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Halabi Najjar R, Ackerman-Barger K. Advancing Equity and Justice in Academic Nursing Through Trauma-Informed Education Practice. J Nurs Educ 2024; 63:507-514. [PMID: 39120505 DOI: 10.3928/01484834-20240502-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
BACKGROUND As educators and schools redouble their efforts to support and graduate a diverse and highly competent student body, there is an urgent need to adopt an academic framework to understand the effects of trauma on student learning, ground equity and justice in nursing education, and underpin policy development. METHOD This article explicates the use of equity-centered trauma-informed education practice (TIEP) as a framework for examining, scrutinizing, and eliminating the influences and effects of racism, including explicit, implicit, systematic, and microaggressions, as well as inequitable approaches in practices, pedagogy, and policy. RESULTS Five key strategies were identified: (1) bias and antiracist work; (2) safety and trust; (3) culturally responsive pedagogy; (4) wellness and balance and (5) community-building. CONCLUSION Transforming nursing education requires a paradigm shift, with changes occurring from an individual to a system level. TIEP ensures changes are equity-centered and justice-focused. [J Nurs Educ. 2024;63(8):507-514.].
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Hines-Stellisch K, Gawlik KS, Teall AM, Tucker S. Implementation of Coaching to Address Burnout in Emergency Clinicians. J Emerg Nurs 2024:S0099-1767(24)00167-3. [PMID: 39046399 DOI: 10.1016/j.jen.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Factors including sleep disturbances, shift work, secondary traumatization, and workplace violence make emergency nurses uniquely susceptible to burnout. A recent study cited nearly half of emergency registered nurses (49.3%) experienced moderate to severe burnout. There is an urgent need for evidence-based solutions to address burnout and turnover in emergency nurses. The objective of this quality improvement project was to determine the effectiveness of a wellness coaching program for reducing burnout and turnover in emergency nurses and advanced practice providers. METHODS Baseline assessments of burnout and turnover intention were measured at the beginning of the coaching program and measured again upon completion of the coaching program. INTERVENTION Eight registered nurses and 2 advanced practice providers from an emergency department in a west coast community hospital completed 6 to 8 weeks of wellness coaching led by a board-certified nurse coach. The wellness coaching program was an evidence-based, modular curriculum in which participants chose the number and length of sessions. RESULTS An average of 6 hours of individualized, 1-on-1 wellness coaching was completed over 7.5 weeks. The project resulted in a large reduction in emotional exhaustion and turnover intention, no effect on depersonalization, and a small reduction in lack of personal achievement (Cohen's d = 0.79, 1.53, -0.18, and -0.35). Ninety percent of clinicians agreed or strongly agreed that coaching helped improve their burnout and said they would consider it again in the future. CONCLUSION This quality improvement project demonstrates wellness coaching was an evidence-based solution for improving burnout and turnover in emergency nurses. More investigation is needed to determine duration of reduction of these outcomes.
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Affiliation(s)
| | | | - Alice M Teall
- The Ohio State University College of Nursing, Columbus, OH
| | - Sharon Tucker
- Helene Fuld Health National Trust Institute for EBP in Nursing and Healthcare, The Ohio State University College of Nursing, Columbus, OH
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Henderson A, Jewell T, Huang X, Simpson A. Personal trauma history and secondary traumatic stress in mental health professionals: A systematic review. J Psychiatr Ment Health Nurs 2024. [PMID: 38972012 DOI: 10.1111/jpm.13082] [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: 03/20/2024] [Revised: 05/21/2024] [Accepted: 06/30/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION Caring for those who have been traumatized can place mental health professionals at risk of secondary traumatic stress, particularly in those with their own experience of personal trauma. AIM To identify the prevalence of personal trauma history and secondary traumatic stress in mental health professionals and whether there is an association between these two variables in mental health professionals. METHOD We preregistered the review with PROSPERO (CRD42022322939) and followed PRISMA guidelines. Medline, Embase, PsycINFO, Web of Science and CINHAL were searched up until 17th August 2023. Articles were included if they assessed both personal trauma history and secondary traumatic stress in mental health professionals. Data on the prevalence and association between these variables were extracted. Quality assessment of included studies was conducted using an adapted form of the Newcastle-Ottawa scale. RESULTS A total of 23 studies were included. Prevalence of personal trauma history ranged from 19%-81%, secondary traumatic stress ranged from 19% to 70%. Eighteen studies reported on the association between personal trauma history and secondary traumatic stress, with 14 out of 18 studies finding a statistically significant positive relationship between these variables. The majority of studies were of fair methodological quality. DISCUSSION Mental health professionals with a personal history of trauma are at heightened risk of suffering from secondary traumatic stress. IMPLICATIONS FOR PRACTICE Targeted support should be provided to professionals to prevent and/or address secondary traumatic stress in the workforce.
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Affiliation(s)
- Anita Henderson
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
- Children & Adolescent Mental Health, Central North West London NHS, London, UK
| | - Tom Jewell
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, David Goldberg Building, London, UK
- Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Xia Huang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, David Goldberg Building, London, UK
- Mental Health Centre, West China Hospital, Sichuan University, West China School of Nursing, Sichuan University, Chengdu, China
| | - Alan Simpson
- Care in Long Term Conditions Research Division, Florence Nightingale Faculty of Nursing Midwifery & Palliative Care, King's College London, London, UK
- Health Service and Population Research, Institute of Psychiatry, Psychology, Neuroscience King's College London, London, UK
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Crawford C, Williams JR. Support Needs of Labor and Delivery Nurses After Traumatic Experiences. J Obstet Gynecol Neonatal Nurs 2024; 53:383-396. [PMID: 38369297 DOI: 10.1016/j.jogn.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/13/2024] [Accepted: 01/23/2024] [Indexed: 02/20/2024] Open
Abstract
OBJECTIVE To examine the effect of psychological distress, overall distress, and institutional support following a traumatic workplace event on absenteeism, turnover intention, and resilience among labor and delivery nurses. DESIGN A quantitative cross-sectional survey. SETTING Online distribution from January 13, 2021, to February 2, 2021. PARTICIPANTS A nationwide convenience sample of labor and delivery nurses recruited from the Association of Women's Health, Obstetric and Neonatal Nurses (N = 171). METHODS Participants completed a survey that included the Second Victim Experience and Support Tool-Revised and the Second Victim Support Desirability survey. We compared available versus desired support options using descriptive analyses. We examined levels of psychological distress and lack of institutional support in relation to turnover intention, absenteeism, and resilience using multiple regression analyses. RESULTS Participants identified and described various traumatic experiences in the workplace, including neonatal and maternal death, complicated births, and workplace violence. Participants indicated that the available support services did not meet their needs. Psychological distress, overall distress, and lack of institutional support were associated with absenteeism and turnover, whereas only institutional support was associated with resilience. CONCLUSION Labor and delivery nurses encounter various traumatic events in the workplace, and the support services provided after an event do not meet their needs. Additional research is needed to understand the scope of the problem and investigate best practices to assist labor and delivery nurses following traumatic events.
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Loy M, Kowalsky R. Narrative Medicine: The Power of Shared Stories to Enhance Inclusive Clinical Care, Clinician Well-Being, and Medical Education. Perm J 2024; 28:93-101. [PMID: 38225914 PMCID: PMC11232909 DOI: 10.7812/tpp/23.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
The COVID-19 pandemic exacerbated the problem of secondary trauma and moral injury for health care workers. This reality, together with the epidemic of social isolation and loneliness, has brought the mental health of health care practitioners and patients to the forefront of the national conversation. Narrative medicine is an accessible, diversity-honoring, low-cost, underutilized pedagogical framework with potentially revolutionary benefits for enhancing patient care, supporting the underserved, mitigating clinician burnout, and improving team dynamics. Herein, the authors review the literature on these benefits and then discuss methods for integrating narrative medicine into clinical care and medical education at the undergraduate and graduate levels as well as continuing medical education.
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Affiliation(s)
- Michelle Loy
- Departments of Medicine and Pediatrics, New York-Presbyterian Hospital Weill Cornell Medicine, New York, NY, USA
| | - Rachel Kowalsky
- Departments of Emergency Medicine and Pediatrics, New York-Presbyterian Hospital Weill Cornell Medicine, New York, NY, USA
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Campbell BM, Knipp MA, Anwar SS, Hoopsick RA. Moral injury and substance use among United States healthcare workers. Stress Health 2024; 40:e3321. [PMID: 37786303 DOI: 10.1002/smi.3321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/08/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
Moral injury (i.e., perpetrating, witnessing, failing to prevent, or being a victim of acts that transgress one's moral beliefs, values, or ethics) has largely been studied in military-connected populations and is associated with a range of adverse psychological sequelae. Emerging literature suggests that healthcare workers also experience moral injury, particularly in the context of the ongoing COVID-19 pandemic. However, it is not known if moral injury contributes to substance use among healthcare workers or whether these effects might differ by gender, race/ethnicity, or occupational level. In March 2022, we collected self-reported pilot data from a diverse sample of US healthcare workers (N = 200) We examined the cross-sectional relationships between moral injury and several measures of substance use (i.e., current non-medical use of prescription drugs [NMUPD], current cannabis use, current use of other illicit drugs, and hazardous drinking) using separate logistic regression models. Next, we used separate interaction models to examine if any of these relations differed by gender, race/ethnicity, or occupational level. In main effects models, healthcare workers reporting greater moral injury had greater odds of current NMUPD (adjusted odds ratio (aOR) = 1.07; p < 0.001), current use of other illicit drugs (aOR = 1.09; p < 0.01), and hazardous drinking (aOR = 1.07; p < 0.01). These relations did not differ by race/ethnicity or occupational level (ps > 0.05); however, men were more likely to report current NMUPD and hazardous drinking (ps < 0.05) in the presence of high moral injury than women healthcare workers. Our findings suggest that healthcare workers experience substantial distress related to morally injurious events, which may affect their likelihood of NMUPD, cannabis use, use of other illicit drugs, and hazardous drinking, and that men in healthcare may be particularly at risk. Healthcare organizations should address systemic issues driving moral injury (e.g., resource shortages, lack of psychosocial support) to prevent substance-related harms among healthcare workers.
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Affiliation(s)
- Benjamin M Campbell
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Michael A Knipp
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Sinan S Anwar
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Rachel A Hoopsick
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
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Liu N, Plouffe RA, Liu JJW, Nouri MS, Saha P, Gargala D, Davis BD, Nazarov A, Richardson JD. Determinants of burnout in Canadian health care workers during the COVID-19 pandemic. Eur J Psychotraumatol 2024; 15:2351782. [PMID: 38775008 PMCID: PMC11123547 DOI: 10.1080/20008066.2024.2351782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Health care workers (HCWs) are among the most vulnerable groups to experience burnout during the coronavirus (COVID-19) pandemic. Understanding the risk and protective factors of burnout is crucial in guiding the development of interventions; however, the understanding of burnout determinants in the Canadian HCW population remains limited.Objective: Identify risk and protective factors associated with burnout in Canadian HCWs during the COVID-19 pandemic and evaluate organizational factors as moderators in the relationship between COVID-19 contact and burnout.Methods: Data were drawn from an online longitudinal survey of Canadian HCWs collected between 26 June 2020 and 31 December 2020. Participants completed questions pertaining to their well-being, burnout, workplace support and concerns relating to the COVID-19 pandemic. Baseline data from 1029 HCWs were included in the analysis. Independent samples t-tests and multiple linear regression were used to evaluate factors associated with burnout scores.Results: HCWs in contact with COVID-19 patients showed significantly higher likelihood of probable burnout than HCWs not directly providing care to COVID-19 patients. Fewer years of work experience was associated with a higher likelihood of probable burnout, whereas stronger workplace support, organizational leadership, supervisory leadership, and a favourable ethical climate were associated with a decreased likelihood of probable burnout. Workplace support, organizational leadership, supervisory leadership, and ethical climate did not moderate the associations between contact with COVID-19 patients and burnout.Conclusions: Our findings suggest that HCWs who worked directly with COVID-19 patients, had fewer years of work experience, and perceived poor workplace support, organizational leadership, supervisory leadership and ethical climate were at higher risk of burnout. Ensuring reasonable work hours, adequate support from management, and fostering an ethical work environment are potential organizational-level strategies to maintain HCWs' well-being.
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Affiliation(s)
- Nancy Liu
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Rachel A. Plouffe
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Jenny J. W. Liu
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Maede S. Nouri
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Priyonto Saha
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Dominic Gargala
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Brent D. Davis
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Computer Science, Western University, London, Canada
| | - Anthony Nazarov
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - J. Don Richardson
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
- St. Joseph’s Operational Stress Injury Clinic, Parkwood Institute, St. Joseph’s Health Care London, London, Canada
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Schiele J, Mazzari G, Struck A, Bailer Y, Langgartner D, Reber SO. Chronic sensory contact with subordinated conspecifics promotes splenic glucocorticoid resistance in experimentally wounded C57BL/6N male mice. Sci Rep 2024; 14:10867. [PMID: 38740863 DOI: 10.1038/s41598-024-61581-7] [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: 02/01/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024] Open
Abstract
Chronic psychosocial stress induced by the chronic subordinate colony housing (CSC, 19 Days) paradigm promotes functional splenic in vitro glucocorticoid (GC) resistance, but only if associated with significant bite wounding or prior abdominal transmitter implantation. Moreover, sensory contact to social defeat of conspecifics represents a social stressor for the observer individual. As the occurence and severity of bite wounding is not adequately controllable, the present study aimed to develop an animal model, allowing a bite wound-independent, more reliable generation of chronically-stressed mice characterized by functional splenic in vitro GC resistance. Therefore, male C57BL/6N mice received a standardized sterile intraperitoneal (i.p.) incision surgery or SHAM treatment one week prior to 19-days of (i) CSC, (ii) witnessing social defeat during CSC exposure in sensory contact (SENS) or (iii) single-housing for control (SHC), before assessing basal and LPS-induced splenic in vitro cell viability and GC resistance. Our results indicate that individually-housed SENS but not CSC mice develop mild signs of splenic in vitro GC resistance, when undergoing prior i.p.-wounding. Taken together and considering that future studies are warranted, our findings support the hypothesis that the combination of repeated standardized i.p.-wounding with chronic sensory stress exposure represents an adequate tool to induce functional splenic in vitro GC resistance independent of the occurrence of uncontrollable bite wounds required in social stress paradigms to induce a comparable phenotype.
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Affiliation(s)
- Jessica Schiele
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 11, 89081, Ulm, Baden-Württemberg, Germany
| | - Giulia Mazzari
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 11, 89081, Ulm, Baden-Württemberg, Germany
| | - Antonia Struck
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 11, 89081, Ulm, Baden-Württemberg, Germany
| | - Yorick Bailer
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 11, 89081, Ulm, Baden-Württemberg, Germany
| | - Dominik Langgartner
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 11, 89081, Ulm, Baden-Württemberg, Germany
| | - Stefan O Reber
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 11, 89081, Ulm, Baden-Württemberg, Germany.
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Łaskawiec-Żuławińska D, Grajek M, Krupa-Kotara K, Szlacheta P, Karacan H, Roszak M, Łabuz-Roszak B, Korzonek-Szlacheta I. Burnout and Life Satisfaction among Healthcare Workers Related to the COVID-19 Pandemic (Silesia, Poland). Behav Neurol 2024; 2024:9945392. [PMID: 38725562 PMCID: PMC11081745 DOI: 10.1155/2024/9945392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/17/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
Background The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as "COVID-19 burnout." The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic. Materials and Methods The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA). Results The study group included 900 participants. There were 300 physicians (mean age 38 ± 7 years), 300 nurses (mean age 35 ± 6 years), and 300 paramedics (mean age 31 ± 5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA (p = 0.001). We found a negative correlation between life satisfaction and EE (p = 0.001), DEP (p = 0.001), and SRPA (p = 0.002). Conclusions The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group.
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Affiliation(s)
- Daria Łaskawiec-Żuławińska
- Department of Cardiovascular Disease Prevention, Faculty of Public Health, Medical University of Silesia in Katowice, Piekarska 18, 41-902 Bytom, Poland
| | - Mateusz Grajek
- Department of Public Health, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 41-902 Bytom, Poland
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Department of Epidemiology and Biostatistics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 41-902 Bytom, Poland
| | - Patryk Szlacheta
- Department of Basic Medical Sciences, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 41-902 Bytom, Poland
| | - Hasan Karacan
- Department of Eastern Languages and Literature, Cyprus Science University, Casaphani, Cyprus
| | - Mateusz Roszak
- Student Scientific Society at the Department of Neurology, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Beata Łabuz-Roszak
- Department of Neurology, Institute of Medical Sciences, University of Opole, 45-040 Opole, Poland
| | - Ilona Korzonek-Szlacheta
- Department of Cardiovascular Disease Prevention, Faculty of Public Health, Medical University of Silesia in Katowice, Piekarska 18, 41-902 Bytom, Poland
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Chatham AA, Petruzzi LJ, Patel S, Brode WM, Cook R, Garza B, Garay R, Mercer T, Valdez CR. Structural Factors Contributing to Compassion Fatigue, Burnout, and Secondary Traumatic Stress Among Hospital-Based Healthcare Professionals During the COVID-19 Pandemic. QUALITATIVE HEALTH RESEARCH 2024; 34:362-373. [PMID: 38011747 PMCID: PMC10905984 DOI: 10.1177/10497323231213825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
High levels of burnout among healthcare providers (HCPs) have been a widely documented phenomenon, which have been exacerbated during the COVID-19 pandemic. In the United States, qualitative studies that are inclusive of HCPs in diverse professional roles have been limited. Therefore, we utilized a qualitative-quantitative design to examine professional quality of life in terms of compassion fatigue, burnout, and secondary traumatic stress among hospital-based HCPs, including social workers, hospitalists, residents, and palliative care team members during COVID-19. HCPs (n = 26) participated in virtual semi-structured focus groups or individual interviews and online surveys (n = 30) including the Professional Quality of Life (ProQOL) Scale. While ProQOL scores indicated low levels of compassion fatigue, burnout, and secondary traumatic stress, thematic analysis of our qualitative data included rich descriptions of compassion fatigue, burnout, and secondary traumatic stress. Safety concerns and value misalignment characterized structural stressors perceived to contribute to HCP compassion fatigue, burnout, and secondary traumatic stress. The discrepancy between our qualitative and quantitative findings may be indication that modifications to current screenings are warranted. These findings also suggest a need to identify and implement structural and policy changes that increase HCPs' physical and emotional safety and promote better alignment of institutional interests with HCP values.
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Affiliation(s)
- Ana A. Chatham
- Steve Hicks School of Social Work at The University of Texas at Austin, Austin, TX, USA
| | - Liana J. Petruzzi
- Population Health Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Snehal Patel
- Population Health Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
- Internal Medicine Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - W. Michael Brode
- Population Health Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
- Internal Medicine Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Rebecca Cook
- Population Health Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
- Internal Medicine Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Brenda Garza
- Population Health Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Ricardo Garay
- Population Health Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Tim Mercer
- Population Health Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
- Internal Medicine Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Carmen R. Valdez
- Steve Hicks School of Social Work at The University of Texas at Austin, Austin, TX, USA
- Population Health Department, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
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11
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Akinleye D, Wu M, Efferen LS, McCauley S, Allen A, Bennett H, Snitkoff LS, Cleary LM, Bliss K, Martiniano R, Wang S, McNutt LA, Osinaga A. Newly Acquired Burnout During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Retrospective Cohort Study on the Experiences of New York State Primary Care Clinicians. J Community Health 2024; 49:34-45. [PMID: 37382837 DOI: 10.1007/s10900-023-01247-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 06/30/2023]
Abstract
The well-being of primary care clinicians represents an area of increasing interest amid concerns that the COVID-19 pandemic may have exacerbated already high prevalence rates of clinician burnout. This retrospective cohort study was designed to identify demographic, clinical, and work-specific factors that may have contributed to newly acquired burnout after the onset of the COVID-19 pandemic. An anonymous web-based questionnaire distributed in August 2020 to New York State (NYS) primary care clinicians, via email outreach and newsletters, produced 1,499 NYS primary care clinician survey respondents. Burnout assessment was measured pre-pandemic and early in the pandemic using a validated single-item question with a 5-point scale ranging from (1) enjoy work to (5) completely burned out. Demographic and work factors were assessed via the self-reporting questionnaire. Thirty percent of 1,499 survey respondents reported newly acquired burnout during the early pandemic period. This was more often reported by clinicians who were women, were younger than 56 years old, had adult dependents, practiced in New York City, had dual roles (patient care and administration), and were employees. Lack of control in the workplace prior to the pandemic was predictive of burnout early in the pandemic, while work control changes experienced following the pandemic were associated with newly acquired burnout. Low response rate and potential recall bias represent limitations. These findings demonstrate that reporting of burnout increased among primary care clinicians during the pandemic, partially due to varied and numerous work environment and systemic factors.
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Affiliation(s)
- Dean Akinleye
- Bureau of Clinical Research and Evaluation, Office of Quality and Patient Safety, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1955, Albany, NY, 12237, USA.
| | - Meng Wu
- Bureau of Clinical Research and Evaluation, Office of Quality and Patient Safety, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1955, Albany, NY, 12237, USA
| | - Linda S Efferen
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
| | - Susan McCauley
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
| | - Amanda Allen
- Communications, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Heather Bennett
- Diversity Equity and Inclusion Task Force, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Louis S Snitkoff
- Albany Medical College, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Lynn M Cleary
- Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Kate Bliss
- Office of Health Insurance Programs, New York State Department of Health, ESP Corning Tower, Room, Albany, NY, 12237, USA
| | - Robert Martiniano
- Center for Health Workforce Studies, University at Albany School of Public Health, 1 University Plaza, Pl #220, Rensselaer, NY, 12144, USA
| | - Shen Wang
- Center for Health Workforce Studies, University at Albany School of Public Health, 1 University Plaza, Pl #220, Rensselaer, NY, 12144, USA
| | - Louise-Ann McNutt
- Institute for Health and the Environment, University at Albany, State University of New York, 5 University Place, Room A217, Rensselaer, NY, 12144, USA
| | - Alda Osinaga
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
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12
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Qian J, Wu G, Jevitt C, Sun S, Wang M, Sun X, Yu X. Psychological pathway to emotional exhaustion among nurses and midwives who provide perinatal bereavement care in China: a path analysis. BMC Psychiatry 2024; 24:90. [PMID: 38297253 PMCID: PMC10832229 DOI: 10.1186/s12888-024-05534-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND A lack of confidence in perinatal bereavement care (PBC) and the psychological trauma experienced by nurses and midwives during bereavement care leads to their strong need for sufficient organisational support. The current study intended to test a hypothesised model of the specific impact paths among organisational support, confidence in PBC, secondary traumatic stress, and emotional exhaustion among nurses and midwives. METHODS A descriptive, cross-sectional survey was conducted in sixteen maternity hospitals in Zhejiang Province, China, from August to October 2021. The sample (n = 779) consisted of obstetric nurses and midwives. A path analysis was used to test the relationships among study variables and assess model fit. RESULTS Organisational support directly and positively predicted confidence in PBC and demonstrated a direct, negative, and significant association with secondary traumatic stress and emotional exhaustion. Confidence in PBC had a positive direct effect on secondary traumatic stress and a positive indirect effect on emotional exhaustion via secondary traumatic stress. Secondary traumatic stress exhibited a significant, direct effect on emotional exhaustion. CONCLUSIONS This study shows that nurses' and midwives' confidence in PBC and mental health were leadingly influenced by organisational support in perinatal bereavement practice. It is worth noting that higher confidence in PBC may lead to more serious psychological trauma symptoms in nurses and midwives. Secondary traumatic stress plays an essential role in contributing to emotional exhaustion. The findings suggest that support from organisations and self-care interventions were required to improve confidence in PBC and reduce negative psychological outcomes among those providing PBC. The development of objective measures for assessing competence in PBC and organizational support are essential.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, Hangzhou, China
- Midwifery Division, Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Gaoyan Wu
- Surgery Department of Thyroid and Breast, Huashan Hospital Fudan University, Shanghai, China
| | - Cecilia Jevitt
- Midwifery Division, Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China, 1st Xueshi Road, Zhejiang Province, 310006
| | - Man Wang
- Zhejiang University School of Medicine, Hangzhou, China
| | - Xiangyu Sun
- Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China, 1st Xueshi Road, Zhejiang Province, 310006.
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13
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Wang L, Norman I, Xiao T, Li Y, Li X, Liu T, Wang J, Zeng L, Zhong Z, Jian C, Leamy M. Feasibility and acceptability of a culturally adapted psychological first aid training intervention (Preparing Me) to support the mental health and well-being of front-line healthcare workers in China: a feasibility randomized controlled trial. Eur J Psychotraumatol 2024; 15:2299195. [PMID: 38269751 PMCID: PMC10812857 DOI: 10.1080/20008066.2023.2299195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/15/2023] [Indexed: 01/26/2024] Open
Abstract
Background: Psychological first aid (PFA) training helps to prepare healthcare workers (HCWs) to manage trauma and stress during healthcare emergencies, yet evidence regarding its effectiveness and implementation is lacking.Method: A two-arm feasibility randomized controlled trial design was conducted in a Chinese tertiary hospital. Participants were randomly allocated to receive either a culturally adapted PFA training (the intervention arm) or psychoeducation (the control arm). Feasibility indicators and selected outcomes were collected.Results: In total, 215 workers who expressed an interest in participating in the trial were screened for eligibility, resulting in 96 eligible participants being randomly allocated to the intervention arm (n = 48) and control arm (n = 48). There was a higher retention rate for the face-to-face PFA training session than for the four online group PFA sessions. Participants rated the PFA training as very helpful (86%), with a satisfaction rate of 74.25%, and 47% reported being able to apply their PFA skills in responding to public health emergencies or providing front-line clinical care. Positive outcome changes were observed in PFA knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth. Their scores on depression, anxiety, stress, and burnout measures all declined. Most of these changes were sustained over 3 months (p < .05). Repeated measures analysis of variance found statistically significant interaction effects on depression (F2,232 = 2.874, p = .046, η p 2 = .031) and burnout (F2,211 = 3.729, p = .018, η p 2 = .037), indicating a greater reduction in symptoms of depression and burnout with PFA compared to psychoeducation training.Conclusion: This culturally adapted PFA training intervention was highly acceptable among Chinese HCWs and was feasible in a front-line care setting. Preliminary findings indicated positive changes for the PFA training intervention on knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth, especially a reduction of depression and burnout. Further modifications are recommended and a fully powered evaluation of PFA training is warranted.
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Affiliation(s)
- Ling Wang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Ian Norman
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Tao Xiao
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Yamin Li
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Xizhao Li
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Ting Liu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jianjian Wang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Lina Zeng
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Ziqing Zhong
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Chengzhu Jian
- Department of Urinary Surgery, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Mary Leamy
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
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Taleb S, Vahedian-Azimi A, Karimi L, Salim S, Mohammad F, Samhadaneh D, Singh K, Hussein NR, Ait Hssain A. Evaluation of psychological distress, burnout and structural empowerment status of healthcare workers during the outbreak of coronavirus disease (COVID-19): a cross-sectional questionnaire-based study. BMC Psychiatry 2024; 24:61. [PMID: 38254016 PMCID: PMC10804486 DOI: 10.1186/s12888-023-05088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/08/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND In light of several recent studies, there is evidence that the coronavirus disease 2019 (COVID-19) pandemic has caused various mental health concerns in the general population, as well as among healthcare workers (HCWs). The main aim of this study was to assess the psychological distress, burnout and structural empowerment status of HCWs during the COVID-19 outbreak, and to evaluate its predictors. METHODS This multi-center, cross-sectional web-based questionnaire survey was conducted on HCWs during the outbreak of COVID-19 from August 2020 to January 2021. HCWs working in hospitals from 48 different countries were invited to participate in an online anonymous survey that investigated sociodemographic data, psychological distress, burnout and structural empowerment (SE) based on Depression Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI) and Conditions for work effectiveness questionnaire (CWEQ_II), respectively. Predictors of the total scores of DASS-21, MBI and CWEQ-II were assessed using unadjusted and adjusted binary logistic regression analysis. RESULTS Out of the 1030 HCWs enrolled in this survey, all completed the sociodemographic section (response rate 100%) A total of 730 (70.9%) HCWs completed the DASS-21 questionnaire, 852 (82.6%) completed the MBI questionnaire, and 712 (69.1%) completed the CWEQ-II questionnaire. The results indicate that 360 out of 730 responders (49.3%) reported severe or extremely severe levels of stress, anxiety, and depression. Additionally, 422 out of 851 responders (49.6%) reported a high level of burnout, while 268 out of 712 responders (37.6%) reported a high level of structural empowerment based on the DASS-21, MBI, and CWEQ-II scales, respectively. In addition, the analysis showed that HCWs working in the COVID-19 areas experienced significantly higher symptoms of severe stress, anxiety, depression and higher levels of burnout compared to those working in other areas. The results also revealed that direct work with COVID-19 patients, lower work experience, and high workload during the outbreak of COVID-19 increase the risks of negative psychological consequences. CONCLUSION Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.
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Affiliation(s)
- Sara Taleb
- Division of Genomics and Translational Biomedicine, College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar
- Proteomics Core, Research department, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Leila Karimi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Safa Salim
- Division of Biological and Biomedical Sciences, College of Health & Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Farhan Mohammad
- Division of Biological and Biomedical Sciences, College of Health & Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | | | - Kalpana Singh
- Nursing Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar.
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar.
- College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar.
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Noureen N, Gul S, Maqsood A, Hakim H, Yaswi A. Navigating the Shadows of Others' Traumas: An In-Depth Examination of Secondary Traumatic Stress and Psychological Distress among Rescue Professionals. Behav Sci (Basel) 2023; 14:21. [PMID: 38247673 PMCID: PMC10813387 DOI: 10.3390/bs14010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/14/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Rescue workers, who often find themselves on the frontlines of traumatic events, face an increased risk of experiencing secondary traumatic stress (STS) and psychological distress (PD). The nature of their work, alongside professional factors, can influence the way these psychological aspects manifest and their level of severity. This study aimed to explore the relationship between STS and PD in rescue workers. Additionally, it sought to understand how factors such as age, years of experience, duration of work, training received and direct exposure to trauma explain significant variations in reporting to STS. To conduct this research, a cross-sectional study design was implemented involving a sample of 80 rescue workers from the Punjab province in Pakistan. Data was collected over eight weeks using the secondary traumatic stress scale (STSS-17) and the general health questionnaire (GHQ-12) as primary assessment tools. Participants' data was analyzed through Pearson correlation analysis, t-tests, and ANOVA. A strong positive correlation between STS and PD among rescue workers was established. Age significantly explains variation in scores, with older workers displaying reduced STS and PD symptoms. Rescue workers working for longer hours reported elevated STS compared to those working shorter shifts. Workers with more extended professional experience showcased lower STS, highlighting the potential resilience acquired over time. The study also underscored the importance of training duration: longer, well-structured training was associated with decreased STS and PD. Interestingly, longer exposure to trauma was found to be related to lower STS scores, albeit this warrants further investigation. This study underscores the intertwined nature of STS and PD among rescue workers and the various modulating factors. The study paves the way for more comprehensive research, expanding geographically and demographically.
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Affiliation(s)
- Nazia Noureen
- Department of Psychology, Foundation University, Rawalpindi 44000, Punjab, Pakistan;
| | - Seema Gul
- General Studies Department, College of Humanities and Sciences, Prince Sultan University, Riyadh 11586, Saudi Arabia; (S.G.); (A.Y.)
| | - Aneela Maqsood
- National Centre for Research on Suicide Prevention, Department of Behavioral Sciences, Fatima Jinnah Women University, Rawalpindi 44000, Punjab, Pakistan
| | - Humaira Hakim
- Department of Behavioral Sciences, Fatima Jinnah Women University, Rawalpindi 44000, Punjab, Pakistan;
| | - Arooj Yaswi
- General Studies Department, College of Humanities and Sciences, Prince Sultan University, Riyadh 11586, Saudi Arabia; (S.G.); (A.Y.)
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16
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Bailey BC, Cox S, Terris L, van Oppen D, Howsare J, Berry JH, Winstanley EL. Rural health care worker wellness during COVID-19: Compassion fatigue, compassion satisfaction & utilization of wellness resources. PLoS One 2023; 18:e0295020. [PMID: 38064476 PMCID: PMC10707602 DOI: 10.1371/journal.pone.0295020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE The goal of this study was to identify factors associated with compassion fatigue (CF) and compassion satisfaction (CS) among rural health care workers (HCWs) during the COVID-19 pandemic. The secondary purpose was to assess utilization of wellness resources and preferences for new resources. METHODS A survey was distributed (October-December 2020) and completed by faculty, clinicians and staff (n = 406) at a rural university. Measures included a modified version of the Professional Quality of Life Scale (PROQOL-21), the Patient Health Questionnaire-4 and the Brief Resilience Coping Scale. Respondents reported their use of wellness resources and their preferences for new resources. RESULTS The mean CF score was 21.1, the mean CS score was 26.8 and 42.0% screened positive for depression or anxiety. Few of the existing wellness resources were utilized and respondents' preferences for new wellness resources included time off (70.7%), onsite food trucks (43.0%) and support animals (36.5%). Younger age, depression and anxiety were associated with higher CF. Older age, better mental health and resilience were associated with higher CS. CONCLUSIONS Rural HCWs have high CF, yet few utilize wellness resources. Rural health care organizations may foster wellness by providing time off for self-care, expanding mental health services and building resilience.
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Affiliation(s)
- Bridget C. Bailey
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
- School of Social Work, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV, United States of America
| | - Stephanie Cox
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
| | - Lisa Terris
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
| | - Dorothy van Oppen
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
| | - Janie Howsare
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
| | - James H. Berry
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
| | - Erin L. Winstanley
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
- Department of Neuroscience, School of Medicine, West Virginia University, Morgantown, WV, United States of America
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Martínez-Arriaga RJ, Dominguez-Rodriguez A, Herdoiza-Arroyo PE, Robles-Garcia R, de la Rosa-Gómez A, Figueroa González JA, Muñoz Anacona YA. Suicide risk and associated factors in healthcare workers seeking psychological support during COVID-19: a cross-sectional study. PSYCHOL HEALTH MED 2023; 28:3076-3090. [PMID: 37224286 DOI: 10.1080/13548506.2023.2216469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
Healthcare workers have been one of the groups most severely affected by the COVID-19 pandemic, leaving them with serious psychological effects. Some of these effects have not been treated promptly, leading to further psychological symptoms. The objective of this study was to evaluate suicide risk in healthcare workers seeking psychological help during the COVID-19 pandemic, and factors associated with this risk on participants that were searching for treatment during the COVID-19 pandemic. This is a cross-sectional study analyzing data from 626 Mexican healthcare workers seeking psychological help due to the COVID-19 pandemic through the www.personalcovid.com platform. Before they entered treatment, the Plutchik Suicide Risk Scale, the Depression Scale of the Center for Epidemiologic Studies, the Pittsburgh Sleep Quality Index, and the Professional Quality of Life Measure, were administered. Results: 49.4% (n = 308) presented suicide risk. The most severely affected groups were nurses (62%, n = 98) and physicians (52.7%, n = 96). Predictors of suicide risk in healthcare workers were secondary traumatic stress, high depressive affect, low positive affect, emotional insecurity and interpersonal problems, and medication use. Conclusions: The suicidal risk detected was high, found mostly in nurses and doctors. This study suggests the presence of psychological effects on healthcare workers, despite the time that has elapsed since the onset of the pandemic.
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Affiliation(s)
- Reyna Jazmín Martínez-Arriaga
- Departamento de Clínicas de Salud Mental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, Mexico
| | - Alejandro Dominguez-Rodriguez
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
- Health Sciences Area, Valencian International University, Valencia, Spain
| | | | - Rebeca Robles-Garcia
- Epidemiological and Psychosocial Research Directorate, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Anabel de la Rosa-Gómez
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Curtis MG, Davoudpour S, Felt D, French AL, Hosek SG, Phillips G, Serrano PA. Monkeypox-Induced Secondary Traumatic Stress: An Exploratory Analysis of Young Sexual and Gender Minority Adults Living in Illinois. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2023; 7:100349. [PMID: 37810174 PMCID: PMC10552682 DOI: 10.1016/j.ejtd.2023.100349] [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] [Indexed: 10/10/2023]
Abstract
Objective Prior epidemic literature suggests that the rapid proliferation of Monkeypox (Mpox) within the United States may trigger severe stress reactions that increase the risk of developing secondary traumatic stress among young adults most at risk of exposure. The present exploratory study aimed to investigate the degree to which proximity to Mpox (i.e. knowing people who acquired Mpox), was associated with symptoms of secondary traumatization. Method An online survey was administered to 253 participants enrolled in Keeping it LITE, a prospective U.S. cohort study of ethnically diverse, sexually active, sexual and gender minority persons ages 19-39 in September 2022. A multiple linear regression was used to examine the association between proximity to Mpox and secondary traumatic stress (STS) symptoms. Results Study findings demonstrated that Mpox morbidity was low (1%); however, 37% of participants reported knowing at least one person diagnosed with Mpox. For most individuals, this person was a friend (28%). 16% of participants were found to have at least one indicator of Mpox-related STS. Results of our multiple linear regression demonstrated a positive association between an individual's indirect exposure to Mpox via their interpersonal relationships and STS symptoms. Conclusions Findings suggest that the more adults' interpersonal relationships are saturated with people who have acquired Mpox, the more likely they are to develop symptoms of secondary traumatization. These findings provide tentative initial evidence that secondary exposure to Mpox via one's social network may undermine adults' mental health even after the conclusion of the outbreak.
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Rodriquez J. Becoming futile: the emotional pain of treating COVID-19 patients. FRONTIERS IN SOCIOLOGY 2023; 8:1231638. [PMID: 38024788 PMCID: PMC10663339 DOI: 10.3389/fsoc.2023.1231638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Introduction The COVID-19 pandemic has had a profoundly detrimental impact on the emotional wellbeing of health care workers. Numerous studies have shown that their rates of the various forms of work-related distress, which were already high before the pandemic, have worsened as the demands on health care workers intensified. Yet much less is known about the specific social processes that have generated these outcomes. This study adds to our collective knowledge by focusing on how one specific social process, the act of treating critically ill COVID-19 patients, contributed to emotional pain among health care workers. Methods This article draws from 40 interviews conducted with intensive care unit (ICU) staff in units that were overwhelmed with COVID-19 patients. The study participants were recruited from two suburban community hospitals in Massachusetts and the interviews were conducted between January and May 2021. Results The results show that the uncertainty over how to treat critically ill COVID-19 patients, given the absence of standard protocols combined with ineffective treatments that led to an unprecedented number of deaths caused significant emotional pain, characterized by a visceral, embodied experience that signaled moral distress, emotional exhaustion, depersonalization, and burnout. Furthermore, ICU workers' occupational identities were undermined as they confronted the limits of their own abilities and the limits of medicine more generally. Discussion The inability to save incurable COVID-19 patients while giving maximal care to such individuals caused health care workers in the ICU an immense amount of emotional pain, contributing to our understanding of the social processes that generated the well-documented increase in moral distress and related measures of work-related psychological distress. While recent studies of emotional socialization among health care workers have portrayed clinical empathy as a performed interactional strategy, the results here show empathy to be more than dramaturgical and, in this context, entailed considerable risk to workers' emotional wellbeing.
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Affiliation(s)
- Jason Rodriquez
- Department of Sociology, University of Massachusetts Boston, Boston, MA, United States
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20
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Shalabi KM, Alshraif ZA, Ismail RI, Almubarak K, Mohmoud N, Shaik SA. Secondary Traumatic Stress Disorder Among Physiotherapists Working in High Morbidity Departments: A Cross-Sectional Study. J Multidiscip Healthc 2023; 16:3287-3297. [PMID: 37954468 PMCID: PMC10637239 DOI: 10.2147/jmdh.s428034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose This study's objective was to measure secondary traumatic stress disorder among Saudi Arabian physiotherapists employed in the critical care, neurology, cardiology, pulmonology, and mental health fields. Also, to identify the factors related to secondary traumatic stress. Methods Between July 2021 and June 2022, a cross-sectional study involving physiotherapists from the critical care, emergency, neurology, cardiology, pulmonology, and mental health departments was carried out. Data were collected from the participants by using the validated Secondary Traumatic Stress Scale (STSS). Appropriate Statistical analysis (bivariate and multivariate) was carried using SPSS 21.0 software to analyse the data. Results We quantified the prevalence of secondary traumatic stress, among 201 healthcare professionals (physiotherapists) in total were assessed; of them, 23.4% worked in the medical/surgical and neurosurgical departments and 5% in the critical care and emergency departments. Twenty-four percent of the participants slept less than five hours each day, and 26.4% worked more than 45 hours per week. Our study subjects had mild STS in 25.4% of cases, moderate stress in 15.9%, high STS in 15.9% and severe STS in 30.9% of cases. The intrusion score (mean = 11.65), avoidance score (mean = 5.5), arousal score (mean = 4.1) and total mean score of 42.50 of the STSS were significantly different across the age groups, marital status and years of experience of study participants. The regression analysis shows age groups and severe stress were independently related to the total STS scores. Conclusion The study has found out higher level of STS among physiotherapists which highlights the necessity for a variety of interventional programs to be implemented in hospital settings in order to enhance communication abilities, lessen emotional discomfort, and apply relaxing techniques.
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Affiliation(s)
- Kholood M Shalabi
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Zahra A Alshraif
- Rehabilitation Services Department, King Abdullah University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Kheloud Almubarak
- Rehabilitation Services Department, King Abdullah University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Noha Mohmoud
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Shaffi A Shaik
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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21
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Feng B, Bian H, Zhang K, Meng C, Gong X, Ma X, Su C, Zhou M, Xu J, Zhang W, Zhang X, Zhou Y, Shang D. The workload change and depression among emergency medical staff after the open policy during COVID-19: a cross-sectional survey in Shandong, China. Front Public Health 2023; 11:1281787. [PMID: 38026268 PMCID: PMC10655007 DOI: 10.3389/fpubh.2023.1281787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction In the middle of December 2022, the Chinese government adjusted the lockdown policy on coronavirus disease 2019 (COVID-19), a large number of infected patients flooded into the emergency department. The emergency medical staff encountered significant working and mental stress while fighting the COVID-19 pandemic. We aimed to investigate the workload change, and the prevalence and associated factors for depression symptoms among emergency medical staff after the policy adjustment. Methods We conducted a cross-sectional online survey of emergency medical staff who fought against COVID-19 in Shandong Province during January 16 to 31, 2023. The respondents' sociodemographic and work information were collected, and they were asked to complete the 9-item Patient Health Questionnaire (PHQ-9) then. Univariate and multivariate logistic regression analyses were applied to identify the potential associated factors for major depression. Results Nine hundred and sixteen emergency medical personnel from 108 hospitals responded to this survey. The respondents' weekly working hours (53.65 ± 17.36 vs 49.68 ± 14.84) and monthly night shifts (7.25 ± 3.85 vs 6.80 ± 3.77) increased after the open policy. About 54.3% of the respondents scored more than 10 points on the PHQ-9 standardized test, which is associated with depressive symptoms. In univariate analysis, being doctors, living with family members aged ≤16 or ≥ 65 years old, COVID-19 infection and increased weekly working hours after the open policy were significantly associated with a PHQ-9 score ≥ 10 points. In the multivariate analysis, only increased weekly working hours showed significant association with scoring ≥10 points. Conclusion Emergency medical staff' workload had increased after the open policy announcement, which was strongly associated with a higher PHQ-9 scores, indicating a very high risk for major depression. Emergency medical staff working as doctors or with an intermediate title from grade-A tertiary hospitals had higher PHQ-9 scores, while COVID-19 infection and weekly working hours of 60 or more after the open policy were associated with higher PHQ-9 scores for those from grade-B tertiary hospitals. Hospital administrators should reinforce the importance of targeted emergency medical staff support during future outbreaks.
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Affiliation(s)
- Baobao Feng
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hongjun Bian
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ke Zhang
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Chong Meng
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xianwei Gong
- Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xueqiang Ma
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chunhua Su
- Department of Emergency, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, China
| | - Mingxiang Zhou
- Department of Emergency, Shandong Public Health Clinical Center Affiliated to Shandong University, Jinan, China
| | - Jiarui Xu
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Wei Zhang
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xingguo Zhang
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yi Zhou
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Deya Shang
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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22
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Jafarian_amiri SR, Qanbari Qalehsari M, Zabihi A, Babanataj R, Chehrazi M. The relationship between empowerment and compassion satisfaction, compassion fatigue, and burnout in nurses during COVID-19 outbreak. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:379. [PMID: 38144007 PMCID: PMC10743936 DOI: 10.4103/jehp.jehp_504_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/07/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The quality of nurses' professional life is at stake in crises such as COVID-19. Empowerment helps employees perform better and advance the goals of the organization. This study aimed to investigate the relationship between empowerment and the quality of nurses' professional life during the outbreak of COVID-19. MATERIALS AND METHODS The current cross-sectional study was conducted in 2021 in the hospitals of Babol University of Medical Sciences with the participation of 200 nurses providing care for COVID-19 patients who were included in the study by convenience sampling method. Data collection tools included the Empowerment Questionnaire (Leader Empowerment Behaviors Scale, Structural Empowerment, and Psychological Empowerment) and the Professional Quality of Life Questionnaire. SPSS software version 23 was used to analyze the data. Multiple linear regressions were used to investigate the relationship between empowerment and quality of professional life. RESULTS In the majority of nurses, compassion satisfaction 140 (70%), burnout 172 (86%), and compassion fatigue 126 (63%) were at moderate level. A significant relationship was found between compassion satisfaction and Leader Empowerment (R = 0.54, P =. 001), Psychological Empowerment (R = 0.55, P =. 001), and Structural Empowerment (R = 0.42, P =. 001) and Compassion Fatigue and Leader Empowerment (R = 0.35, P =. 001), psychological empowerment (R = 0.42, P =. 001), and structural empowerment (R = 0.49, P =. 001). CONCLUSION Nursing managers' attention to empowerment strategies in crises such as COVID-19 can improve compassion satisfaction and reduce compassion fatigue in nurses. It is also necessary to implement policies and guidelines for the development of psychosocial support to health promotion of the workplace, education, informing, and empowering nurses.
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Affiliation(s)
- Seyedeh Roghayeh Jafarian_amiri
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Mojtaba Qanbari Qalehsari
- Nursing Care Research Center, Health Research Institute, Nursing and Midwifery School, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Ali Zabihi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Reyhaneh Babanataj
- Trauma Nursing Research Center, Medical Surgical of Science Department, Faculty of Nursing, Kashan University of Medical Science, Kashan, Islamic Republic of Iran
| | - Mohammad Chehrazi
- Department of Epidemiology and Biostatistics, School of Health, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
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23
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Mijakoski D, Atanasovska A, Bislimovska D, Brborović H, Brborović O, Cvjeanov Kezunović L, Milošević M, Minov J, Önal B, Pranjić N, Rapas L, Stoleski S, Vangelova K, Žaja R, Bulat P, Milovanović A, Karadžinska-Bislimovska J. Associations of burnout with job demands/resources during the pandemic in health workers from Southeast European countries. Front Psychol 2023; 14:1258226. [PMID: 37954180 PMCID: PMC10637351 DOI: 10.3389/fpsyg.2023.1258226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Despite several studies assessing job demands and burnout in countries from the Southeast European (SEE) region, there is still a lack of data about the psychological impact of the pandemic on health workers (HWs). Aims The present study aimed to demonstrate and compare levels of burnout dimensions in HWs from SEE countries and to reveal the burnout-job demands/resources relationships in these workers during the pandemic. Materials and methods During the autumn of 2020, this online multicentric cross-sectional survey studied a large group (N = 4.621) of HWs working in SEE countries. The Maslach Burnout Inventory was used for the measurement of burnout dimensions. We analyzed the job demands by using the Hospital Experience Scale. Remuneration and relationships with superiors were measured using the Questionnaire sur les Ressources et Contraintes Professionnelles (English version). Results A series of ANOVA comparisons of means revealed the countries in which respondents showed higher mean values of emotional exhaustion (Bosnia and Herzegovina, Bulgaria, Croatia, Moldova, Montenegro, and North Macedonia) and the countries in which respondents showed lower mean values of this burnout dimension (Israel and Romania) (Welch F = 17.98, p < 0.001). We also found differences among HWs from different countries in job demands and job resources. The testing of hierarchical regression models, which have been controlled for certain confounding factors, clearly revealed that emotional exhaustion was predicted by job demands (R2 = 0.37) and job resources (R2 = 0.16). Conclusion Preventive measures for the improvement of mental health in HWs during the pandemic and beyond have to take into account the differences between countries regarding the country context and current scientific knowledge. A modified stress test should be implemented in hospitals regarding future shocks that might include new pandemics, terrorism, catastrophes, or border conflicts.
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Affiliation(s)
- Dragan Mijakoski
- Faculty of Medicine, Institute of Occupational Health of RN Macedonia, World Health Organization Collaborating Center (WHO CC), Global Allergy and Asthma Excellence Network Collaborating Center (GA2LEN CC), Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Aneta Atanasovska
- Faculty of Medicine, Institute of Occupational Health of RN Macedonia, World Health Organization Collaborating Center (WHO CC), Global Allergy and Asthma Excellence Network Collaborating Center (GA2LEN CC), Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Dragana Bislimovska
- Faculty of Medicine, Institute of Occupational Health of RN Macedonia, World Health Organization Collaborating Center (WHO CC), Global Allergy and Asthma Excellence Network Collaborating Center (GA2LEN CC), Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Hana Brborović
- Department of Environmental and Occupational Health and Sports Medicine, School of Medicine, Andrija Štampar School of Public Health, University of Zagreb, Zagreb, Croatia
| | - Ognjen Brborović
- Department of Social Medicine and Organization of Health Care, School of Medicine, Andrija Štampar School of Public Health, University of Zagreb, Zagreb, Croatia
| | | | - Milan Milošević
- Department of Environmental and Occupational Health and Sports Medicine, School of Medicine, Andrija Štampar School of Public Health, University of Zagreb, Zagreb, Croatia
| | - Jordan Minov
- Faculty of Medicine, Institute of Occupational Health of RN Macedonia, World Health Organization Collaborating Center (WHO CC), Global Allergy and Asthma Excellence Network Collaborating Center (GA2LEN CC), Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Buhara Önal
- International Commission on Occupational Health National Secretary (ICOH NS) for Turkey, Ankara, Türkiye
| | - Nurka Pranjić
- Department of Occupational Medicine, Medical Faculty, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Liliana Rapas
- Directorate of Public Health Bucharest, Ministry of Health, Bucharest, Romania
| | - Sasho Stoleski
- Faculty of Medicine, Institute of Occupational Health of RN Macedonia, World Health Organization Collaborating Center (WHO CC), Global Allergy and Asthma Excellence Network Collaborating Center (GA2LEN CC), Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Katya Vangelova
- Department of Health at Work, National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Roko Žaja
- Department of Environmental and Occupational Health and Sports Medicine, School of Medicine, Andrija Štampar School of Public Health, University of Zagreb, Zagreb, Croatia
| | - Petar Bulat
- Faculty of Medicine, Serbian Institute of Occupational Health, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Milovanović
- Faculty of Medicine, Serbian Institute of Occupational Health, University of Belgrade, Belgrade, Serbia
| | - Jovanka Karadžinska-Bislimovska
- Faculty of Medicine, Institute of Occupational Health of RN Macedonia, World Health Organization Collaborating Center (WHO CC), Global Allergy and Asthma Excellence Network Collaborating Center (GA2LEN CC), Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
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Phuspa SM, Alim S, Dharmastuti A, Saefudin MA, Lutfiyah NU, Sutomo AH. Instruments for assessing health workers' burnout during the COVID-19 pandemic: a scoping review. J Ment Health 2023; 32:935-950. [PMID: 36068961 DOI: 10.1080/09638237.2022.2118689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/16/2022] [Accepted: 07/21/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, health workers' workload is increasing, with the risk of burnout. Several instruments for assessing burnout have been developed since the concept was coined in the 1970s. It is important to map and describe the application of burnout instruments for health workers in the current COVID-19 pandemic situation. AIMS This article aimed to map and describe what instruments are used and variations of their application to research burnout in health workers during the COVID-19 pandemic. METHODS This scoping review searched articles systematically through 7 databases (PubMed, Clinical Key, Scopus, EBSCOhost, APA PsycINFO, Science Direct, and Wiley Online Library). Articles were screened and analyzed following the Arksey and O'Malley framework. RESULTS From 507 results, 31 peer-reviewed articles were selected. These studies involved 33,879 participants from various health professions. Generally, the research instrument is still dominated by Maslach Burnout Inventory. Applications of burnout measurements vary widely because there is no consensus on the concept of burnout assessment. CONCLUSION Inconsistency in burnout-measuring tools can be seen as providing flexibility and alternatives, but at the same time, it is a gap that challenges researchers to develop more comprehensive instruments, especially for the burnout phenomenon in health workers during the COVID-19 pandemic.
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Affiliation(s)
- Sisca Mayang Phuspa
- Faculty of Medicine, Public Health, and Nursing at Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Health Science at Universitas Darussalam Gontor, Ponorogo, Indonesia
| | - Syahirul Alim
- Faculty of Medicine, Public Health, and Nursing at Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | | | | | - Adi Heru Sutomo
- Faculty of Medicine, Public Health, and Nursing at Universitas Gadjah Mada, Yogyakarta, Indonesia
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25
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Abstract
Background and Purpose: Secondary traumatic stress (STS) results in detrimental effects in healthcare professionals, impacting the safety of patients and their care. There are multiple instruments being used to measure STS, reflecting the uncertainty on how to best measure STS. The purpose of this review is to present an overview of the state of measurement of STS. Methods: PubMed, CINAHL, and Cochrane Database of Systematic Reviews databases were searched using the terms "secondary traumatic stress" and "measurement." Results: The search resulted in nine applicable articles and four instruments used to measure STS. Utility and psychometric properties of the instruments are examined. Conclusions: The secondary traumatic stress scale is most appropriate to measure STS given that it is the only instrument intended to measure only STS, but psychometric testing with nurses is needed.
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26
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Chen S, Lan X, Yu H. A social network analysis: mental health scales used during the COVID-19 pandemic. Front Psychiatry 2023; 14:1199906. [PMID: 37706038 PMCID: PMC10495585 DOI: 10.3389/fpsyt.2023.1199906] [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: 04/04/2023] [Accepted: 08/11/2023] [Indexed: 09/15/2023] Open
Abstract
Introduction The focus on psychological issues during COVID-19 has led to the development of large surveys that involve the use of mental health scales. Numerous mental health measurements are available; choosing the appropriate measurement is crucial. Methods A rule-based named entity recognition was used to recognize entities of mental health scales that occur in the articles from PubMed. The co-occurrence networks of mental health scales and Medical Subject Headings (MeSH) terms were constructed by Gephi. Results Five types of MeSH terms were filtered, including research objects, research topics, research methods, countries/regions, and factors. Seventy-eight mental health scales were discovered. Discussion The findings provide insights on the scales used most often during the pandemic, the key instruments used to measure healthcare workers' physical and mental health, the scales most often utilized for assessing maternal mental health, the tools used most commonly for assessing older adults' psychological resilience and loneliness, and new COVID-19 mental health scales. Future studies may use these findings as a guiding reference and compass.
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Affiliation(s)
| | - Xue Lan
- Department of Health Management, China Medical University, Shenyang, China
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27
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Scafuto F, Ciacchini R, Orrù G, Crescentini C, Conversano C, Mastorci F, Porricelli M, Gemignani A. COVID-19 Pandemic and Internet Addiction in Young Adults: A Pilot Study on Positive and Negative Psychosocial Correlates. CLINICAL NEUROPSYCHIATRY 2023; 20:240-251. [PMID: 37791079 PMCID: PMC10544255 DOI: 10.36131/cnfioritieditore20230403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Objective During and after the lockdowns of the COVID-19 pandemic period, a strain was put on young adults who have taken refuge in the problematic use of internet, social media, gaming, and gambling. This paper aims to investigate possible correlates of Internet Addiction Disorder (IAD), hypothesizing anxiety, depression and perceived stress would promote addiction, while mindfulness skills, resilience and socialization would, conversely, hamper IAD, and promote, consequently, a more functional internet use. Method A pilot study was carried out with a sample of 31 young adults, recruited through a snowball sampling using social networks. Participants filled out an online questionnaire including the following measures: Internet Use, Abuse and Addiction (UADI), Beck Depression Inventory (BDI-II); State-Trait Anxiety Inventory (STAI-Y); Perceived Stress Scale (PSS); Five Facet Mindfulness Questionnaire (FFMQ); Mindfulness Attention and Awareness Scale (MAAS); Resilience Scale (RS-14). It was also administered an ad hoc questionnaire for the assessment of socialization behaviour (6 items) and gambling (2 items). Results All the measures, but socialization, showed adequate reliability. Our sample showed high levels of anxiety, stress, IA and gambling, while presenting low levels of resilience, the mindful skill of no-reactivity and socialization. The first hypothesis was confirmed, finding positive and significant correlations between Internet Addiction on one side and PSS, STAI-Y1, STAY-2, and BDI II on the other side. We also partially confirmed the second hypothesis about UADI negatively correlated with both RS-14 and Mindful Acting. Finally, no correlations were found between Gambling and IA. Conclusions In conclusion, the more one perceives an emotional overload with less stress-control, high anxiety, and depression, and the less one can leverage on the skills of mindful acting and resilience, the more one uses the internet as a strategy to escape from a threatening reality.
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Affiliation(s)
- Francesca Scafuto
- Department of Language, Literature, Communication, Education and Society-University of Udine
| | - Rebecca Ciacchini
- Department of Surgical, Medical, Molecular and Critical Area Pathology-University of Pisa
| | - Graziella Orrù
- Department of Surgical, Medical, Molecular and Critical Area Pathology-University of Pisa
| | - Cristiano Crescentini
- Department of Language, Literature, Communication, Education and Society-University of Udine
| | - Ciro Conversano
- Department of Surgical, Medical, Molecular and Critical Area Pathology-University of Pisa
| | - Francesca Mastorci
- Department of Surgical, Medical, Molecular and Critical Area Pathology-University of Pisa
| | - Marika Porricelli
- Department of Surgical, Medical, Molecular and Critical Area Pathology-University of Pisa
| | - Angelo Gemignani
- Department of Surgical, Medical, Molecular and Critical Area Pathology-University of Pisa
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28
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Hăisan A, Hogaș S, Măirean C, Punei MO, Volovăț SR, Hogaș M, Kantor C, Cimpoeșu D. Compassion fatigue and compassion satisfaction among Romanian emergency medicine personnel. Front Med (Lausanne) 2023; 10:1189294. [PMID: 37554501 PMCID: PMC10406243 DOI: 10.3389/fmed.2023.1189294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
Background Contemporary scientific literature has emphasized two specific aspects of healthcare professionals: compassion satisfaction and compassion fatigue. In the context of the COVID-19 pandemic, which has placed significant strain on health systems and healthcare workers, the Russian-Ukrainian crisis appears to have a magnifying effect, particularly on mental health. Methods The aim of the present study was to investigate the relationship between threat perception, daily worries, and professional quality of life in a sample of Emergency Medicine Personnel during two major events mentioned above. The sample included 372 participants (56.7% nurses and 43.3% physicians) from emergency units in five county hospitals in the Eastern region of Romania. Results The study revealed that threats related to the pandemic were positively linked to secondary traumatic stress, and daily worries were positively linked to both secondary traumatic stress and burnout. Threats generated by the war did not manifest a direct relation with any of the indicators of professional quality of life, but daily worries generated by war positively predicted both secondary traumatic stress and burnout. Conclusion Both the pandemic, which involved cumulative exposure, and the war, which involved a lower and more distant level of exposure, had the potential to generate worries and predict a low quality of life. However, our results did not reveal any association between threats, worries, and compassion satisfaction. As a result, this positive indicator of quality of life remained stable despite the presence of threats and worries.
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Affiliation(s)
- Anca Hăisan
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
| | - Simona Hogaș
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
| | - Cornelia Măirean
- Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iași, Romania
| | - Mirabela-Olivia Punei
- Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iași, Romania
| | | | - Mihai Hogaș
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
| | - Cristina Kantor
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
| | - Diana Cimpoeșu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
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29
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Borges MMS, Nunes VR, Pires MP, Lima BG, Hipólito UV, Almeida MCDS. Quality of life at work and Burnout in family health strategy workers. Rev Gaucha Enferm 2023; 44:e20220279. [PMID: 37436227 DOI: 10.1590/1983-1447.2023.20220279.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/23/2022] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVE To analyze the correlation between quality of life at work and Burnout in workers in the Family Health Strategy. METHODS Correlational, cross-sectional study carried out with 112 workers, in the pandemic period (October/2020 to June/2021), in Palmas/Tocantins. The Quality of Work Life Assessment Questionnaire (QWLQ-bref) and the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) were used. RESULTS A strong negative correlation was identified between Emotional Exhaustion and the Physical/Health, Professional and Total Quality of Life Score at work; and moderate negative correlation between Depersonalization and all domains of Quality of Work Life. Professional Achievement showed a moderate positive correlation with the Psychological and Personal domains and with the Total Quality of Work Life Score. CONCLUSION The best Quality of Work Life indices were correlated with lower Emotional Exhaustion and Depersonalization scores and higher scores of Professional Achievement.
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Affiliation(s)
| | - Viviane Reis Nunes
- Universidade Federal do Tocantins (UFT), Curso de Enfermagem. Palmas, Tocantins, Brasil
| | - Mateus Portilho Pires
- Universidade Federal do Tocantins (UFT), Curso de Enfermagem. Palmas, Tocantins, Brasil
| | - Bianca Guimarães Lima
- Universidade Federal do Tocantins (UFT), Curso de Enfermagem. Palmas, Tocantins, Brasil
| | | | - Mirian Cristina Dos Santos Almeida
- Universidade Federal do Tocantins (UFT), Curso de Enfermagem. Palmas, Tocantins, Brasil
- Fundação Escola Saúde Pública de Palmas (FESP). Palmas, Tocantins, Brasil
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30
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Naert MN, Pruitt C, Sarosi A, Berkin J, Stone J, Weintraub AS. A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in maternal-fetal medicine physicians in the United States. Am J Obstet Gynecol MFM 2023; 5:100989. [PMID: 37127208 DOI: 10.1016/j.ajogmf.2023.100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Compassion fatigue is secondary traumatic distress experienced by providers from ongoing contact with patients who are suffering. Compassion satisfaction is emotional fulfillment from caring for others. Burnout is distress related to dissonance between job demands and available resources. Although burnout is well-studied, compassion satisfaction and compassion fatigue are neglected components of physician well-being. Because of recurrent exposure to adverse outcomes, maternal-fetal medicine providers may be at particular risk for compassion fatigue. OBJECTIVE This study aimed to better characterize both clinical and nonclinical drivers of work-related distress vs satisfaction. STUDY DESIGN The modified Compassion Fatigue and Satisfaction Self-Test and a questionnaire of professional and personal characteristics were distributed electronically to maternal-fetal medicine providers nationally. Multivariable regression models were constructed for compassion fatigue, burnout, and compassion satisfaction as a function of potential predictors. RESULTS The survey response rate was 24% (n=366), primarily consisting of White physicians working in academic medical centers. Significant predictors of lower burnout scores included employment at 1 institution for >20 years, discussing work-related distress with friends, and having one's most recent involvement in decision-making for a periviable fetus >6 months ago; distress because of coworkers and personal factors predicted higher scores. Female sex, self-report of significant emotional depletion, use of mental health services, and having other maternal-fetal medicine physicians as part of the care team for a fetus with severe anomalies were significant predictors of higher compassion fatigue scores, whereas White race and having social work as part of the care team for a maternal mortality predicted lower scores. Personal spiritual practice was a significant predictor of higher compassion satisfaction score, whereas employment at current institution for <5 years predicted lower scores. CONCLUSION Compassion fatigue, compassion satisfaction, and burnout are associated with several modifiable risk factors, such as practice type, having a multidisciplinary team, and emotional support outside of the workplace; these are potential targets for intervention.
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Affiliation(s)
- Mackenzie N Naert
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Naert, Berkin, and Stone); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Dr Naert).
| | - Cassandra Pruitt
- Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Pruitt, Sarosi, and Weintraub); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Dr Pruitt)
| | - Alex Sarosi
- Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Pruitt, Sarosi, and Weintraub); Division of Plastic Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY (Dr Sarosi)
| | - Jill Berkin
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Naert, Berkin, and Stone)
| | - Joanne Stone
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Naert, Berkin, and Stone)
| | - Andrea S Weintraub
- Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Pruitt, Sarosi, and Weintraub)
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Vaughn RM, Bagatell N, McGovern H, Feinberg R, Hendry K, Chowdhury R, Cassidy JM. Politics, policies, and patient care: Rehabilitation therapists' experiences during the COVID-19 Pandemic. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2023; 7:10823. [PMID: 37441129 PMCID: PMC10336862 DOI: 10.4081/qrmh.2023.10823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/18/2023] [Indexed: 07/15/2023] Open
Abstract
The year 2020 represents a historically turbulent period for the United States marked by the COVID-19 pandemic, a contentious political season, and heightened awareness of racism among citizens. This intersection of medicine, politics, and social unrest generated a demanding clinical environment for healthcare workers, including understudied groups such as physical therapists, occupational therapists, and speech-language pathologists. This descriptive qualitative study focused on experiences and perspectives of clinical rehabilitation therapists working in inpatient rehabilitation and acute-care units from September to November, 2020. Thirteen participants completed individual, semi-structured interviews focused on clinical practice and coping strategies. The analysis included a multi-step, inductive process. Four interconnecting factors chronicling participants' experiences emerged: sociopolitical, institutional, hospital unit, and personal. Stressors and buffers were noted that further shaped individual experiences. Utilization of an ecological framework provided a way to recognize the impact of a complex range of social and environmental factors affecting participants' experiences on personal and professional levels. Awareness of rehabilitation therapists' experiences enriches understanding of the pandemic's effect on healthcare workers and presents clinical implications for healthcare systems to promote therapist well-being.
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Affiliation(s)
| | | | | | | | | | | | - Jessica M. Cassidy
- Department of Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Emirza S, Yılmaz Kozcu G. Protecting healthcare workers' mental health against COVID-19-related stress: The effects of stress mindset and psychological resilience. Nurs Health Sci 2023. [PMID: 37098413 DOI: 10.1111/nhs.13018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/20/2023] [Accepted: 03/28/2023] [Indexed: 04/27/2023]
Abstract
Healthcare workers have been on the frontline of the battle against COVID-19 disease. However, this has taken a toll on them, resulting in elevated stress and poor mental health. We argue that healthcare workers' stress mindset and resilience could mitigate negative outcomes of COVID-19-related stress by helping them view this stressful situation in a more positive light and appraise it as a challenge rather than a threat. Accordingly, we hypothesized that both a stress-is-enhancing mindset about COVID-19-related stress and resilience would improve healthcare workers' appraisal of their personal resources and increase their challenge appraisals, positively contributing to their mental health. We collected data from 160 healthcare workers and performed structural equation modeling for hypothesis testing. The results indicate that both a stress-is-enhancing mindset about COVID-19-related stress and psychological resilience are indirectly related to better mental well-being and lower health-related anxiety through challenge appraisals. This study contributes to research in mental health by suggesting that protecting and promoting healthcare workers' mental health is possible by empowering them through increasing personal resources such as a positive mindset about stressful situations and resilience.
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Affiliation(s)
- Sevgi Emirza
- Department of Business Administration, Dokuz Eylül University, İzmir, Turkey
| | - Gizem Yılmaz Kozcu
- Department of Business Administration, Dokuz Eylül University, İzmir, Turkey
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Stodolska A, Wójcik G, Barańska I, Kijowska V, Szczerbińska K. Prevalence of burnout among healthcare professionals during the COVID-19 pandemic and associated factors - a scoping review. Int J Occup Med Environ Health 2023; 36:21-58. [PMID: 36727492 PMCID: PMC10464746 DOI: 10.13075/ijomeh.1896.02007] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/12/2022] [Indexed: 02/03/2023] Open
Abstract
The outbreak of the COVID-19 pandemic exerted significant mental burden on healthcare workers (HCWs) operating in the frontline of the COVID-19 care as they experienced high levels of stress and burnout. The aim of this scoping review was to identify prevalence and factors associated with burnout among HCWs during the first year of the COVID-19 pandemic. A literature search was performed in PubMed, Web of Science, and CINAHL. Studies were selected based on the following inclusion criteria: cross-sectional, longitudinal, case-control, or qualitative analyses, published in peer-reviewed journals, between January 1, 2020 and February 28, 2021. Studies carried out on other occupations than healthcare workers or related to other pandemics than COVID-19 were excluded. Following the abstract screen, from 141 original papers identified, 69 articles were eventually selected. A large variation in the reported burnout prevalence among HCWs (4.3-90.4%) was observed. The main factors associated with increase/ decrease of burnout included: demographic characteristics (age, gender, education level, financial situation, family status, occupation), psychological condition (psychiatric diseases, stress, anxiety, depression, coping style), social factors (stigmatisation, family life), work organization (workload, working conditions, availability of staff and materials, support at work), and factors related with COVID-19 (fear of COVID-19, traumatic events, contact with patients with COVID-19, having been infected with COVID-19, infection of a colleague or a relative with COVID-19, higher number of deaths observed by nurses during the COVID-19 pandemic). The findings should be useful for policy makers and healthcare managers in developing programs preventing burnout during the current and future pandemics. Int J Occup Med Environ Health. Int J Occup Med Environ Health. 2023;36(1):21-58.
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Affiliation(s)
- Agata Stodolska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Grzegorz Wójcik
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
- Jagiellonian University, Kraków, Poland (Faculty of Management and Social Communication, Institute of Applied Psychology)
| | - Ilona Barańska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Violetta Kijowska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Katarzyna Szczerbińska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
- University Hospital in Krakow, Kraków, Poland
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Lamuri A, Shatri H, Umar J, Sudaryo MK, Malik K, Sitepu MS, Saraswati, Muzellina VN, Nursyirwan SA, Idrus MF, Renaldi K, Abdullah M. Burnout dimension profiles among healthcare workers in Indonesia. Heliyon 2023; 9:e14519. [PMID: 36945347 PMCID: PMC10008048 DOI: 10.1016/j.heliyon.2023.e14519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
Background Besides biological impact, COVID-19 also poses a threat to psychological wellbeing and the quality of life. Healthcare workers, especially those assuming a front-line post, are at a higher risk of being affected, both physically and psychologically. This study aims to analyse variables potentially associated with burnout and psychological distress among healthcare workers with various health center stratifications, where we commenced a nationwide survey to establish the baseline data. Method An analytic observational study with a cross-sectional design was conducted on the 11th - September 18, 2020. Participants were enrolled from healthcare institutions represented by epicenter of the COVID-19 pandemic in Indonesia, which were Java, Sumatra, Bali, and were asked questionnaires, including the Depression, Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI), Somatic Symptom Scale 8 (SSS-8), also Well-Being Index (WBI). A linear mixed effect model was used to analyse how three dimensions of burnout vary across occupations. Results A total of 3629 healthcare workers were analysed in this study. Burnout syndrome was found in 37.5% of healthcare workers. The prevalence of burnout among medical personnel, nurses, and midwives was 44.6%, 33.5%, and 36.2%, respectively. The prevalence of burnout in healthcare workers was most common in Java (38.4%) and healthcare workers who work in the hospital (28.6%). Based on the burnout dimensions, 48.2% of healthcare workers experienced moderate to high emotional exhaustion, 51.8% moderate to high depersonalization, and 96.9% high personal accomplishment. The R 2 values was 0.33,0.28,0.27 for emotional exhaustion, depersonalization and personal accomplishment model. Calculated power of the emotional exhaustion and depersonalization model was 100% for both midwife and nurse variable. Meanwhile, the power of the personal accomplishment model was 100% for midwife and 94.7% for nurse variable. Conclusion The extent of the three burnout dimensions is pervasive in all occupational levels and the place of work (hospital/community health center).
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Affiliation(s)
- Aly Lamuri
- Indonesia Medical Education and Research Institute, Neuroscience and Brain Development Cluster, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hamzah Shatri
- Division of Psychosomatic and Palliative Care, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Jahja Umar
- Faculty of Psychology, Universitas Islam Negeri Syarif Hidayatullah, Jakarta, Indonesia
| | | | - Khamelia Malik
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | | | | | - Virly N Muzellina
- Division of Gastroenterology, Pancreatobiliary, And Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Saskia A Nursyirwan
- Division of Gastroenterology, Pancreatobiliary, And Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Muhammad F Idrus
- Division of Gastroenterology, Pancreatobiliary, And Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Kaka Renaldi
- Division of Gastroenterology, Pancreatobiliary, And Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Murdani Abdullah
- Division of Gastroenterology, Pancreatobiliary, And Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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Gesi C, Cirnigliaro G, Achilli F, Cerioli M, Cafaro R, Boscacci M, Dell’Osso B. The Impact of COVID-19 Pandemic First Wave on Healthcare Workers: A New Perspective from Qualifying PTSD Criterion A to Assessing Post-Traumatic Growth. J Clin Med 2023; 12:jcm12051862. [PMID: 36902649 PMCID: PMC10003652 DOI: 10.3390/jcm12051862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
Post-traumatic growth (PTG) and specific traumatic events have been poorly explored in the literature focusing on post-traumatic stress disorder (PTSD) among healthcare workers (HWs) tackling the COVID-19 pandemic. In a large sample of Italian HWs, we investigated the kinds of traumatic events and whether PTG affects the risk of PTSD, along with its prevalence and features, during the first COVID-19 wave. COVID-19-related stressful events, Impact of Event Scale-Revised (IES-R) and PTG Inventory-Short Form (PTGI-SF) scores were collected through an online survey. Out of 930 HWs included in the final sample, 257 (27.6%) received a provisional PTSD diagnosis based on IES-R scores. Events referring to the overall pandemic (40%) and to a threat to a family member (31%) were reported as the most stressful events. Female sex, previous mental disorders, job seniority, unusual exposure to sufferance and experiencing a threat to one's family significantly increased the provisional PTSD diagnosis' risk, while being a physician, the availability of personal protective equipment and moderate/greater scores on the PTGI-SF spiritual change domain were found to be protective factors.
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Affiliation(s)
- Camilla Gesi
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Giovanna Cirnigliaro
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
- Correspondence: ; Tel.: +39-0239042904
| | - Francesco Achilli
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Matteo Cerioli
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Rita Cafaro
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Maria Boscacci
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Bernardo Dell’Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, Stanford, CA 94305, USA
- CRC “Aldo Ravelli” for Neurotechnology & Experimental Brain Therapeutics, University of Milan, 20122 Milan, Italy
- Centro per lo Studio dei Meccanismi Molecolari alla Base delle Patologie Neuro-Psico-Geriatriche, University of Milan, 20122 Milan, Italy
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Štěpánek L, Nakládalová M, Janošíková M, Ulbrichtová R, Švihrová V, Hudečková H, Sovová E, Sova M, Vévoda J. Prevalence of Burnout in Healthcare Workers of Tertiary-Care Hospitals during the COVID-19 Pandemic: A Cross-Sectional Survey from Two Central European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3720. [PMID: 36834414 PMCID: PMC9962650 DOI: 10.3390/ijerph20043720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 05/25/2023]
Abstract
COVID-19 has led to an unprecedented strain on healthcare workers (HCWs). This study aimed to determine the prevalence of burnout in hospital employees during a prolonged pandemic-induced burden on healthcare systems. An online survey among employees of a Czech and Slovak university hospital was conducted between November 2021 and January 2022, approximately when the incidence rates peaked in both countries. The Maslach Burnout Inventory-Human Services Survey was applied. We obtained 807 completed questionnaires (75.1% from Czech employees, 91.2% from HCWs, 76.2% from women; mean age of 42.1 ± 11 years). Burnout in emotional exhaustion (EE) was found in 53.2%, depersonalization (DP) in 33%, and personal accomplishment (PA) in 47.8% of respondents. In total, 148 (18.3%) participants showed burnout in all dimensions, 184 (22.8%) in two, and 269 (33.3%) in at least one dimension. Burnout in EE and DP (65% and 43.7%) prevailed in physicians compared to other HCWs (48.6% and 28.8%). Respondents from COVID-19-dedicated units achieved burnout in the EE and DP dimensions with higher rates than non-frontline HCWs (58.1% and 40.9% vs. 49.9% and 27.7%). Almost two years of the previous overloading of healthcare services, caused by the COVID-19 pandemic, resulted in the relatively high prevalence of burnout in HCWs, especially in physicians and frontline HCWs.
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Affiliation(s)
- Ladislav Štěpánek
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic
| | - Marie Nakládalová
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic
| | - Magdaléna Janošíková
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic
| | - Romana Ulbrichtová
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Viera Švihrová
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Henrieta Hudečková
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Eliška Sovová
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic
| | - Milan Sova
- Department of Pulmonary Diseases and Tuberculosis, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jiří Vévoda
- Department of Humanities and Social Sciences, Faculty of Health Sciences, Palacký University in Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic
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37
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Breyre A, Crowe RP, Fernandez AR, Jabr A, Myers JB, Kupas DF. Emergency medical services clinicians in the United States are increasingly exposed to death. J Am Coll Emerg Physicians Open 2023; 4:e12904. [PMID: 36817079 PMCID: PMC9930738 DOI: 10.1002/emp2.12904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/12/2023] [Accepted: 01/26/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction Exposure to patient death places healthcare workers at increased risk for burnout and traumatic stress, yet limited data exist exploring exposure to death among emergency medical services (EMS) clinicians. Our objective was to describe changes in EMS encounters involving on-scene death from 2018 to 2021. Methods We retrospectively analyzed deidentified EMS records for 9-1-1 responses from the ESO Data Collaborative from 2018 to 2021. We identified cases where patient dispositions of death on scene, with or without attempted resuscitation, and without EMS transport. A non-parametric test of trend was used to assess for monotonic increase in agency-level encounters involving on-scene death and the proportion of EMS clinicians exposed to ≥1 on-scene death. Results We analyzed records from 1109 EMS agencies. These agencies responded to 4,286,976 calls in 2018, 5,097,920 calls in 2019, 4,939,651 calls in 2020, and 5,347,340 calls in 2021.The total number of encounters with death on scene rose from 49,802 in 2018 to 60,542 in 2019 to 76,535 in 2020 and 80,388 in 2021. Agency-level annual counts of encounters involving death on scene rose from a median of 14 (interquartile range [IQR], 4-40) in 2018 to 2023 (IQR, 6-63) in 2021 (P-trend < 0.001). In 2018, 56% of EMS clinicians responded to a call with death on scene, and this number rose to 63% of EMS clinicians in 2021 (P-trend < 0.001). Conclusion From 2018 to 2021, EMS clinicians were increasingly exposed to death. This trend may be driven by COVID-19 and its effects on the healthcare system and reinforces the need for evidence-based death notification training to support EMS clinicians.
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Affiliation(s)
- Amelia Breyre
- Department of Emergency MedicineYale UniversityNew HavenConnecticutUSA
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38
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McLean CP, Betsworth D, Bihday C, Daman MC, Davis CA, Kaysen D, Rosen CS, Saxby D, Smith AE, Spinelli S, Watson P. Helping the Helpers: Adaptation and Evaluation of Stress First Aid for Healthcare Workers in the Veterans Health Administration During the COVID-19 Pandemic. Workplace Health Saf 2023; 71:162-171. [PMID: 36726298 PMCID: PMC9899680 DOI: 10.1177/21650799221148650] [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] [Indexed: 02/03/2023]
Abstract
BACKGROUND Early interventions are needed to support the behavioral health of healthcare staff in the context of the COVID-19 pandemic. Stress First Aid (SFA) is a self-care and peer support model for reducing burnout and stress that is designed for use in high-stress occupations. METHODS We conducted a mixed-methods evaluation of an SFA program in the Veterans Health Administration (VHA). This brief, multi-session, didactic program was adapted for hospital workgroups. Program attendees completed a survey assessing implementation outcomes, burnout, stress, mood, and SFA skills at the beginning (N = 246) and end (n = 94) of the SFA program and a subgroup (n = 11) completed qualitative feedback interviews. FINDINGS Program acceptability, appropriateness, and feasibility were rated highly. From pre- to post-SFA, the impact of the pandemic on stress and anxiety, as well as proficiency in supporting peers increased. Qualitative findings suggest the program provided a shared language to discuss stress, normalized stress reactions, met a need for stress management tools, and helped staff feel valued, empowered, connected with each other. Staff reported being more aware of their stress, but SFA was insufficient to address many of the systemic sources of burnout and stress. CONCLUSIONS AND APPLICATIONS TO PRACTICE While the SFA program was well received, the impact of brief programs is likely to be modest when implemented in the middle of an ongoing pandemic and when burnout arises from chiefly from systemic sources. Lessons learned during the program implementation that may guide future efforts are discussed.
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Affiliation(s)
- Carmen P. McLean
- Dissemination and Training Division, VA
Palo Alto Healthcare System, National Center for PTSD,Department of Psychiatry and Behavioral
Sciences, Stanford University,Carmen P. McLean, PhD, National Center for
PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 795
Willow Rd, Menlo Park, CA 94025, USA;
| | | | | | | | - C. Adrian Davis
- Dissemination and Training Division, VA
Palo Alto Healthcare System, National Center for PTSD
| | - Debra Kaysen
- Dissemination and Training Division, VA
Palo Alto Healthcare System, National Center for PTSD,Department of Psychiatry and Behavioral
Sciences, Stanford University
| | - Craig S. Rosen
- Dissemination and Training Division, VA
Palo Alto Healthcare System, National Center for PTSD,Department of Psychiatry and Behavioral
Sciences, Stanford University
| | | | | | | | - Patricia Watson
- Executive Division, VA Medical Center
(116D), National Center for PTSD,Department of Psychiatry, Geisel School
of Medicine, Dartmouth University
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Havsteen-Franklin D, de Knoop J, Agtarap T, Hackett S, Haeyen S. Evaluation of an Arts Therapies Approach to Team Development for Non-Acute Healthcare Teams in Low Control and High-Pressure Environments. ARTS IN PSYCHOTHERAPY 2023. [DOI: 10.1016/j.aip.2023.102003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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40
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Tang L, Yu XT, Wu YW, Zhao N, Liang RL, Gao XL, Jiang WY, Chen YF, Yang WJ. Burnout, depression, anxiety and insomnia among medical staff during the COVID-19 epidemic in Shanghai. Front Public Health 2023; 10:1019635. [PMID: 36699909 PMCID: PMC9869169 DOI: 10.3389/fpubh.2022.1019635] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has progressively impacted our daily lives, resulting in unexpected physical and mental stress on medical staff. This study is designed to investigate the levels of and risk factors for burnout, depression, anxiety, and insomnia among medical staff during the COVID-19 epidemic breakout in Shanghai, China. Methods This cross-sectional survey was conducted from May 1 to May 31, 2022, among medical staff who were on the frontline during the epidemic breakout in Shanghai from different institutions. The MBI-HSS was used to assess burnout, PHQ-9, GAD-7 and ISI were used to evaluate mental status and insomnia. Results A total of 543 valid questionnaires were collected. The depersonalization, depression, anxiety, and insomnia scores of medical staff were significantly higher during the pandemic in Shanghai compared with norms, while lack of personal achievement scores were decreased. Working time, work unit, work environment and age are important influencers of burnout, depression and anxiety of medical staff. Long working hours are the most likely causes of burnout and emotional disorders. Medical staff in primary hospitals were most likely to suffer from burnout and emotional disorders, while medical staff in tertiary hospitals had a reduced sense of personal achievement. Young medical staff are prone to negative emotions such as depression and anxiety, while older medical staff have a lower sense of personal accomplishment. Medical staff who were not in the shelter hospitals or designated hospitals were more likely to have problems of emotional exhaustion, depersonalization and anxiety than those who were in the shelter hospitals or designated hospitals. Contracting COVID-19 had no effect on medical staff. Emotional exhaustion and depersonalization were positively correlated with anxiety, depression, and sleep disorders while personal achievement was negatively correlated with these factors. Conclusion Medical staff in Shanghai had high burnout, depression, anxiety and insomnia levels during the epidemic outbreak in Shanghai. During the COVID-19, medical staff may suffer different psychological problems which should be concerned. Care and supports about burnout, mental health and insomnia need to be taken to promote the mental health of medical staff according to different characteristics of medical staff.
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Affiliation(s)
- Lin Tang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin-tong Yu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yu-wei Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Na Zhao
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui-long Liang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-lin Gao
- Shanghai Fourth People's Hospital Affiliated Tongji University, Shanghai, China
| | - Wen-yan Jiang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yun-fei Chen
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Yun-fei Chen ✉
| | - Wen-jia Yang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,*Correspondence: Wen-jia Yang ✉
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41
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Song W, Huang D, Yu J. How does centralized isolation treatment strategy affect the medical staff's mental health during the COVID-19 pandemic? Front Public Health 2023; 10:1055564. [PMID: 36684938 PMCID: PMC9846266 DOI: 10.3389/fpubh.2022.1055564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Background During the coronavirus 2019 (COVID-19) pandemic, the Chinese Government adopted a centralized isolation treatment (CIT) strategy for patients, which has greatly improved the efficiency of the pandemic response. However, compared to those in local hospitals, anti-COVID-19 medical staff in mobile cabin hospitals, where the CIT strategy was adopted, suffered more mental health problems. This study aimed to explore how the CIT strategy affected the medical staff's mental health by comparing anti-COVID-19 medical staff who worked in mobile cabin hospitals to those in fever clinics of local hospitals. Methods Following the standard scale development procedure, this study first developed a scale measuring the mental health of anti-COVID-19 medical staff. Using SPSS 23.0 and Amos 23.0 software, the exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability analysis method were conducted to support the scale development. In the main investigation, a survey method using the developed scale was used, and 839 anti-COVID-19 medical staff from five hospitals in northern China were recruited as participants by snowball-sampling method. The first survey was conducted in February 2020, when the first round of COVID-19 was at a serious time. In April 2020, after the first round of COVID-19 in China was initially contained, and medical staff who worked in mobile cabin hospitals returned to local hospitals, a follow-up survey was conducted on these participants. Using SPSS 23.0 software, a series of 2 × 2 mixed-design ANOVA was conducted, in which working conditions (mobile cabin hospital vs. local hospital) served as a between-subject factor, time points (during vs. after the first round of COVID-19) served as a within-subject variable, and the indicators of the medical staff's mental health served as dependent variables respectively. Results The reliability and validity of the developed scale were desirable. The mental health problems of anti-COVID-19 medical staff were mainly manifested as anxiety, powerlessness, fear of infection, and somatization. Compared to those who worked in local hospitals, anti-COVID-19 medical staff who worked in mobile cabin hospitals where the CIT strategy was adopted suffered more powerlessness, fear of infection, and somatization. After returning to local hospitals, symptoms of fear of infection and powerlessness of medical staff who used to work in mobile cabin hospitals decreased significantly. However, their anxiety symptoms were not relieved, and their somatization symptoms even increased. Conclusion This study implied that the mental health of anti-COVID-19 medical staff in mobile cabin hospitals adopting CIT was worse than in local hospitals. Moreover, with the first outbreak in remission, the mental health recovery of medical staff in CIT hospitals was slower than in local hospitals. Relevant practitioners should pay more attention to the mental health condition of anti-COVID-19 medical staff who work in CIT hospitals. The psychological assistance service for them should continue even after they return to the local hospitals.
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Affiliation(s)
- Wei Song
- Yatai School of Business Management, Jilin University of Finance and Economics, Changchun, China
| | - Dongmei Huang
- Department of Psychology, School of Philosophy and Sociology, Jilin University, Changchun, China
| | - Jiejing Yu
- Department of Psychology, School of Philosophy and Sociology, Jilin University, Changchun, China
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Salameh B, Daibes AG, Qaddumi J. Assessing the Prevalence, Predictors, and Consequences of Secondary Traumatic Stress Among Emergency Nurses in Palestine During the COVID-19 Pandemic. SAGE Open Nurs 2023; 9:23779608231207224. [PMID: 37830081 PMCID: PMC10566272 DOI: 10.1177/23779608231207224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/09/2023] [Accepted: 09/23/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction Emergency nurses who are working in direct contact with COVID-19 patients are at an increased risk of developing secondary traumatic stress disorder. This study aimed to assess the prevalence, predictors, and consequences of secondary traumatic stress among emergency nurses in Palestine during the COVID-19 pandemic. Methods The study utilized a cross-sectional design and recruited a total of 189 emergency nurses from multiple healthcare centers in Palestine. Data collected from January 21, 2021, to March 31, 2021. Results The study revealed that emergency nurses had a high degree of secondary traumatic stress with the prevalence of high to severe symptoms of secondary traumatic stress being 61% of the total participants. In terms of predictors, the results showed that years of experience, level of education, burnout, and organizational support were significantly correlated with secondary traumatic stress and thus that years of experience and burnout are predictors of secondary traumatic stress. Conclusion Based on our findings, nurses in emergency departments in Palestine have a high degree of secondary traumatic stress disorder which impacts their lives on a personal and professional level.
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Affiliation(s)
- Basma Salameh
- Department of Nursing, Arab American University of Jenin, Jenin, Palestine
| | - Abdalla Ghassen Daibes
- ICU Department, Palestinian Ministry of Health-Jenin Hospital, ICU department, Jenin, Palestine
| | - Jamal Qaddumi
- Nursing Department, An-Najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine
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Ferraz JADC, Zanin L, Oliveira AMG, Flório FM. Burnout syndrome in higher education health professionals working in indigenous health in Brazil. CIENCIA & SAUDE COLETIVA 2023. [DOI: 10.1590/1413-81232023281.09272022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract The aim of this study was to investigate the prevalence of burnout syndrome in higher education health professionals working in indigenous health in Brazil, and to identify associated factors. This is an observational, analytical, and cross-sectional study. Data collection was based on the application of a questionnaire (personal profile and MBI-HSS) and included 513 professionals. The prevalence of burnout was 65%. Greater likelihood of emotional exhaustion was observed among younger professionals, who had worked in indigenous health for longer time, in the care function and with lower level of tranquility when working during the pandemic. Lower likelihood of having low personal accomplishment at work was observed among older professionals, professionals who had worked in indigenous health for shorter time, who worked in clinical care during the pandemic and those with lower level of tranquility when working during the pandemic. Greater likelihood of depersonalization was found among married professionals, who worked in clinical care during the pandemic and those with lower level of tranquility when working during the pandemic. This study contributes with an important assessment of the existence of BS predictors in health professionals working in indigenous health.
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Metin Akten I, Yıldırım TB, Dığın F. Examining the burnout levels of healthcare employees and related factors during the COVID-19 pandemic: A cross-sectional study. Work 2023; 76:461-471. [PMID: 37092203 DOI: 10.3233/wor-220562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND The high prevalence, severe contagious nature, and associated morbidity and mortality rates of COVID-19 increased the demand for healthcare and social care services worldwide. No doubt, the COVID-19 pandemic affected frontline healthcare employees the most. OBJECTIVE The purpose of the present study was to examine the burnout levels of healthcare employees and related factors during the COVID-19 pandemic in Turkey. METHODS The descriptive, cross-sectional study was completed with 478 healthcare professionals. The study's sampling included all healthcare professionals who were actively working in Turkey during the COVID-19 pandemic and agreed to participate in the study. The study data were collected through the internet (online) between 10.05.2021 and 10.08.2021. The Healthcare Staff Information Form and Maslach Burnout Inventory were used to collect the study data. RESULTS Emotional burnout (p < 0.001) and desensitization (p = 0.007) scores were higher in those who lived separately from people they normally lived with. Emotional burnout and desensitization scores of the nurses were significantly higher than those of doctors and other healthcare professionals (p < 0.001). CONCLUSION It was determined that healthcare professionals in Turkey experienced moderate levels of burnout in terms of emotional burnout and desensitization, and high levels of burnout in terms of personal achievement. It is recommended to improve working conditions, monitor employees in high-risk units more closely, and provide psychological support to prevent or reduce the burnout of healthcare employees during the pandemic period.
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Affiliation(s)
- Ilknur Metin Akten
- Department of Nursing, Faculty of Health Sciences, Kırklareli University, Kırklareli, Turkey
| | - Tuğçe Bilge Yıldırım
- Department of Nursing, Institute of Health Sciences, Kırklareli University, Kırklareli, Turkey
| | - Figen Dığın
- Department of Nursing, Faculty of Health Sciences, Kırklareli University, Kırklareli, Turkey
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Müller MM, Baillès E, Blanch J, Torres X, Rousaud A, Cañizares S, Cervera Teruel M, Conti C, Dunne PJ, Stanculete MF, Farré JM, Font E, Gayán E, Guagnano MT, König S, Kundinger N, Lanzara R, Lobo A, Nejatisafa AA, Obach A, Offiah G, Peri JM, Rosa I, Schuster SK, Waller C, Stein B. Burnout among hospital staff during the COVID-19 pandemic: Longitudinal results from the international Cope-Corona survey study. J Psychosom Res 2023; 164:111102. [PMID: 36508846 PMCID: PMC9677553 DOI: 10.1016/j.jpsychores.2022.111102] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Long-term changes in burnout and its predictors in hospital staff during the COVID-19 pandemic were investigated in an international study. METHODS Two online surveys were distributed to hospital staff in seven countries (Germany, Andorra, Ireland, Spain, Italy, Romania, Iran) between May and October 2020 (T1) and between February and April 2021 (T2), using the following variables: Burnout (emotional exhaustion and depersonalization), job function, age, gender, and contact with COVID-19 patients; individual resources (self-compassion, sense of coherence, social support) and work-related resources and demands (support at the workplace, risk perception, health and safety at the workplace, altruistic acceptance of risk). Data were analyzed using linear mixed models repeated measures, controlled for age. RESULTS A total of 612 respondents were included (76% women). We found an increase in burnout from T1 to T2. Burnout was high among personnel with high contact with COVID-19 patients. Individual factors (self-compassion, sense of coherence) and work-related factors (support at the workplace, risk perception, health and safety at the workplace) showed associations with burnout. Low health and safety at the workplace at T1 was associated with an increase in emotional exhaustion at T2. Men showed an increase in depersonalization if they had much contact with COVID-19 patients. CONCLUSION Burnout represents a potential problematic consequence of occupational contact with COVID-19 patients. Special attention should be paid to this group in organizational health management. Self-compassion, sense of coherence, support at the workplace, risk perception, and health and safety at the workplace may be important starting points for interventions. REGISTRATION Müller, M. M. (2020, August 30). Cope-Corona: Identifying and strengthening personal resources of hospital staff to cope with the Corona pandemic. Open Science Foundation.
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Affiliation(s)
- Markus M. Müller
- Corresponding author at: Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Prof-Ernst-Nathan-Str. 1, 90418 Nuremberg, Germany
| | - Eva Baillès
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Jordi Blanch
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Xavier Torres
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Araceli Rousaud
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Silvia Cañizares
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Marta Cervera Teruel
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Chiara Conti
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | | | - Mihaela Fadgyas Stanculete
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Josep Maria Farré
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Elena Font
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Elena Gayán
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Maria Teresa Guagnano
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Sarah König
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Nina Kundinger
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Roberta Lanzara
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Antonio Lobo
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Ali-Akbar Nejatisafa
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Amadeu Obach
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Gozie Offiah
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Josep Maria Peri
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Ilenia Rosa
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Sara Katharina Schuster
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Christiane Waller
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Barbara Stein
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
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Ferraz JADC, Zanin L, Oliveira AMG, Flório FM. Burnout syndrome in higher education health professionals working in indigenous health in Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:93-106. [PMID: 36629584 DOI: 10.1590/1413-81232023281.09272022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 08/05/2022] [Indexed: 01/11/2023] Open
Abstract
The aim of this study was to investigate the prevalence of burnout syndrome in higher education health professionals working in indigenous health in Brazil, and to identify associated factors. This is an observational, analytical, and cross-sectional study. Data collection was based on the application of a questionnaire (personal profile and MBI-HSS) and included 513 professionals. The prevalence of burnout was 65%. Greater likelihood of emotional exhaustion was observed among younger professionals, who had worked in indigenous health for longer time, in the care function and with lower level of tranquility when working during the pandemic. Lower likelihood of having low personal accomplishment at work was observed among older professionals, professionals who had worked in indigenous health for shorter time, who worked in clinical care during the pandemic and those with lower level of tranquility when working during the pandemic. Greater likelihood of depersonalization was found among married professionals, who worked in clinical care during the pandemic and those with lower level of tranquility when working during the pandemic. This study contributes with an important assessment of the existence of BS predictors in health professionals working in indigenous health.
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Affiliation(s)
| | - Luciane Zanin
- Departamento de Saúde Coletiva, Faculdade São Leopoldo Mandic. R. José Rocha Junqueira 13. 13045-755 Campinas SP Brasil.
| | - Arlete Maria Gomes Oliveira
- Departamento de Saúde Coletiva, Faculdade São Leopoldo Mandic. R. José Rocha Junqueira 13. 13045-755 Campinas SP Brasil.
| | - Flávia Martão Flório
- Departamento de Saúde Coletiva, Faculdade São Leopoldo Mandic. R. José Rocha Junqueira 13. 13045-755 Campinas SP Brasil.
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Tsouvelas G, Kalaitzaki A, Tamiolaki A, Rovithis M, Konstantakopoulos G. Secondary traumatic stress and dissociative coping strategies in nurses during the COVID-19 pandemic: The protective role of resilience. Arch Psychiatr Nurs 2022; 41:264-270. [PMID: 36428058 PMCID: PMC9428110 DOI: 10.1016/j.apnu.2022.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/07/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
During the COVID-19 pandemic, nurses are repeatedly exposed to acute stress at their workplace, and therefore, they are at high risk for developing mental health symptoms. The prolonged exposure of healthcare professionals may lead to Secondary Traumatic Stress (STS). STS is an aspect of "cost of care", the natural consequence of providing care to people who suffer physically or psychologically. The purpose of this study was to investigate the levels of STS in nurses during the first phase of the COVID-19 pandemic in Greece and to detect aggravating and protective factors. Participants were 222 nurses (87.4 % women; mean age 42.3 years) who completed an online survey. The questionnaire comprised of the Secondary Traumatic Stress Scale, the Brief Resilience Scale, and the Brief Coping Orientation to Problems Experienced Inventory. Nurses had high levels of STS. The hierarchical regression analyses showed that STS and its dimensions Avoidance and Arousal were positively predicted mainly by denial and self-distraction coping strategies and inversely by resilience. Resilience exhibited a protective (partial mediation) effect on the strong relationship between the dissociative coping strategies (denial, self-distraction, venting and behavioral disengagement) and STS. Trauma-informed care psychosocial interventions are needed to support the already overburdened nursing staff during the coronavirus pandemic.
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Affiliation(s)
- George Tsouvelas
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece.
| | - Argyroula Kalaitzaki
- Department of Social Work, Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Affiliated Researcher of the Research Centre 'Institute of Agri-Food and Life Sciences', Hellenic Mediterranean University, CP: 71004 Heraklion, Greece.
| | - Alexandra Tamiolaki
- Department of Social Work, Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Hellenic Mediterranean University, CP: 71004 Heraklion, Greece
| | - Michael Rovithis
- Department of Nursing, Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life, Affiliated Researcher of the Research Centre 'Institute of Agri-Food and Life Sciences', Health Sciences Faculty, Hellenic Mediterranean University, CP: 71004 Heraklion, Crete, Greece.
| | - George Konstantakopoulos
- Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece; Department of Clinical, Education and Health Psychology, University College London, London, UK.
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The experience of secondary traumatic stress among community violence interventionists in Chicago. Prev Med 2022; 165:107186. [PMID: 35940475 DOI: 10.1016/j.ypmed.2022.107186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/22/2022]
Abstract
Community violence intervention strategies are rising in prominence as promising alternatives to traditional criminal justice responses to gun violence. Although such approaches may offer policy advantages and yield societal benefits, the costs to the practitioners of this work-owing to the intimate proximity to violence required by the job-have generally been overlooked. Using a first of its kind survey of nearly the entire population of community-based violence interventionists in Chicago, Illinois (United States), this study assesses the extent to which violence intervention workers experience Secondary Traumatic Stress (STS). Responses to a series of 17 items on a Secondary Traumatic Stress Scale revealed alarmingly high levels of STS among violence interventionists: 94% of workers reported at least one STS indicator in the past 7 days and a full 50% reported experiencing 9 out of the 17 STS items. Our analysis further showed that the STS responses of interventionists were impacted by on-the-job traumatic experiences, particularly the death of a client. These results offer an important first systematic analysis of the trauma and mental health risks associated with community violence intervention practice and suggest that policymakers and practitioners should monitor and address worker risk of traumatic stress within this important public health profession.
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Arıkan A, Esenay FI. Compassion fatigue and burnout in Turkish pediatric emergency nurses during the COVID-19 pandemic. J Pediatr Nurs 2022:S0882-5963(22)00273-1. [PMID: 36424330 PMCID: PMC9678743 DOI: 10.1016/j.pedn.2022.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 11/05/2022] [Accepted: 11/05/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE This study was conducted to determine compassion fatigue and burnout in nurses working in the pediatric emergency department (PED) during the COVID-19 pandemic in Turkey. DESIGN AND METHODS This descriptive and cross-sectional study was conducted with 164 nurses working in the PED and following the social media platforms of the Emergency Nurses Association between September 1, 2020, and January 1, 2021. Data were collected using the online survey method with the Descriptive Data Form, Maslach Burnout Inventory (MBI), and Compassion Fatigue-Short Scale (CF-SS). RESULTS Pediatric emergency nurses reported that they experienced high emotional exhaustion (28.25 ± 6.05) and depersonalization (11.89 ± 2.39), low personal accomplishment (17.98 ± 3.12), and moderate compassion fatigue (4.99 ± 1.43). CONCLUSION Pediatric emergency nurses had high levels of burnout and moderate levels of compassion fatigue during the pandemic in Turkey. To prevent any long-term negative effects of the pandemic, addressing the physiological, psychological, and psychosocial needs of nurses should be prioritized. PRACTICAL IMPLICATIONS Compassion fatigue and burnout can affect the quality of care provided by nurses, but also negatively affect their well-being and quality of life during the pandemic. Therefore, the development of interventions to reduce compassion fatigue and burnout can help manage these symptoms.
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Affiliation(s)
- Aylin Arıkan
- Graduate Schools of Health Sciences at Ankara University, Ankara, Turkey.
| | - Figen Işık Esenay
- Department of Pediatric Nursing, Faculty of Nursing, Ankara University, Ankara, Turkey.
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Powell T, Scott J, Yuma P, Hsiao Y. Surviving the storm: A pragmatic non-randomised examination of a brief intervention for disaster-affected health and social care providers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6217-e6227. [PMID: 36196872 PMCID: PMC10092715 DOI: 10.1111/hsc.14059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/16/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Disasters affect the well-being of individuals, families and communities. Health and social care providers are essential in response and recovery efforts and are among the most vulnerable to negative physical and mental health impacts of a disaster. Few evidence-based interventions are available to address the psychological needs of providers. The aim of this study was to examine the psychological distress of health and social care providers before and after participating in the brief group intervention, Resilience and Coping for the Healthcare Community (RCHC) and its expanded version, RCHC+. We conducted a pragmatic non-randomised cluster trial with 762 health and social care providers in south Texas and Puerto Rico post-Hurricanes Harvey and Maria. Participants completed surveys assessing post-traumatic stress (PTSD), anxiety, burnout and secondary traumatic stress (STS) prior to intervention delivery and at two time points post-intervention. We calculated the frequency of symptom cut-off scores at baseline, then estimated multilevel ordinal models to examine changes in symptoms across time. Prior to participation in the RCHC (approximately 12 months after the hurricanes), providers reported high levels of PTSD, anxiety and STS symptoms. After participation, providers in both intervention conditions reported a significant reduction in PTSD symptoms from baseline that was sustained over both time points. The likelihood of a reduction in symptoms of anxiety and STS from baseline was sustained at both time points for participants in the RCHC+ condition. These findings indicate that both the RCHC and RCHC+ interventions may reduce psychological distress for health and social care providers and could be an important part of advance planning to support provider's mental health during and after a disaster. Further examination of the RCHC in other disaster contexts could provide additional insight into the responsiveness of the intervention to reducing psychological distress symptoms.
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Affiliation(s)
- Tara Powell
- University of Illinois School of Social WorkUrbanaIllinoisUSA
| | - Jennifer Scott
- Louisiana State University, School of Social WorkBaton RougeLouisianaUSA
| | - Paula Yuma
- Colorado State University, School of Social WorkFort CollinsColoradoUSA
| | - Yuan Hsiao
- Department of CommunicationUniversity of WashingtonSeattleWashingtonUSA
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