training needs: Findings from emergency medical services providers in Baltimore County, Maryland. EVALUATION AND PROGRAM PLANNING 2023; 101:102353. [PMID: 37595485 DOI: 10.1016/j.evalprogplan.2023.102353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/10/2023] [Indexed: 08/20/2023]
Abstract
Emergency Medical Services (EMS) providers are on the frontlines of the opioid response. This study explored the EMS training needs in Baltimore County, Maryland. An online survey conducted between January-June 2021 assessed knowledge, attitudes, awareness, and self-efficacy to use opioid overdose prevention strategies; burnout, compassion fatigue, stress, and wellness; and training needs among EMS providers (N = 256). Participants reported positive attitudes toward the use of opioid treatment guidelines and confidence in their ability to use the guidelines. They indicated positive attitudes toward harm reduction, but less favorable attitudes toward opioid use disorder (OUD). Although the participants understood the role of a peer recovery specialist moderately well, they were not fully comfortable with making a referral. They reported relatively low levels of burnout and compassion fatigue and good wellness practices, but indicated a moderate level of stress associated with COVID-19. Perceived training needs included: lifetime fitness and wellness, trauma-informed care, stigma awareness, stages of change, and harm reduction. Offering these trainings and enhancing EMS providers' comfort to make referrals to peer recovery support services may strengthen the referral systems and connect overdose survivors to a continuum of care.
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Affiliation(s)
- Bina Ali
- Pacific Institute for Research and Evaluation, Beltsville, MD, USA.
| | - Steve Shamblen
- Pacific Institute for Research and Evaluation, Beltsville, MD, USA
| | | | - Katharine Atwood
- Pacific Institute for Research and Evaluation, Beltsville, MD, USA
| | | | - Elise Andrews
- Baltimore County Department of Health, Towson, MD, USA
| | - Jan Markowitz
- Baltimore County Department of Health, Towson, MD, USA
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Voth M, Chisholm S, Sollid H, Jones C, Smith-MacDonald L, Brémault-Phillips S. Correction: Efficacy, Effectiveness, and Quality of Resilience-Building Mobile Health Apps for Military, Veteran, and Public Safety Personnel Populations: Scoping Literature Review and App Evaluation. JMIR Mhealth Uhealth 2023; 11:e51609. [PMID: 37639713 PMCID: PMC10495842 DOI: 10.2196/51609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
[This corrects the article DOI: 10.2196/26453.].
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Affiliation(s)
- Melissa Voth
- Heroes in Mind, Advocacy and Research ConsortiumFaculty of Rehabilitation MedicineUniversity of AlbertaEdmonton, ABCanada
- Department of Occupational TherapyFaculty of RehabilitationUniversity of AlbertaEdmonton, ABCanada
| | - Shannon Chisholm
- Department of Occupational TherapyFaculty of RehabilitationUniversity of AlbertaEdmonton, ABCanada
| | - Hannah Sollid
- Department of Occupational TherapyFaculty of RehabilitationUniversity of AlbertaEdmonton, ABCanada
| | - Chelsea Jones
- Heroes in Mind, Advocacy and Research ConsortiumFaculty of Rehabilitation MedicineUniversity of AlbertaEdmonton, ABCanada
- Leiden University Medical CentreLeiden UniversityLeidenNetherlands
- Operational Stress Injury ClinicAlberta Health ServicesEdmonton, ABCanada
| | - Lorraine Smith-MacDonald
- Heroes in Mind, Advocacy and Research ConsortiumFaculty of Rehabilitation MedicineUniversity of AlbertaEdmonton, ABCanada
- Department of Occupational TherapyFaculty of RehabilitationUniversity of AlbertaEdmonton, ABCanada
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research ConsortiumFaculty of Rehabilitation MedicineUniversity of AlbertaEdmonton, ABCanada
- Department of Occupational TherapyFaculty of RehabilitationUniversity of AlbertaEdmonton, ABCanada
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Abstract
We evaluated how an online post-traumatic growth program affected rumination, social support, and post-traumatic growth. We recruited 33 firefighters from two Korean provinces and employed a nonequivalent control group pretest-post-test design. We administered the pretest for the intervention group (n = 16), consisting of eight sessions with an online workbook and messenger group counseling. We conducted post-tests immediately after the program and 4 weeks later. Post-traumatic growth and social support increased significantly. There were no statistically significant differences for intrusive or deliberate rumination. Psychological support programs should be developed to reflect firefighters' work characteristics and needs, including programs designed to induce rumination.
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Affiliation(s)
- Minyeong Kwak
- Department of Nursing, Kyungsung University, Busan, South Korea
| | - Mihae Im
- Department of Nursing, Masan University, Changwon, South Korea
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Pritchard E, van Vreden C, Xia T, Newnam S, Collie A, Lubman DI, de Almeida Neto A, Iles R. Impact of work and coping factors on mental health: Australian truck drivers' perspective. BMC Public Health 2023; 23:1090. [PMID: 37280567 DOI: 10.1186/s12889-023-15877-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/11/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION Truck driving is one of the most common male occupations worldwide. Drivers endure long working hours, isolation, separation from family, compromised sleep, and face rigid regulatory requirements. Studies have documented the work factors contributing to poor health outcomes, however these have not been explored in the Australian context. The aim of this grounded theory study was to explore the impact of work and coping factors on mental health of Australian truck drivers from their perspective. METHODS Recruitment used a purposive snowball sampling, through social media campaigns and direct email invites. Interview data were collected via phone/teleconference, audio recorded and typed verbatim. Inductive coding and thematic analysis were completed with triangulation of themes. RESULTS Seventeen interviews were completed (94% male). Six themes arose, two supporting (Connections; Coping methods), and four disrupting mental health (Compromised supports; Unrealistic demands; Financial pressures; Lack of respect). Drivers had concerns regarding the many things beyond their control and the interactions of themes impacting their health even further. CONCLUSION This study explored the impact of work and coping factors affecting truck driver mental health in Australia. Themes described the importance of connections and coping methods drivers had to support their health. Many factors that compromised their health were often outside their control. These results highlight the need for a multi-faceted collaboration between stakeholders; the driver, employing companies, policy makers/regulators and the public to address the negative impact of truck driving on mental health.
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Affiliation(s)
- Elizabeth Pritchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Caryn van Vreden
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ting Xia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sharon Newnam
- Monash University Accident Research Centre, Melbourne, VIC, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health and Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Victoria, Australia
| | | | - Ross Iles
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Mavragani A, Deady M, Mead O, Foright RM, Brenneman EM, Yeager JR, Bryant RA, Harvey SB. Web-Based Mind-Body Tactical Resilience Training Program for First Responders: Pre-Post Study Assessing Feasibility, Acceptability, and Usability. JMIR Form Res 2023; 7:e40145. [PMID: 36724011 PMCID: PMC9932877 DOI: 10.2196/40145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 12/17/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND First responders report elevated rates of mental disorders, including posttraumatic stress disorder (PTSD), yet many are reluctant to seek care. Preventative resilience training programs attempt to proactively address this issue, and there is evidence showing promise for programs targeting cognitive processes. However, these programs rarely address the physical health conditions associated with PTSD. There is emerging evidence of mind-body exercise training improving PTSD symptoms as well as its associated physical health symptoms. However, the feasibility and acceptability of delivering a web-based mind-body resilience training among first responders are not yet known. OBJECTIVE This study aimed to evaluate the feasibility, usability, and acceptability of a web-based mind-body tactical resilience training program designed for first responders. In addition, we explored the preliminary effectiveness of the training program on mental health outcomes, adaptive cognitive strategies, and work productivity. METHODS A total of 42 first responders based in the United States enrolled in the web-based training program. Participants were administered web-based surveys before enrolling in the 6-week web-based program and at the end of the program. The primary outcomes of feasibility were measured using the number of training hours, program adherence rates, and self-reported data on frequency of practice. Acceptability and usability were measured using self-reported data. Secondary outcomes were symptoms of PTSD, psychological distress, emotion regulation, stress mindset, psychological preparedness, and work performance. RESULTS Overall, the training program was feasible based on the median number of training hours spent on the web-based program (7.57 hours out of an expected total of 6 to 9 hours), and 55% (23/42) of the enrolled participants completed more than half of the program. Although acceptability, usability, and frequency of practice were rated as high, this was based on only 29% (12/42) of the respondents who provided follow-up data. Secondary outcomes showed a significant improvement in the adaptive cognitive strategy of the stress mindset, with a mean difference of -5.42 (SD 4.81; 95% CI -8.475 to -2.358; t11=-3.898; P=.002). All other secondary outcomes were not significant. However, the secondary outcomes were exploratory only, and this study was neither designed nor powered to adequately assess efficacy. CONCLUSIONS These findings suggest that a mind-body tactical resilience training program delivered in a web-based format is feasible and acceptable among first responders; however, further refinements may be required to improve adherence rates. Further research using a larger, more rigorous trial design is warranted to examine the effectiveness of this type of training as a possible prevention or treatment strategy for this population.
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Affiliation(s)
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Olivia Mead
- YogaShield Yoga For First Responders, Castle Rock, CO, United States
| | - Rebecca M Foright
- YogaShield Yoga For First Responders, Castle Rock, CO, United States.,Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Eric M Brenneman
- YogaShield Yoga For First Responders, Castle Rock, CO, United States
| | - Jamie R Yeager
- YogaShield Yoga For First Responders, Castle Rock, CO, United States
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, Australia
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Smith J, Cvejic E, Lal TJ, Fisher A, Tracy M, McCaffery KJ. Impact of alternative terminology for depression on help-seeking intention: A randomized online trial. J Clin Psychol 2023; 79:68-85. [PMID: 35802773 PMCID: PMC10953448 DOI: 10.1002/jclp.23410] [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: 10/07/2021] [Revised: 04/08/2022] [Accepted: 06/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE People with depression experience barriers to seeking professional help. Different diagnostic terminology can influence people's treatment/management preferences. The aim of this study was to investigate how alternative depression diagnostic labels and recommendations impact help-seeking intentions and psychosocial outcomes. METHODS Participants (18-70 years) were recruited using an online panel (Australia) to complete a randomized controlled trial. They read a hypothetical scenario where they discussed experiencing depressive symptoms with their GP and were randomized to receive one of four diagnoses ("depression," "burnout," "functional impairment syndrome" [fictitious label], no label [control]), and one of two follow-up recommendations ("clinical psychologist," "mind coach"). PRIMARY OUTCOME help-seeking intention (5-point scale, higher = greater intention); secondary outcomes: intention to speak to boss, self-stigma, worry, perceived severity, illness perceptions, and personal stigma. RESULTS A total of 676 participants completed the survey. There was no main effect of diagnostic label on help-seeking intention or stigma outcomes. Intention to speak to a boss was higher with the depression compared to burnout label (MD = 0.40, 95% CI: 0.14-0.66) and perceived severity was higher with the depression label compared to control (MD = 0.48, 95% CI: 0.22-0.74) and all other labels. Those who received the "clinical psychologist" recommendation reported higher help-seeking intention (MD = 0.43, 95% CI: 0.25-0.60) and treatment control (MD = 0.69, 95% CI: 0.29-1.10) compared to the "mind coach" recommendation. CONCLUSION Findings highlight the success of efforts to promote help-seeking from clinical psychologists for depression. If burnout is considered a separate diagnostic entity to depression, greater awareness around what such a diagnosis means may be needed. Future research should examine how different terminologies surrounding other mental health conditions impact help-seeking and stigma.
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Affiliation(s)
- Jenna Smith
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Erin Cvejic
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Tara J. Lal
- University of New EnglandArmidaleNew South WalesAustralia
| | - Alana Fisher
- eCentre Clinic, School of Psychological SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Marguerite Tracy
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Kirsten J. McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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Claringbold G, Robinson N, Anglim J, Kavadas V, Walker A, Forsyth L. A systematic review of well-being interventions and initiatives for Australian and New Zealand emergency service workers. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2022. [DOI: 10.1080/00049530.2022.2123282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
| | - Nicky Robinson
- School of Psychology, Deakin University, Geelong, Australia
| | - Jeromy Anglim
- School of Psychology, Deakin University, Geelong, Australia
| | - Vicki Kavadas
- School of Psychology, Deakin University, Geelong, Australia
| | - Arlene Walker
- School of Psychology, Deakin University, Geelong, Australia
| | - Loch Forsyth
- School of Psychology, Deakin University, Geelong, Australia
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Ang WHD, Chew HSJ, Dong J, Yi H, Mahendren R, Lau Y. Digital training for building resilience: Systematic review, meta-analysis, and meta-regression. Stress Health 2022; 38:848-869. [PMID: 35460533 PMCID: PMC10084366 DOI: 10.1002/smi.3154] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/25/2022] [Accepted: 04/19/2022] [Indexed: 01/01/2023]
Abstract
Resilience is learnable and broadly described as an individual's adaptive coping ability, its potential value for stress reduction must be explored. With a global coronavirus pandemic, innovative ways to deliver resilience training amidst heightened mental health concerns must be urgently examined. This systematic review aimed to (1) evaluate the effectiveness of digital training for building resilience and reducing anxiety, depressive and stress symptoms and (2) to identify essential features for designing future digital training. A three-step search was conducted in eight electronic databases, trial registries and grey literature to locate eligible studies. Randomised controlled trials examining the effects of digital training aimed at enhancing resilience were included. Data analysis was conducted using the Stata version 17. Twenty-two randomised controlled trials involving 2876 participants were included. Meta-analysis revealed that digital training significantly enhanced the participants' resilience with moderate to large effect (g = 0.54-1.09) at post-intervention and follow-up. Subgroup analyses suggested that training delivered via the Internet with a flexible programme schedule was more effective than its counterparts. This review supports the use of digital training in improving resilience. Further high-quality randomised controlled trials with large sample size are needed.
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Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jie Dong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendren
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Bevan MP, Priest SJ, Plume RC, Wilson EE. Emergency First Responders and Professional Wellbeing: A Qualitative Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14649. [PMID: 36429361 PMCID: PMC9691130 DOI: 10.3390/ijerph192214649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Emergency first responders (EFRs) such as police officers, firefighters, paramedics and logistics personnel often suffer high turnover due to work-related stress, high workloads, fatigue, and declining professional wellbeing. As attempts to counter this through resilience programmes tend to have limited success, there is a need for further research into how organisational policies could change to improve EFRs' professional wellbeing. AIM To identify the factors that may contribute to or affect EFRs' professional wellbeing. METHODS A systematic literature review has been carried out. Three databases (Science Direct, ProQuest, and PubMed) were searched using keywords developed based on the PICo (population, interest, and context) framework. A total of 984 articles were extracted. These were then critically appraised for the quality of the evidence presented, leading to a total of five being ultimately included for review. RESULTS Thematic analysis revealed that although EFRs may be exposed daily to traumatic events, factors that contribute to a decline in professional wellbeing emerge from within the organisational environment, rather than from the event itself. CONCLUSION The study concludes that organisational and team relations factors significantly impact EFRs ability to cope with stress. As such, organisational policy should evolve to emphasise team relations over resilience programmes.
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Affiliation(s)
- Malcolm P. Bevan
- Flood Hazard Research Centre, Middlesex University, London NW4 4BT, UK
| | - Sally J. Priest
- Flood Hazard Research Centre, Middlesex University, London NW4 4BT, UK
| | - Ruth C. Plume
- Department of Natural Sciences, Middlesex University, London NW4 4BT, UK
| | - Emma E. Wilson
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham NG7 2RD, UK
- Nottingham Centre for Evidence Based Healthcare, University of Nottingham, Nottingham NG7 2RD, UK
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Workplace Meditation Interventions for Reducing Psychological Stress and Other Cardiovascular Risk Factors: Workplace Wellness Policy Implications. CURRENT CARDIOVASCULAR RISK REPORTS 2022. [DOI: 10.1007/s12170-022-00708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Beauchamp AM, Weerakoon SM, Ponder WN, Jetelina KK. Possible substance use disorders among first responders during the COVID-19 era: a quasi-experimental study of personal and residential vulnerability. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:724-733. [PMID: 35867134 DOI: 10.1080/00952990.2022.2088376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background: During the COVID-19 pandemic possible substance use disorders (SUD) were exacerbated from increased stress and isolation. Experiences of symptomology differ widely by occupations.Objectives: The objectives were to determine if there is a temporal relationship between COVID-19 vulnerability and possible SUDs among first responders, and to examine the association with neighborhood vulnerability.Methods: We conducted an analysis with two distinct cohorts dependent on time of entry: 1) First responders that began counseling prior to COVID-19 and 2) First responders that began counseling after the start of COVID-19. Data were collected at intake from first responders seeking mental health services between 2017 and 2021 at an organization in Dallas/Fort Worth, Texas. The study sample included 195 mostly male (75%) first responders (51% law enforcement officers; 49% emergency medical technicians/firefighters). Bivariate models tested unadjusted relationships between covariates and possible SUD. Adjusted models consisted of a two-level multivariable logistic regression models.Results: Nearly 40% (n = 77) screened positive for a possible SUD. Those beginning counseling after COVID-19 did not have higher odds of SUDs. For every unit increase in neighborhood Severe COVID-19 Health Risk Index at a first responder's residential location there was an increase in the odds of a possible SUD (AOR = 3.14, 95% CI: 1.47, 6.75).Conclusions: Our study highlights the degree to which personal and residential vulnerability to COVID-19 impacted first responders. The increased occupational stress of this population, and an established pattern of maladaptive coping, elucidates the need for preventative and clinical approaches to strengthen the resilience of this population.
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Affiliation(s)
- Alaina M Beauchamp
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, School of Public Health, Dallas, TX, USA
| | - Sitara M Weerakoon
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, School of Public Health, Dallas, TX, USA.,Center for Pediatric Population Health, University of Texas Health Science Center, School of Public Health, Dallas, TX, USA
| | - Warren N Ponder
- Outcomes and Evaluation, One Tribe Foundation, Fort Worth, TX, USA
| | - Katelyn K Jetelina
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, School of Public Health, Dallas, TX, USA
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Armaou M, Araviaki E, Dutta S, Konstantinidis S, Blake H. Effectiveness of Digital Interventions for Deficit-Oriented and Asset-Oriented Psychological Outcomes in the Workplace: A Systematic Review and Narrative Synthesis. Eur J Investig Health Psychol Educ 2022; 12:1471-1497. [PMID: 36286087 PMCID: PMC9601105 DOI: 10.3390/ejihpe12100102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Digital psychological interventions can target deficit-oriented and asset-oriented psychological outcomes in the workplace. This review examined: (a) the effectiveness of digital interventions for psychological well-being at work, (b) associations with workplace outcomes, and (c) associations between interventions' effectiveness and their theory-base. METHODS six electronic databases were searched for randomised controlled trials (RCT) and quasi-experimental studies. The methodological quality of studies that used randomisation was conducted with the "Cochrane Collaboration's Risk of Bias" tool, while the "JBI Critical Appraisal Checklist" was used for non-randomised studies. Studies' theory-base was evaluated using an adaptation of the "theory coding scheme" (TSC). Due to heterogeneity, narrative synthesis was performed. RESULTS 51 studies were included in a synthesis describing four clusters of digital interventions: (a) cognitive behavioural therapy, (b) stress-management interventions and workplace well-being promotion, (c) meditation training and mindfulness-based interventions, and (d) self-help interventions. Studies demonstrated a high risk of contamination effects and high attrition bias. Theory-informed interventions demonstrated greater effectiveness. Cognitive behavioural therapy demonstrated the most robust evidence for reducing depression symptoms among healthy employees. With the exception of the Headspace application, there was weak evidence for meditation training apps, while relaxation training was a key component of effective stress-management interventions.
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Affiliation(s)
- Maria Armaou
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
| | | | - Snigdha Dutta
- Cambridge Centre for Teaching and Learning, University of Cambridge, Cambridge CB2 3PT, UK
| | | | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
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Use of Mobile Apps and Online Programs of Mindfulness and Self-Compassion Training in Workers: A Scoping Review. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 7:477-515. [PMID: 36091081 PMCID: PMC9444703 DOI: 10.1007/s41347-022-00267-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022]
Abstract
Mindfulness and self-compassion interventions are two strategies helpful in preventing and reducing burnout and work stress. However, professionals with overburdened schedules can experience obstacles in learning and practicing these interventions, originally taught with lengthy programs. The use of digital technologies could make these interventions more accessible to workers, as studied in a recent, growing body of evidence. The evidence available is diverse in terms of interventions, designs, outcomes, and populations. This calls for a review that can take into consideration this diversity while still rigorously synthesize it. Scoping reviews are designed to examine emerging evidence and summarize the evidence on a specific topic of interest. The present scoping review aims to assess the current state of the literature on the use of online programs and mobile applications of self-compassion, mindfulness, and meditation (digital mindfulness-based interventions; dMBIs) by workers. More specifically, information on the type of intervention, population, advantages, and disadvantages, measured outcomes, and advice for future research are gathered. MEDLINE (PubMed; Ovid), PsychInfo (Ovid), and Web of Science (Clarivate) were searched to identify all relevant articles. The screening process resulted in 56 articles being included in this scoping review. Inclusion criteria were (1) participants are workers; (2) the intervention is individual, digital, and mindfulness/self-compassion/meditation-based; and (3) articles were available in French or English language at the time of the review. Interventions used were mostly mindfulness-based, equally categorized under web-based and app-based interventions. Most interventions included information on mindfulness, meditation or self-compassion, meditation exercises, other types of exercises, instructions on how to use, and reminders. dMBIs are often studied in the healthcare population and predominantly in female samples. Although dMBIs present advantages (low cost, accessibility, practicality, feasibility), obstacles can arise in their implementation (low engagement and motivation, concerns about confidentiality). Included articles measured outcomes related to work, mindfulness or self-compassion, and other psychological variables (stress/anxiety, depression, resilience, wellbeing). Articles provided important directions to further research on dMBIs regarding methodological aspects, modality and intervention, and individual and organizational questions. dMBIs are becoming more popular and interventions are diverse. Although not without limitations, this scoping provided a synthesis on different aspects of the use of dMBIs within workers and highlighted pertinent future research directions.
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Noda Y, Asano K, Shimizu E, Hirano Y. The mediating effect of symptoms of posttraumatic stress disorder and depression on the relationship between personality traits and quality of life in emergency service workers. Compr Psychiatry 2022; 116:152327. [PMID: 35643052 DOI: 10.1016/j.comppsych.2022.152327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Emergency service workers are often exposed to fatalities during accidents or disasters. Therefore, they may be more prone to experiencing posttraumatic stress disorder (PTSD) and depression. It has been shown that these comorbid disorders are related to personality traits and quality of life (QOL). METHODS We hypothesized that mental disorders, such as symptoms of PTSD and depression, mediate the relationship between personality traits, as measured on the 10-Item Personality Inventory (TIPI), and QOL, as measured on the MOS 36-item Short-Form Health Survey (SF-36). RESULTS Participants were aged 23-61 years. Questionnaires were sent to 373 participants, 220 of whom returned responses. A direct effect was found between two subscales of the TIPI (Extraversion and Emotional stability) and mental component summary scores of the SF-36 (Extraversion: β = 0.154, p < .001; Emotional stability: β = 0.179, p < .001), which indicated partial mediation. A significant indirect effect was revealed between two personality traits and mental health summary scores (Extraversion: β = 0.058, p < .001; Emotional stability: β = 0.087, p < .001). We also found a direct effect of extraversion scores of the TIPI on role/social component summary scores of the SF-36 (β = 0.084, p < .05). However, none of the 95% confidential intervals was significant, which indicated full mediation, and the indirect effect was significant (β = 0.023, p < .01). Sensitivity analysis indicated that a direct effect between extraversion scores of the TIPI and role/social component summary scores of the SF-36 was significant, which indicated partial mediation. CONCLUSIONS The findings of direct and indirect effects highlight the importance of identifying effective methods for protecting individuals from developing symptoms of PTSD and depression; moreover, they may help improve QOL. The capacity of dealing with incidents among emergency service workers may vary depending on their personality traits. Therefore, the screening of mental health states that includes a personality trait inventory may be valuable.
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Affiliation(s)
- Yoshikazu Noda
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; Department of Nursing, Teikyo University of Science, 34-1 Senjumotomachi, Adachi-ku, Tokyo 120-0041, Japan.
| | - Kenichi Asano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan
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A Qualitative Analysis of the Mental Health Training and Educational Needs of Firefighters, Paramedics, and Public Safety Communicators in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126972. [PMID: 35742221 PMCID: PMC9222833 DOI: 10.3390/ijerph19126972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 02/01/2023]
Abstract
Background—Public safety personnel (PSP) are at heightened risk of developing mental health challenges due to exposures to diverse stressors including potentially psychologically traumatic experiences. An increased focus on protecting PSP mental health has prompted demand for interventions designed to enhance resilience. While hundreds of available interventions are aimed to improve resilience and protect PSPs’ mental health, research evidence regarding intervention effectiveness remains sparse. Methods—Focus groups with PSP elicited a discussion of psychoeducational program content, preferred modes of program delivery, when such training should occur, and to whom it ought to be targeted. Results—The results of thematic analyses suggest that PSP participants feel that contemporary approaches to improving mental health and resilience are lacking. While welcomed, the provision of sporadic one-off mental health and resilience programs by organizations was seen as insufficient, and the available organizational mental health supports were perceived as being questionable. The available programs also left participants feeling insufficiently prepared to deal with personal mental health problems and in discussing mental health concerns with co-workers. Conclusions—Participants reported needing more engaging methods for delivering information, career-long mental health knowledge acquisition, and a systems approach to improve the workplace culture, particularly regarding mental health.
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Somohano VC, Vasquez A, Shank T, Irrgang M, Newman AG, Evans C, Wyse J, Denneson L, O'Neil M, Lovejoy T. Perceptions of Women With Comorbid PTSD and Substance Use Disorder on Mechanisms Underlying Mindfulness-Based Interventions. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Voth M, Chisholm S, Sollid H, Jones C, Smith-MacDonald L, Brémault-Phillips S. Efficacy, Effectiveness, and Quality of Resilience-Building Mobile Health Apps for Military, Veteran, and Public Safety Personnel Populations: Scoping Literature Review and App Evaluation. JMIR Mhealth Uhealth 2022; 10:e26453. [PMID: 35044307 PMCID: PMC8811698 DOI: 10.2196/26453] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/09/2021] [Accepted: 11/19/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Military members (MMs) and public safety personnel (PSP) are vulnerable to occupational stress injuries because of their job demands. When MMs and PSP transition out of these professions, they may continue to experience mental health challenges. The development and implementation of resilience-building mobile health (mHealth) apps as an emergent mental health intervention platform has allowed for targeted, cost-effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of health care professionals. OBJECTIVE This study aims to evaluate the evidence-based quality, efficacy, and effectiveness of resilience-building mobile apps targeted toward the MMs, PSP, and veteran populations via a scoping literature review of the current evidence base regarding resilience apps for these populations and an evaluation of free resilience apps designed for use among these populations. METHODS The studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and were guided by PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A narrative synthesis of the resulting papers was performed. The Alberta Rating Index for Apps was used to conduct a review of each of the identified apps. The inclusion criteria consisted of apps that were free to download in either the Google Play Store or the Apple App Store; updated within the last 3 years; available in English and in Canada; and intended for use by MMs, veterans, and PSP. RESULTS In total, 22 apps met the inclusion criteria for evaluation. The resilience strategies offered by most apps included psychoeducation, mindfulness, cognitive behavioral therapy, and acceptance and commitment therapy. Overall, 50% (11/22) of apps had been tested in randomized controlled trials, 7 (32%) apps had been evaluated using other research methods, and 5 (23%) apps had not been studied. Using the Alberta Rating Index for Apps, the app scores ranged from 37 to 56 out of 72, with higher rated apps demonstrating increased usability and security features. CONCLUSIONS The mHealth apps reviewed are well-suited to providing resilience strategies for MMs, PSP, and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. Although not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for posttraumatic stress disorder, depression, anxiety, and other mental health conditions. In clinical practice, apps can be used to supplement treatment and provide clients with population-specific confidential tools to increase engagement in the treatment process.
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Affiliation(s)
- Melissa Voth
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Shannon Chisholm
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Hannah Sollid
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Chelsea Jones
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Leiden University Medical Centre, Leiden University, Leiden, Netherlands
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Lorraine Smith-MacDonald
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
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Doody CB, Robertson L, Cox KM, Bogue J, Egan J, Sarma KM. Pre-deployment programmes for building resilience in military and frontline emergency service personnel. Cochrane Database Syst Rev 2021; 12:CD013242. [PMID: 34870330 PMCID: PMC8647095 DOI: 10.1002/14651858.cd013242.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Military personnel and frontline emergency workers may be exposed to events that have the potential to precipitate negative mental health outcomes such as depression, symptoms of post-traumatic stress and even post-traumatic stress disorder (PTSD). Programmes have been designed to build psychological resilience before staff are deployed into the field. This review presents a synthesis of the literature on these "pre-deployment resilience-building programmes". OBJECTIVES The objective of this review was to assess the effectiveness of programmes that seek to build resilience to potentially traumatic events among military and frontline emergency service personnel prior to their deployment. These resilience programmes were compared to other interventions, treatment as usual or no intervention. SEARCH METHODS Studies were identified through searches of electronic databases including Ovid MEDLINE, Embase, PsycINFO, Web of Science and Google Scholar. The initial search took place in January 2019, with an updated search completed at the end of September 2020. SELECTION CRITERIA Only studies that used a randomised controlled trial (RCT)/cluster-RCT methodology were included. The programmes being evaluated must have sought to build resilience prior to exposure to trauma. Study participants must have been 18 years or older and be military personnel or frontline emergency workers. DATA COLLECTION AND ANALYSIS Studies that met the inclusion criteria were assembled. Data extracted included methods, participants' details, intervention details, comparator details, and information on outcomes. The primary outcomes of interest were resilience, symptoms of post-traumatic stress and PTSD. Secondary outcomes of interest included acute stress disorder, depression, social support, coping skills, emotional flexibility, self-efficacy, social functioning, subjective levels of aggression, quality of sleep, quality of life and stress. Assessment of risk of bias was also completed. A total of 28 studies were included in a narrative synthesis of results. MAIN RESULTS All 28 included studies compared an experimental resilience building intervention versus a control or no intervention. There was a wide range of therapeutic modalities used, including cognitive behavioural therapy (CBT) informed programmes, biofeedback based programmes, stress-management programmes, mindfulness and relaxation programmes, neuropsychological-based programmes, and psychoeducational-informed programmes. The main outcomes are specified here, secondary outcomes such as depression, social support, coping skills, self-efficacy, subjective levels of aggression and stress are reported in text. No studies reported on the following pre-specified outcomes; acute stress disorder, emotional flexibility, social functioning, quality of sleep and quality of life. Resilience Eight studies reported resilience as an outcome. We narratively synthesised the data from these studies and our findings show that five of these interventions had success in building resilience in their respective samples. Two of the studies that reported significant results utilised a CBT approach to build resilience, while the other three successful programmes were mindfulness-based interventions. Symptoms of post-traumatic stress Our narrative synthesis of results included eight studies. Two of the eight studies produced significant reductions in symptoms of post traumatic stress compared to controls. These interventions used neuropsychological and biofeedback intervention models respectively. PTSD caseness Four studies reported PTSD caseness as an outcome. Our narrative synthesis of results suggests that evidence is mixed as to the effectiveness of these interventions in reducing clinical diagnosis of PTSD. One study of a neuropsychology-orientated Attention Bias Modification Training (AMBT) programme had success in reducing both symptoms of post-traumatic stress and numbers of participants receiving a diagnosis of PTSD. A stress-management programme reported that, when baseline differences in rates of pre-deployment mental health issues were controlled for, participants in the control condition were at 6.9 times the risk of a diagnosis of PTSD when compared to the intervention group. Given the diversity of intervention designs and theoretical orientations used (which included stress-management, neuropsychological and psychoeducational programmes), a definitive statement on the efficacy of pre-deployment programmes at reducing symptoms of post-traumatic stress and PTSD cannot be confidently offered. AUTHORS' CONCLUSIONS While a number of evaluations of relevant programmes have been published, the quality of these evaluations limits our ability to determine if resilience-building programmes 'work' in terms of preventing negative outcomes such as depression, symptoms of post-traumatic stress and diagnoses of PTSD. Based on our findings we recommend that future research should: a) report pre-/post-means and standard deviation scores for scales used within respective studies, b) take the form of large, RCTs with protocols published in advance, and c) seek to measure defined psychological facets such as resilience, PTSD and stress, and measure these concepts using established psychometric tools. This will provide more certainty in future assessments of the evidence base. From a clinical implications point of view, overall there is mixed evidence that the interventions included in this review are effective at safe guarding military personnel or frontline emergency workers from experiencing negative mental health outcomes, including PTSD, following exposure to potentially traumatic events. Based on this, practitioners seeking to build resilience in their personnel need to be aware of the limitations of the evidence base. Practitioners should have modest expectations in relation to the efficacy of resilience-building programmes as a prophylactic approach to employment-related critical incident traumas.
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Affiliation(s)
- Colm B Doody
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Lindsay Robertson
- Cochrane Common Mental Disorders, University of York, York, UK
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Katie M Cox
- National University of Ireland Galway, Galway, Ireland
| | - John Bogue
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jonathan Egan
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Kiran M Sarma
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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Pace TWW, Zeiders KH, Cook SH, Sarsar ED, Hoyt LT, Mirin NL, Wood EP, Tatar R, Davidson RJ. Feasibility, Acceptability, and Preliminary Efficacy of an App-Based Meditation Intervention to Decrease Firefighter Psychological Distress and Burnout: A One-Group Pilot Study (Preprint). JMIR Form Res 2021; 6:e34951. [PMID: 35675115 PMCID: PMC9218885 DOI: 10.2196/34951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/15/2022] Open
Abstract
Background Firefighters are often exposed to occupational stressors that can result in psychological distress (ie, anxiety and depression) and burnout. These occupational stressors have only intensified with the onset of the COVID-19 pandemic and will likely persist in the postpandemic world. Objective To address occupational stressors confronting firefighters, we pilot tested a novel, cost-effective, smartphone app–based meditation intervention created by Healthy Minds Innovations that focused on mindfulness (awareness) training along with practices designed to cultivate positive relationships (connection), insight into the nature of the self (insight), and a sense of purpose in the context of challenge (purpose) with a sample of professional firefighters from a large metropolitan area in southwestern United States. Methods A total of 35 participants were recruited from a closed online group listserv and completed the self-guided 10-unit meditation app over the course of 10 days, at 1 unit per day. We assessed anxiety symptoms, depression symptoms, burnout, and negative affect as well as saliva diurnal cortisol rhythm, an objective indicator of stress-related biology, before and after use of the meditation app. Results This study demonstrated the meditation app was both feasible and acceptable for use by the majority of firefighters. We also found significant reductions in firefighters’ anxiety (P=.01), burnout (P=.05), and negative affect (P=.04), as well as changes in cortisol diurnal rhythm, such as waking cortisol (P=.02), from before to after use of the meditation app. Conclusions Our study findings call for future research to demonstrate the efficacy of this meditation app to reduce psychological distress and burnout in firefighters.
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Affiliation(s)
- Thaddeus W W Pace
- Division of Biobehavioral Health Science, College of Nursing, University of Arizona, Tucson, AZ, United States
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
- Department of Psychology, College of Science, University of Arizona, Tucson, AZ, United States
| | - Katharine H Zeiders
- Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Stephanie H Cook
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY, United States
| | - Evelyn D Sarsar
- Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Lindsay T Hoyt
- Department of Psychology, Fordham University, Bronx, NY, United States
| | - Nicholas L Mirin
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Erica P Wood
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Raquel Tatar
- Healthy Minds Innovation, Madison, WI, United States
| | - Richard J Davidson
- Department of Psychology, University of Wisconsin, Madison, WI, United States
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Scheuch I, Peters N, Lohner MS, Muss C, Aprea C, Fürstenau B. Resilience Training Programs in Organizational Contexts: A Scoping Review. Front Psychol 2021; 12:733036. [PMID: 34721200 PMCID: PMC8551487 DOI: 10.3389/fpsyg.2021.733036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/13/2021] [Indexed: 11/22/2022] Open
Abstract
The importance of resilience for employees' well-being and performance at work has grown steadily in recent years. This development has become even more pronounced through the recent COVID-19 pandemic and its consequences, including major changes in occupational settings. Although there is increasing interest in resilience in general and a growing number of publications focusing on the development of resilience in particular, many questions remain about resilience training, especially in organizational contexts. The purpose of this scoping review is to uncover what is known about resilience training in organizational contexts. A systematic search of four databases for articles published through 2021 was conducted. A total of 48 studies focusing on resilience training programs in organizational contexts were included in this review. The review provides relevant insights into resilience training programs by focusing on program characteristics, target group, study design, and outcomes. Based on the results, the main aspects that concern the development of resilience training programs for organizational settings and requirements for the study design for empirical investigation were summarized. The results of the review highlight possible directions for future research and offer useful insights for resilience-enhancing training programs in organizations.
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Affiliation(s)
- Ianina Scheuch
- Faculty of Business and Economics, Chair of Business Education and Management Training, TU Dresden, Dresden, Germany
| | - Natalie Peters
- Faculty of Business and Economics, Chair of Business Education and Management Training, TU Dresden, Dresden, Germany
| | - Max S Lohner
- Business School, Chair of Business and Economic Education - Instructional Systems Design and Evaluation, University of Mannheim, Mannheim, Germany
| | - Caroline Muss
- Faculty of Business and Economics, Chair of Business Education and Management Training, TU Dresden, Dresden, Germany
| | - Carmela Aprea
- Business School, Chair of Business and Economic Education - Instructional Systems Design and Evaluation, University of Mannheim, Mannheim, Germany
| | - Bärbel Fürstenau
- Faculty of Business and Economics, Chair of Business Education and Management Training, TU Dresden, Dresden, Germany
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22
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Resilience, well-being, and organizational outcomes of Croatian, Thai, and US workers during COVID-19. JOURNAL OF MANAGEMENT & ORGANIZATION 2021. [PMCID: PMC8593378 DOI: 10.1017/jmo.2021.58] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AbstractDrawing on social cognitive theory (SCT), this study examines the effects of employee resilience, through well-being, on job productivity, and relational satisfaction among extraverted versus introverted workers in Croatia, Thailand, and the United States during the early period of the coronavirus disease 2019 pandemic. Participants included 832 working adults from various industries. Moderated mediation analyses revealed employee resilience positively predicted psychological well-being which, in turn, positively predicted both productivity and relational satisfaction. Regardless of culture, extraverted workers reported less productivity but greater satisfaction with coworkers compared to introverted workers. Also, resilience dampened the negative effects of introversion on relational satisfaction. The findings support the multilevel perspective of resilience and SCT assertion that behavioral outcomes are determined by an interaction between personal and environmental factors and highlight the need to promote employee resilience and well-being during times of crisis. Recommendations on how managers can support employees during this unprecedented global health crisis are provided.
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Edgelow M, Scholefield E, McPherson M, Mehta S, Ortlieb A. A review of workplace mental health interventions and their implementation in public safety organizations. Int Arch Occup Environ Health 2021; 95:645-664. [PMID: 34628523 DOI: 10.1007/s00420-021-01772-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Workplace mental health is relevant to public safety organizations due to the exposure that many public safety personnel (PSP) have to psychological trauma in the course of their daily work. While the importance of attending to PSP mental health has been established, the implementation of workplace mental health interventions is not as well understood. This scoping review describes workplace mental health interventions and their implementation in public safety organizations. METHODS English published primary studies with any publication date up to July 3, 2020 were considered. JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was followed. RESULTS 89 citations met inclusion criteria out of the 62,299 found. Articles and reports found were largely published within the last decade, most frequently from Western nations, and most often applied to police, followed by firefighters. The focus of interventions was commonly stress management and resilience, and a frequent implementation strategy was multi-session group training. Comprehensive quality improvement initiatives, a focus on supervisors and managers, and interventions across primary, secondary, and tertiary prevention, were infrequent. CONCLUSION Public safety organizations are frequently reporting on stress management and resilience interventions for police and firefighters, implemented through multi-session group training. A focus across a range of PSP, including paramedics, corrections officers, and emergency dispatchers, using implementation strategies beyond group training, is suggested. This area of research is currently expanding, with many studies published within the past decade; ongoing evaluation of the quality of interventions and implementation strategies is recommended.
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Affiliation(s)
- Megan Edgelow
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada.
| | - Emma Scholefield
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada
| | - Matthew McPherson
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada
| | - Sonam Mehta
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada
| | - Aquila Ortlieb
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada
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Di Nota PM, Kasurak E, Bahji A, Groll D, Anderson GS. Coping among public safety personnel: A systematic review and meta–analysis. Stress Health 2021; 37:613-630. [PMID: 34597464 PMCID: PMC8013542 DOI: 10.1002/smi.3039] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/13/2021] [Accepted: 02/24/2021] [Indexed: 12/02/2022]
Abstract
Public safety personnel (PSP) are routinely exposed to potentially psychologically traumatic events (PPTEs) that, in turn, can result in posttraumatic stress injuries (PTSI), including burnout and increased symptoms of depression and anxiety. However, the longitudinal impact of PPTEs on PSP coping remains unclear. Coping can be operationalized as various strategies (i.e., behaviours, skills, thought and emotion regulation) for dealing with stressors, which are broadly categorized as either approach (adaptive, positive, social support) or avoidant coping strategies (maladaptive withdrawal, avoidance, substance use). This systematic review and meta-analysis aims to evaluate longitudinal coping outcomes among PSP. Thirteen eligible repeated-measures studies explicitly evaluated coping in 1854 police officers, firefighters, and rescue and recovery workers. Study designs included randomized-control trials, within-subject interventions and observational studies. Effect sizes (Cohen's d) at follow-up were described in 11 studies. Separate meta-analyses reveal small (d < 0.2) but non-significant improvements in approach and avoidant coping. Studies were of moderate quality and low risk of publication bias. Heterogeneity in outcome measures, follow-up durations, and study types precluded subgroup analyses. The current findings can inform the development and evaluation of organizational training programs that effectively promote sustained adaptive coping for PSP and mitigate PTSIs.
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Affiliation(s)
- Paula M. Di Nota
- Office of Applied Research and Graduate StudiesJustice Institute of British ColumbiaNew Westminster, BCCanada,Department of PsychologyUniversity of TorontoTorontoCanada
| | - Emily Kasurak
- Department of PsychiatryQueen's UniversityKingston, OntarioCanada
| | - Anees Bahji
- Department of PsychiatryUniversity of CalgaryCalgaryCanada
| | - Dianne Groll
- Department of PsychiatryQueen's UniversityKingston, OntarioCanada
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Reflections of a Mindful Teacher's Shift from In-Person to Online Courses. Mindfulness (N Y) 2021; 12:2559-2561. [PMID: 34413907 PMCID: PMC8364441 DOI: 10.1007/s12671-021-01722-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/18/2022]
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Cherry N, Galarneau J, Haynes W, Sluggett B. The role of organizational supports in mitigating mental ill health in firefighters: A cohort study in Alberta, Canada. Am J Ind Med 2021; 64:593-601. [PMID: 33945167 PMCID: PMC8252071 DOI: 10.1002/ajim.23249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/25/2021] [Accepted: 03/22/2021] [Indexed: 12/17/2022]
Abstract
Introduction Little is known about the effectiveness of ongoing mental health support in reducing the mental health impacts of a traumatic deployment. Methods A cohort of firefighters was established among those deployed to a devastating wildfire in Alberta, Canada in May 2016. Firefighters completed three questionnaires: at recruitment giving details of exposures, a first follow‐up reporting mental health supports before, during, and after the fire and a second follow‐up, at least 30 months after the fire, with screening questionnaires for anxiety, depression, and posttraumatic stress disorder (PTSD). Fire chiefs were interviewed about mental health provisions. The impact of supports on mental ill health was estimated, adjusting for clustering within fire service and potential confounders. Results Of 1234 firefighters in the cohort, 840 completed the questionnaire on mental health supports. In total, 78 of 82 fire chiefs were interviewed. Analysis of the impact of supports on mental ill health included 745 firefighters from 67 fire services. Only 45.8% of reports of peer support were concordant between firefighters and fire chiefs. After adjusting for confounding, the odds ratios (OR) for peer support reported by both fire chief and firefighter were depressive disorder: OR = 0.22, 95% confidence interval (CI), 0.08–0.61; anxiety disorder: OR = 0.45, 95% CI, 0.24–0.82; PTSD: OR = 0.62, 95% CI, 0.37–1.02. Symptoms of anxiety and depression but not PTSD were reduced by resiliency training before the fire and by support offered within 48 h of return from deployment. Conclusion The results suggest peer support in firefighters is protective but its availability is poorly recognized. PTSD was somewhat less responsive, perhaps reflecting the cumulative effects of previous exposures.
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Affiliation(s)
- Nicola Cherry
- Division of Preventive Medicine University of Alberta Edmonton Alberta Canada
| | | | - Whitney Haynes
- Division of Preventive Medicine University of Alberta Edmonton Alberta Canada
| | - Bryan Sluggett
- Division of Preventive Medicine University of Alberta Edmonton Alberta Canada
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27
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Heyen JM, Weigl N, Müller M, Müller S, Eberle U, Manoliu A, Vetter S, Brown AD, Berger T, Kleim B. Multimodule Web-Based COVID-19 Anxiety and Stress Resilience Training (COAST): Single-Cohort Feasibility Study With First Responders. JMIR Form Res 2021; 5:e28055. [PMID: 33999835 PMCID: PMC8189283 DOI: 10.2196/28055] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/31/2021] [Accepted: 04/17/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Since the emergence of COVID-19, health care workers and first responders have been at a high risk for mental health symptoms owing to their exposure to the virus and increased work stress during the pandemic. Although interventions exist to address mental health issues following exposure to disasters, emergencies, and humanitarian crises, considerably less is known about web-based unguided interventions to help mitigate the negative impacts of such events. Additionally, in contexts in which emergencies reduce access to in-person care, remote forms of support are critical, yet there are limited studies on the use of such interventions. Evidence-based, easy-to-use, scalable interventions are direly needed for this population. OBJECTIVE This study aimed to develop and test the feasibility of an unguided electronic mental health program, COVID-19 Anxiety and Stress Resilience Training (COAST), tailored to first responders and health care personnel, based on scientific evidence and empirically based techniques. METHODS We developed COVID-19-specific training modules focusing on several domains that are previously reported as key to resilience and stress recovery: self-efficacy, mindfulness, sleep quality, and positive thinking. The program was made available to 702 first responders between May and August 2020, during the COVID-19 pandemic. Sociodemographic, work-, and COVID-19-related information was collected, and psychometric questionnaires were completed. We examined user acceptance and user activity, including module choice and participant feedback. RESULTS In total, 52 of 702 (7%) first responders to whom we reached out used the program at least once. COAST use was independent of age, sex, or baseline levels of self-efficacy, mindful awareness, sleep quality, and positive thinking (for all, P>.39). First responders who had tested positive and those who had been quarantined were more likely to engage in the program. A click count analysis per module showed that participants used the self-efficacy and mindfulness modules most often, with 382 and 122 clicks, respectively, over 15 weeks. Overall, first responders expressed satisfaction with the program. CONCLUSIONS Engagement of first responders in the multimodule web-based COAST program was feasible and the first responder cohort expressed overall satisfaction with the program. Those in more difficult circumstances, including those in quarantine and those who tested positive, may be more likely to engage in such programs. Further controlled studies could pave the way for efficacy studies and the development of additional modules, including just-in-time interventions or blended interventions combining individual use of an unguided self-help intervention, such as COAST, with subsequent individual psychotherapy for those who continue to experience stress and psychological symptoms.
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Affiliation(s)
- Janna Marie Heyen
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
- Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Noé Weigl
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
| | | | - Urs Eberle
- Zurich Schutz und Rettung, Zürich, Switzerland
| | - Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
- McLean Hospital Belmont, Harvard Medical School, Boston, MA, United States
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
| | - Adam D Brown
- Department of Psychology, New School for Social Research, New York, NY, United States
- Department of Psychiatry, New York University, New York, NY, United States
| | - Thomas Berger
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
- Department of Psychology, University of Zurich, Zürich, Switzerland
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28
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Hooper JJ, Saulsman L, Hall T, Waters F. Addressing the psychological impact of COVID-19 on healthcare workers: learning from a systematic review of early interventions for frontline responders. BMJ Open 2021; 11:e044134. [PMID: 34020974 PMCID: PMC8142676 DOI: 10.1136/bmjopen-2020-044134] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Protecting healthcare workers from psychological harm is an urgent clinical issue within the current COVID-19 pandemic. Research on early psychological programmes that aim to prevent or reduce mental health symptoms and that have been tested in frontline responders may assist service providers with choosing a suitable intervention for rapid dissemination in healthcare settings. DESIGN AND OUTCOME MEASURES First, Embase, Web of Science, PsycINFO and Google Scholar were searched through a systematic literature review of early psychological interventions administered to frontline responders in the last 15 years. Interventions were included if they were designed to prevent or reduce psychological impact and had outcome measures of psychological distress (eg, general psychopathology, post-traumatic stress disorder and stress) and/or positive mental health domains (eg, resilience, self-efficacy and life satisfaction). Second, the suitability of these programmes for the healthcare workforce was evaluated according to the criteria of effectiveness, content applicability and feasibility. RESULTS Of 320 articles retrieved, 12 relevant studies were included that described six early psychological interventions. Although the evidence base is limited, psychological first aid, eye movement desensitisation and reprocessing, and trauma risk management showed effectiveness across at least two studies each with frontline workers. Resilience and coping for the healthcare community; anticipate, plan, and deter; and resilience at work programmes found promising results in single studies. Concerning other suitability criteria, all programmes appear applicable to healthcare settings and have acceptable feasibility for rapid implementation. CONCLUSIONS Despite the limited evidence, several interventions were identified as potentially suitable and useful for improving psychological functioning of healthcare workers across a variety of disaster situations. Service providers should continue to implement and evaluate early psychological interventions in frontline workers in order to refine best practices for managing the psychological impact of future disasters.
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Affiliation(s)
- Jasmine Jean Hooper
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Lisa Saulsman
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Tammy Hall
- Clinical Research Centre Gascoyne House, West Wing, Graylands Hospital, Mount Claremont, Western Australia, Australia
| | - Flavie Waters
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
- Clinical Research Centre Gascoyne House, West Wing, Graylands Hospital, Mount Claremont, Western Australia, Australia
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29
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Supporting the Mental Health and Well-Being of First Responders from Career to Retirement: A Scoping Review. Prehosp Disaster Med 2021; 36:475-480. [PMID: 33928892 DOI: 10.1017/s1049023x21000431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION First responders are at greater risk of mental ill health and compromised well-being compared to the general population. It is important to identify strategies that will be effective in supporting mental health, both during and after the first responder's career. METHODS A scoping review was conducted using the PubMed database (1966 to October 1, 2020) and the Google Scholar database (October 1, 2020) using relevant search terms, truncation symbols, and Boolean combination functions. The reference lists of all relevant publications were also reviewed to identify further publications. RESULTS A total of 172 publications were retrieved by the combined search strategies. Of these, 56 met the inclusion criteria and informed the results of this overview paper. These publications identified that strategies supporting first responder mental health and well-being need to break down stigma and build resilience. Normalizing conversations around mental health is integral for increasing help-seeking behaviors, both during a first responder's career and in retirement. Organizations should consider the implementation of both pre-retirement and post-retirement support strategies to improve mental health and well-being. CONCLUSION Strategies for supporting mental health and well-being need to be implemented early in the first responder career and reinforced throughout and into retirement. They should utilize holistic approaches which encourage "reaching in" rather than placing an onus on first responders to "reach out" when they are in crisis.
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30
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Di Nota PM, Bahji A, Groll D, Carleton RN, Anderson GS. Proactive psychological programs designed to mitigate posttraumatic stress injuries among at-risk workers: a systematic review and meta-analysis. Syst Rev 2021; 10:126. [PMID: 33910641 PMCID: PMC8079856 DOI: 10.1186/s13643-021-01677-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/15/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Public safety personnel and frontline healthcare professionals are at increased risk of exposure to potentially psychologically traumatic events (PPTE) and developing posttraumatic stress injuries (PTSI, e.g., depression, anxiety) by the nature of their work. PTSI are also linked to increased absenteeism, suicidality, and performance decrements, which compromise occupational and public health and safety in trauma-exposed workers. Evidence is lacking regarding the effectiveness of "prevention" programs designed to mitigate PTSI proactively. The purpose of this review is to measure the effectiveness of proactive PTSI mitigation programs among occupational groups exposed to PPTE on measures of PTSI symptoms, absenteeism, and psychological wellness. METHODS Five electronic databases were searched per PRISMA guidelines for English or French peer-reviewed studies from 2008 to 2019 evaluating PTSI and psychological wellness in adults exposed to occupational PPTE. The risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS We identified 42 studies evaluating 3182 public safety and frontline healthcare professionals, PPTE-exposed educational staff, and miners. Significant overlap was found across program themes that included mindfulness, psychoeducation, resilience promotion, and stress management strategies. Post-program effect sizes were small (SMD < 0.5) to moderate (SMD < 0.8) for reductions in PTSI symptoms and for promoting measures of well-being as indicated by a meta-analysis on 36 studies. There was no evidence for significant reductions in substance use, absenteeism, or biomarkers of distress except for heart rate. Subgroup analyses indicated that multimodal programs effectively improved general psychological health, while resilience programs improved measures of depression, burnout, coping, and resilience. Effect sizes for resilience, depression, and general psychological health improvements were greatest immediately or 1-month post-training, while improvements in PTSD symptoms and coping were larger at longer follow-up. Studies were of moderate quality and risk of bias. CONCLUSIONS The current results showcase modest evidence for time-limited reductions in PTSI following participation in holistic programs that promote resilience, stress, and emotion regulation among at-risk workers. Implications for organizational implementation of proactive PTSI mitigation programs and areas of future research are discussed. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42019133534).
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Affiliation(s)
- Paula M Di Nota
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Anees Bahji
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, Canada
| | | | - Gregory S Anderson
- Faculty of Science, Thompson Rivers University, TRU Way, Kamloops, BC, V2C 0C8, Canada.
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31
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Kim SC, Quiban C, Sloan C, Montejano A. Predictors of poor mental health among nurses during COVID-19 pandemic. Nurs Open 2021; 8:900-907. [PMID: 33570266 PMCID: PMC7753542 DOI: 10.1002/nop2.697] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/28/2020] [Accepted: 10/29/2020] [Indexed: 01/19/2023] Open
Abstract
AIMS To examine the impact of various factors affecting nurses' mental health during the COVID-19 pandemic. DESIGN An online cross-sectional study. METHODS Registered nurses who graduated from a nursing school in Southern California, USA, participated in the study from 20 April-10 May 2020 (N = 320). Kendall's tau correlations and multivariate logistic regression procedures were performed with stress, anxiety and depression as outcome variables. RESULTS Most nurses reported moderate/high stress (80.1%), while 43% and 26% reported moderate/severe anxiety and depression, respectively. COVID-19 patient care was positively associated with moderate/severe high stress (OR = 2.25; p = .012) and moderate/severe anxiety (OR = 3.04; p < .001), whereas quarantine was associated with moderate/severe depression (OR = 2.68; p < .001). High levels of family functioning, resilience and spirituality predicted two- to sixfold lower odds of moderate/severe stress, anxiety or depression. High resilience, spirituality and family functioning appear to be good coping mechanisms for nurses against stress, anxiety and depression during the pandemic.
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Affiliation(s)
- Son Chae Kim
- School of NursingPoint Loma Nazarene UniversitySan DiegoCAUSA
| | - Carlota Quiban
- School of NursingPoint Loma Nazarene UniversitySan DiegoCAUSA
| | - Christine Sloan
- School of NursingPoint Loma Nazarene UniversitySan DiegoCAUSA
| | - Anna Montejano
- School of NursingPoint Loma Nazarene UniversitySan DiegoCAUSA
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32
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Veer IM, Riepenhausen A, Zerban M, Wackerhagen C, Puhlmann LMC, Engen H, Köber G, Bögemann SA, Weermeijer J, Uściłko A, Mor N, Marciniak MA, Askelund AD, Al-Kamel A, Ayash S, Barsuola G, Bartkute-Norkuniene V, Battaglia S, Bobko Y, Bölte S, Cardone P, Chvojková E, Damnjanović K, De Calheiros Velozo J, de Thurah L, Deza-Araujo YI, Dimitrov A, Farkas K, Feller C, Gazea M, Gilan D, Gnjidić V, Hajduk M, Hiekkaranta AP, Hofgaard LS, Ilen L, Kasanova Z, Khanpour M, Lau BHP, Lenferink DB, Lindhardt TB, Magas DÁ, Mituniewicz J, Moreno-López L, Muzychka S, Ntafouli M, O’Leary A, Paparella I, Põldver N, Rintala A, Robak N, Rosická AM, Røysamb E, Sadeghi S, Schneider M, Siugzdaite R, Stantić M, Teixeira A, Todorovic A, Wan WWN, van Dick R, Lieb K, Kleim B, Hermans EJ, Kobylińska D, Hendler T, Binder H, Myin-Germeys I, van Leeuwen JMC, Tüscher O, Yuen KSL, Walter H, Kalisch R. Psycho-social factors associated with mental resilience in the Corona lockdown. Transl Psychiatry 2021; 11:67. [PMID: 33479211 PMCID: PMC7817958 DOI: 10.1038/s41398-020-01150-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/11/2022] Open
Abstract
The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience (p < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics.
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Affiliation(s)
- Ilya M. Veer
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Antje Riepenhausen
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany ,grid.7468.d0000 0001 2248 7639Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Zerban
- grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Carolin Wackerhagen
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lara M. C. Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.4372.20000 0001 2105 1091Research Group Social Stress and Family Health, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany
| | - Haakon Engen
- grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany ,grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway
| | - Göran Köber
- grid.5963.9Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany ,grid.5963.9Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Sophie A. Bögemann
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen Weermeijer
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Aleksandra Uściłko
- grid.12847.380000 0004 1937 1290Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Netali Mor
- grid.413449.f0000 0001 0518 6922Tel Aviv Sourasky Medical Center, Sagol Brain Institute Tel Aviv, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Marta A. Marciniak
- grid.7400.30000 0004 1937 0650Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland ,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Adrian Dahl Askelund
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway
| | - Abbas Al-Kamel
- grid.33236.370000000106929556University of Bergamo, Bergamo, Italy
| | - Sarah Ayash
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Giulia Barsuola
- grid.5335.00000000121885934MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Vaida Bartkute-Norkuniene
- grid.466222.60000 0004 0382 1349Faculty of Business and Technologies at Utena University of Applied Sciences, Utena, Lithuania
| | - Simone Battaglia
- grid.6292.f0000 0004 1757 1758Center for Studies and Research in Cognitive Neuroscience, Department of Psychology, University of Bologna, Bologna, Italy
| | - Yaryna Bobko
- Faculty of Psychology, University of Economics and Human Sciences, Warsaw, Warsaw, Poland
| | - Sven Bölte
- grid.467087.a0000 0004 0442 1056Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,grid.467087.a0000 0004 0442 1056Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,grid.1032.00000 0004 0375 4078Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA Australia
| | - Paolo Cardone
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Edita Chvojková
- grid.7177.60000000084992262Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Kaja Damnjanović
- grid.7149.b0000 0001 2166 9385Laboratory for Experimental Psychology, Department of Psychology, University of Belgrade, Belgrade, Serbia
| | - Joana De Calheiros Velozo
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Lena de Thurah
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Yacila I. Deza-Araujo
- grid.8591.50000 0001 2322 4988Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, Medical School, University of Geneva, Geneva, Switzerland
| | - Annika Dimitrov
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kinga Farkas
- grid.11804.3c0000 0001 0942 9821Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary ,grid.6759.d0000 0001 2180 0451Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
| | - Clémence Feller
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Mary Gazea
- grid.424223.1Concentris Research Management GmbH, Fürstenfeldbruck, Germany
| | - Donya Gilan
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Vedrana Gnjidić
- grid.4808.40000 0001 0657 4636Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Michal Hajduk
- grid.7634.60000000109409708Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Bratislava, Slovak Republic ,grid.7634.60000000109409708Center for Psychiatric Disorders Research, University in Bratislava, Science Park Comenius, Bratislava, Slovak Republic ,grid.7634.60000000109409708Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Anu P. Hiekkaranta
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Live S. Hofgaard
- grid.5510.10000 0004 1936 8921PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Laura Ilen
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Zuzana Kasanova
- grid.5596.f0000 0001 0668 7884Leuven Research and Development, Spin-off and Innovation Unit, KU Leuven, Leuven, Belgium
| | - Mohsen Khanpour
- grid.46072.370000 0004 0612 7950University of Tehran, Tehran, Iran
| | - Bobo Hi Po Lau
- grid.445012.60000 0001 0643 7658Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong
| | - Dionne B. Lenferink
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas B. Lindhardt
- grid.7048.b0000 0001 1956 2722Center of Functionally Integrative Neuroscience (CFIN) and MINDLab, Department of Clinical Medicine, Århus University, Århus, Denmark
| | - Dávid Á. Magas
- grid.6759.d0000 0001 2180 0451Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
| | - Julian Mituniewicz
- grid.12847.380000 0004 1937 1290Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Laura Moreno-López
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Sofiia Muzychka
- Faculty of Psychology, University of Economics and Human Sciences, Warsaw, Warsaw, Poland
| | - Maria Ntafouli
- grid.5216.00000 0001 2155 0800Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Aet O’Leary
- grid.411088.40000 0004 0578 8220Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany ,grid.10939.320000 0001 0943 7661Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Ilenia Paparella
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, Lyon, France
| | - Nele Põldver
- grid.10939.320000 0001 0943 7661Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Aki Rintala
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium ,grid.508322.eFaculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - Natalia Robak
- grid.12847.380000 0004 1937 1290College of Inter-faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland
| | - Anna M. Rosická
- grid.10267.320000 0001 2194 0956Faculty of Social Studies, Department of Psychology, Masaryk University, Brno, Czech Republic
| | - Espen Røysamb
- grid.5510.10000 0004 1936 8921PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Siavash Sadeghi
- grid.5802.f0000 0001 1941 7111Johannes Gutenberg University Mainz, Mainz, Germany
| | - Maude Schneider
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Roma Siugzdaite
- grid.5335.00000000121885934MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK ,grid.5342.00000 0001 2069 7798Department of Experimental Clinical and Health Psychology, Ghent University, Gent, Belgium
| | - Mirta Stantić
- grid.4991.50000 0004 1936 8948Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Ana Teixeira
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Ana Todorovic
- grid.4991.50000 0004 1936 8948Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Wendy W. N. Wan
- grid.265231.10000 0004 0532 1428Department of International Business, Tunghai University, Taichung City, Taiwan
| | - Rolf van Dick
- grid.7839.50000 0004 1936 9721Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Birgit Kleim
- grid.7400.30000 0004 1937 0650Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland ,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Erno J. Hermans
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dorota Kobylińska
- grid.12847.380000 0004 1937 1290Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Talma Hendler
- grid.413449.f0000 0001 0518 6922Tel Aviv Sourasky Medical Center, Sagol Brain Institute Tel Aviv, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546School of Psychological Science, Tel Aviv University, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Harald Binder
- grid.5963.9Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany ,grid.5963.9Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Inez Myin-Germeys
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Judith M. C. van Leeuwen
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Kenneth S. L. Yuen
- grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany ,Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany ,grid.7468.d0000 0001 2248 7639Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany. .,Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
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Kim SC, Sloan C, Montejano A, Quiban C. Impacts of Coping Mechanisms on Nursing Students' Mental Health during COVID-19 Lockdown: A Cross-Sectional Survey. NURSING REPORTS 2021; 11:36-44. [PMID: 34968310 PMCID: PMC8608075 DOI: 10.3390/nursrep11010004] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/30/2020] [Accepted: 01/05/2021] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic and consequent lockdown have precipitated significant disruption in the educational system. Nursing students are known to have higher levels of stress and anxiety than other non-nursing students, but there is a dearth of evidence regarding the impacts of the COVID-19 lockdown on their mental health and coping mechanisms. PURPOSE The aim of this study was to explore the influence of coping mechanisms as predictors of stress, anxiety, and depression among nursing students during the COVID-19 lockdown. METHODS A cross-sectional online survey was conducted from 20 April to 10 May 2020 among 173 nursing students at a private university in Southern California, USA. RESULTS Self-reported stress, anxiety, and depression were significantly higher during the lockdown compared to the pre-lockdown period (p < 0.001). Almost a quarter of participants reported high stress, while more than half reported moderate-to-severe symptoms of anxiety and depression. High resilience was negatively associated with high stress (Odds Ratio (OR) = 0.46; 95% Confidence Interval (CI) = 0.22-0.98; p = 0.045), moderate-to-severe anxiety (OR = 0.47; 95%CI = 0.25-0.90; p = 0.022), and moderate-to-severe depression (OR = 0.50; 95%CI = 0.26-0.95; p = 0.036). Similarly, high family functioning was negatively associated with high stress (OR = 0.41; 95%CI = 0.20-0.86; p = 0.018), moderate-to-severe anxiety (OR = 0.41; 95%CI = 0.21-0.80; p = 0.009), and moderate-to-severe depression (OR = 0.41; 95%CI = 0.20-0.81; p = 0.011). High spiritual support was negatively associated with moderate-to-severe depression (OR = 0.48; 95%CI = 0.24-0.95; p = 0.035). CONCLUSIONS During the COVID-19 lockdown, nursing students experienced remarkable levels of poor mental health. High levels of resilience and family functioning were associated with 2- to 2.4-fold lower risk of stress, anxiety, and depression, whereas high spiritual support was associated with 2-fold lower risk of depression. As the pandemic evolves, fostering these coping mechanisms may help students to maintain their psychological wellbeing.
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Shin JH, Choi JY. [Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy]. J Korean Acad Nurs 2021; 51:334-346. [PMID: 34215711 DOI: 10.4040/jkan.21019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. METHODS The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients' needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. RESULTS ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. CONCLUSION The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.
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Affiliation(s)
- Jee Hye Shin
- Department of Nursing, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Ja Yun Choi
- College of Nursing, Chonnam National University, Gwangju, Korea.
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Al Tunaiji H, Al Qubaisi M, Dalkilinc M, Campos LA, Ugwuoke NV, Alefishat E, Aloum L, Ross R, Almahmeed W, Baltatu OC. Impact of COVID-19 Pandemic Burnout on Cardiovascular Risk in Healthcare Professionals Study Protocol: A Multicenter Exploratory Longitudinal Study. Front Med (Lausanne) 2020; 7:571057. [PMID: 33415114 PMCID: PMC7783289 DOI: 10.3389/fmed.2020.571057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/23/2020] [Indexed: 01/19/2023] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has created new and unpredictable challenges for healthcare systems. Healthcare professionals are heavily affected by this rapidly changing situation, especially frontline healthcare professionals who are directly engaged in the diagnosis, treatment, and care of patients with COVID-19 and may experience psychological burdens. The objective of this study is to explore the evolution of psychosocial, cardiovascular, and immune markers in healthcare professionals with different levels of exposure to the COVID-19 pandemic. Methods and Analysis: This is a STROBE compliant, blended, exploratory study involving online and onsite approaches that use wearable monitoring. A planned random probability sample of residents, staff physicians, nurses, and auxiliary healthcare professionals will be recruited. The study sample will be stratified by exposure to the COVID-19 pandemic. As a first step, recruitment will be conducted online, with e-consent and using e-surveys with Maslach Burnout Inventory, Fuster-BEWAT score, and sociodemographic characteristics. Onsite visits will be planned for the second step where participants will receive a wearable setup that will measure heart rate, actimetry, and sleep quality monitoring, which will be used together with blood sampling for immune biomarkers. Steps 1 and 2 will then be repeated at 2-3 months, and 6 months. Power BI and Tableau will be used for data visualization, while front-end data capture will be used for data collection using specific survey/questionnaires, which will enable data linkage between e-surveys, internet of things wearable devices, and clinical laboratory data. Clinical Trial Registration: ClinicalTrials.gov; Identifier: NCT04422418.
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Affiliation(s)
| | - Mai Al Qubaisi
- Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | | | - Luciana Aparecida Campos
- College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates.,Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil.,Institute of Biomedical Engineering, Anhembi Morumbi University-Laureate International Universities, Sao Jose dos Campos, Brazil
| | | | - Eman Alefishat
- College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Lujain Aloum
- College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ramzy Ross
- Myriad Global Solutions, Abu Dhabi, United Arab Emirates
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil.,Institute of Biomedical Engineering, Anhembi Morumbi University-Laureate International Universities, Sao Jose dos Campos, Brazil.,College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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MacMillan F, Kolt GS, Le A, George ES. Systematic review of randomised control trial health promotion intervention studies in the fire services: study characteristics, intervention design and impacts on health. Occup Environ Med 2020; 78:oemed-2020-106613. [PMID: 33004434 DOI: 10.1136/oemed-2020-106613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 12/26/2022]
Abstract
The objective of this study was to systematically review health promotion interventions in the fire services. Four databases were searched for articles reporting on health promotion interventions for firefighters evaluated in randomised controlled trials (RCT) and measuring efficacy on health or lifestyle behaviour outcomes. Data were extracted to create a narrative synthesis regarding study design, intervention characteristics and impact on outcomes. Risk of bias was assessed using a 13-item tool. Of 448 papers identified, after removal of duplicates, 209 were excluded based on title/abstract screening. A further 60 papers were excluded, mostly due to studies not being RCTs, not including a lifestyle behaviour intervention, or not focusing on health or lifestyle behaviour outcomes. Ten studies (reported in 11 papers) were eligible for inclusion. Six studies compared an intervention to usual practice, one compared a full intervention to a minimal intervention, one compared two exercise programmes and two compared two interventions to usual practice. Four studies evaluated structured physical activity interventions. Five studies evaluated physical activity and diet-focused behaviour change programmes, and one study included a mindfulness programme. When assessing risk of bias, three studies had low risk ratings for >8/13 items, leaving seven studies with high-risk ratings for ≥5/13 items. Eight of the 10 studies reported improvements in at least 1 outcome from baseline to final follow-up in the intervention group over a comparison group. The majority of lifestyle behaviour interventions targeted physical activity and/or diet. Findings from included studies suggest that programmes for firefighters initiated in the workplace can improve some health outcomes.
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Affiliation(s)
- Freya MacMillan
- School of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australia
| | - Gregory S Kolt
- School of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australia
| | - April Le
- School of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australia
| | - Emma S George
- School of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australia
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Thompson J, Drew JM. Warr;or21: A 21-Day Program to Enhance First Responder Resilience and Mental Health. Front Psychol 2020; 11:2078. [PMID: 33013529 PMCID: PMC7505768 DOI: 10.3389/fpsyg.2020.02078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
First responders face multiple stressors on a daily basis. They have experienced higher rates of anxiety disorders, depression, burnout, post-traumatic stress disorder (PTSD), suicide (Asmundson and Stapleton, 2008), alcohol and substance abuse (Ballenger et al., 2010), and deficient sleep hygiene (Pearsall, 2012) compared to the general population. Existing resilience research can be utilized and adapted to help first responders cope in a positive manner as a form of prevention and also as part of their recovery. New resiliency programs continue to emerge and this paper details one – warr;or21. The warr;or21 program is explained and based on an evaluation of the program’s preliminary data, the results are promising with how the program can assist first responders (and the general public) increase their resiliency and mental health.
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Affiliation(s)
- Jeff Thompson
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Jacqueline M Drew
- Griffith Criminology Institute, Griffith University, Mt Gravatt, QLD, Australia
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Sommer JL, El-Gabalawy R, Taillieu T, Afifi TO, Carleton RN. Associations between Trauma Exposure and Physical Conditions among Public Safety Personnel: Associations entre l'exposition à un traumatisme et les problèmes physiques chez le personnel de la santé publique. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:548-558. [PMID: 32275461 PMCID: PMC7361655 DOI: 10.1177/0706743720919278] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Trauma exposure is associated with adverse health-related correlates, including physical comorbidities, and is highly prevalent among public safety personnel (PSP). The current study (1) examined the association between context of index trauma exposure (part of job vs. other) and physical conditions and (2) established the prevalence of physical conditions according to PSP category (e.g., police, paramedic) and index trauma type (e.g., serious accident, physical assault) in a large Canadian sample of PSP. METHODS PSP completed an online survey between September 2016 and January 2017. Multivariable logistic regressions examined associations between context of index trauma exposure (i.e., part of job vs. other) and physical condition categories. Cross-tabulations with chi-square analyses examined whether the prevalence of physical conditions significantly differed according to PSP category and index trauma type. RESULTS There were 5,267 PSP included in the current study. Results from the most stringent model of logistic regressions demonstrated that, compared to PSP who experienced their index trauma in any other context, PSP who experienced it as part of their job had reduced odds of "other" physical conditions (adjusted odds ratio = 0.73, 95% confidence interval, 0.57 to 0.94, P < 0.05). Results also revealed significant differences in the prevalence of physical conditions across all PSP categories and select index trauma types. CONCLUSION Results highlight the relevance of trauma exposure outside of an occupational context among PSP and may have implications for the positive impact of stress inoculation and resiliency training programs for PSP.
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Affiliation(s)
- Jordana L. Sommer
- Department of Psychology, University of Manitoba, Winnipeg,
Canada
- Department of Anesthesiology, Perioperative and Pain Medicine,
University of Manitoba, Winnipeg, Canada
| | - Renée El-Gabalawy
- Department of Psychology, University of Manitoba, Winnipeg,
Canada
- Department of Anesthesiology, Perioperative and Pain Medicine,
University of Manitoba, Winnipeg, Canada
- Department of Clinical Health Psychology, University of Manitoba,
Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg,
Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba,
Winnipeg, Canada
| | - Tracie O. Afifi
- Department of Psychiatry, University of Manitoba, Winnipeg,
Canada
- Department of Community Health Sciences, University of Manitoba,
Winnipeg, Canada
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Wong AH, Pacella-LaBarbara ML, Ray JM, Ranney ML, Chang BP. Healing the Healer: Protecting Emergency Health Care Workers' Mental Health During COVID-19. Ann Emerg Med 2020; 76:379-384. [PMID: 32534830 PMCID: PMC7196406 DOI: 10.1016/j.annemergmed.2020.04.041] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/15/2020] [Accepted: 04/28/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Ambrose H Wong
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
| | | | - Jessica M Ray
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Megan L Ranney
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY
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Christopher M, Bowen S, Witkiewitz K. Mindfulness-based resilience training for aggression, stress and health in law enforcement officers: study protocol for a multisite, randomized, single-blind clinical feasibility trial. Trials 2020; 21:236. [PMID: 32111233 PMCID: PMC7048059 DOI: 10.1186/s13063-020-4165-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/12/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force, as well as mental health consequences, including post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. Mindfulness training is a promising approach with high-stress populations that has been shown effective for increasing resilience and improving negative mental health outcomes common among LEOs. METHOD Implemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multisite trial assessing effects of mindfulness-based resilience training versus an attention control (stress management education) and a no-intervention control on physiological, behavioral, and psychological outcomes. To prepare for this future clinical trial, the current study is designed to: enhance efficiency of recruitment, engagement, and retention; optimize laboratory, assessment, and data management procedures; optimize intervention training and ensure fidelity to intervention protocols; and assess participant experience and optimize outcome measures across two sites. Herein, we describe the protocol and methodology of this multisite, randomized, single-blind clinical feasibility trial. DISCUSSION The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience and mental health among LEOs, as well as yield significant benefits for the communities and residents they serve. TRIAL REGISTRATION ClinicalTrials.gov, NCT03784846. Registered on 24 December 2018.
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Affiliation(s)
- Michael Christopher
- School of Graduate Psychology, Pacific University, 190 SE 8th Ave, Suite 260, Hillsboro, OR 97123 USA
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, 190 SE 8th Ave, Suite 260, Hillsboro, OR 97123 USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, 2001 Redondo S Dr, Albuquerque, NM 87106 USA
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Denkova E, Zanesco AP, Rogers SL, Jha AP. Is resilience trainable? An initial study comparing mindfulness and relaxation training in firefighters. Psychiatry Res 2020; 285:112794. [PMID: 32078885 DOI: 10.1016/j.psychres.2020.112794] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 12/17/2022]
Abstract
Motivated by the growing interest in promoting resilience in first responders and other professionals who face threatening professional circumstances, the current study investigated the effectiveness of offering a short-form mindfulness training (MT) program to firefighters. The overarching question was to determine if psychological and cognitive markers of resilience are bolstered via MT. Firefighters (n = 121) were assigned to an MT program (n = 42), an active-comparison relaxation training program (RT, n = 31), or served as no-training controls (NTC, n = 48). Both the MT and RT programs were contextualized for firefighters and consisted of 4, 2-h training sessions delivered over 4 weeks by the same expert trainer, as well as 10-15 min of daily out-of-class practice. Intent-to-treat analyses revealed a significantly greater increase in psychological resilience from baseline (T1) to post-training (T2) in firefighters who received MT vs. RT or no training. In addition, positive affect and objective attentional task performance demonstrated a greater increase over time (from T1 to T2) with more days per week of out-of-class practice for the MT group but not for the RT group. These results suggest that MT moreso than RT bolsters markers of resilience in firefighters.
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Affiliation(s)
- Ekaterina Denkova
- Department of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables 33146, FL, USA
| | - Anthony P Zanesco
- Department of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables 33146, FL, USA
| | | | - Amishi P Jha
- Department of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables 33146, FL, USA.
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Aidman E. Cognitive Fitness Framework: Towards Assessing, Training and Augmenting Individual-Difference Factors Underpinning High-Performance Cognition. Front Hum Neurosci 2020; 13:466. [PMID: 32009919 PMCID: PMC6971199 DOI: 10.3389/fnhum.2019.00466] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/19/2019] [Indexed: 12/01/2022] Open
Abstract
The aim of this article is to introduce the concept of Cognitive Fitness (CF), identify its key ingredients underpinning both real-time task performance and career longevity in high-risk occupations, and to canvas a holistic framework for their assessment, training, and augmentation. CF as a capacity to deploy neurocognitive resources, knowledge and skills to meet the demands of operational task performance, is likely to be multi-faceted and differentially malleable. A taxonomy of CF constructs derived from Cognitive Readiness (CR) and Mental fitness (MF) literature maps into phases of operational cycles from foundational to advanced, mission-ready and recovery. Foundational cognitive attributes, such as attention, executive control and co-action, were hypothesized to be trainable at the initial Cognitive Gym phase. More advanced training targets at the CR phase included stress and arousal regulation, adaptability, teamwork, situation awareness (including detection, sense-making and prediction) and decision making (de-biasing and confidence calibration). The mission-ready training phase is focused on tolerances (to sleep loss, monotony, pain, frustration, uncertainty) and resistance (to distraction, deception or manipulation). Operational Augmentation phase relies on support tools such as decision aids and fatigue countermeasures, while the Recovery phase employs reflexive (e.g., mindfulness), and restorative practices (e.g., nutrition and sleep hygiene). The periodization of cognitive training in this cycle is hypothesized to optimize both real-time cognitive performance and the resilience that enables life-long thriving. One of the most promising avenues of validating this hypothesis is by developing an expert consensus on the key CF ingredients and their relative importance in high-performance settings.
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Affiliation(s)
- Eugene Aidman
- Land Division, Defence Science & Technology Group, Edinburgh, SA, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia.,School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW, Australia
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44
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Wild J, Greenberg N, Moulds ML, Sharp ML, Fear N, Harvey S, Wessely S, Bryant RA. Pre-incident Training to Build Resilience in First Responders: Recommendations on What to and What Not to Do. Psychiatry 2020; 83:128-142. [PMID: 32338579 DOI: 10.1080/00332747.2020.1750215] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Emergency services are under enormous pressure to offer programmes that could protect their staff from the psychological impact of stressors encountered in their roles. There has been a surge in the number of pre-incident training programmes aimed at first responders to maintain their psychological wellbeing after critical incidents. These include pre-employment screening programmes, psychoeducation, operational training, line manager training and interventions aimed at improving resilience, wellbeing or stress management. Whilst developed with the best intentions, these programmes vary in efficacy. Therefore, knowing what training to offer first responders prior to exposure to critical incidents is far from clear. In this review, we critique the available evidence and make recommendations about what to offer and what to avoid offering first responders prior to exposure to critical incidents. We found no evidence of the effectiveness of pre-employment screening or psychoeducation offered as a standalone package, and little evidence for interventions aimed to improve wellbeing and resilience to stress - although current trials of empirically-driven interventions for first responders are underway and show promise in preventing stress-related psychopathology. Operational and line manager training showed the most promise but need to be evaluated in high quality trials with sufficient follow-up to draw conclusions about their preventative benefits.
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Lippmann M, Laudel H, Heinzle M, Narciss S. Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis. J Med Internet Res 2019; 21:e12497. [PMID: 31774413 PMCID: PMC6906627 DOI: 10.2196/12497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 08/17/2019] [Accepted: 09/26/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Internet-based mindfulness interventions are a promising approach to address challenges in the dissemination and implementation of mindfulness interventions, but it is unclear how the instructional design components of such interventions are associated with intervention effectiveness. OBJECTIVE The objective of this study was to identify the instructional design components of the internet-based mindfulness interventions and provide a framework for the classification of those components relative to the intervention effectiveness. METHODS The critical interpretive synthesis method was applied. In phase 1, a strategic literature review was conducted to generate hypotheses for the relationship between the effectiveness of internet-based mindfulness interventions and the instructional design components of those interventions. In phase 2, the literature review was extended to systematically explore and revise the hypotheses from phase 1. RESULTS A total of 18 studies were identified in phase 1; 14 additional studies were identified in phase 2. Of the 32 internet-based mindfulness interventions, 18 were classified as more effective, 11 as less effective, and only 3 as ineffective. The effectiveness of the interventions increased with the level of support provided by the instructional design components. The main difference between effective and ineffective interventions was the presence of just-in-time information in the form of reminders. More effective interventions included more supportive information (scores: 1.91 in phases 1 and 2) than less effective interventions (scores: 1.00 in phase 1 and 1.80 in phase 2), more part-task practice (scores: 1.18 in phase 1 and 1.60 in phase 2) than less effective interventions (scores: 0.33 in phase 1 and 1.40 in phase 2), and provided more just-in-time information (scores: 1.35 in phase 1 and 1.67 in phase 2) than less effective interventions (scores: 0.83 in phase 1 and 1.60 in phase 2). The average duration of more effective, less effective, and ineffective interventions differed for the studies of phase 1, with more effective interventions taking up more time (7.45 weeks) than less effective (4.58 weeks) or ineffective interventions (3 weeks). However, this difference did not extend to the studies of phase 2, with comparable average durations of effective (5.86 weeks), less effective (5.6 weeks), and ineffective (7 weeks) interventions. CONCLUSIONS Our results suggest that to be effective, internet-based mindfulness interventions must contain 4 instructional design components: formal learning tasks, supportive information, part-task practice, and just-in-time information. The effectiveness of the interventions increases with the level of support provided by each of these instructional design components.
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Affiliation(s)
- Marie Lippmann
- Department of Psychology, California State University, Chico, CA, United States
| | - Helena Laudel
- Psychology of Learning and Instruction, Faculty of Psychology - School of Science, Technische Universität Dresden, Dresden, Germany
| | - Marlene Heinzle
- Department of Media, Cognition and Communication, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Narciss
- Psychology of Learning and Instruction, Faculty of Psychology - School of Science, Technische Universität Dresden, Dresden, Germany
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