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Cogan N, Craig A, Milligan L, McCluskey R, Burns T, Ptak W, Kirk A, Graf C, Goodman J, De Kock J. 'I've got no PPE to protect my mind': understanding the needs and experiences of first responders exposed to trauma in the workplace. Eur J Psychotraumatol 2024; 15:2395113. [PMID: 39238472 PMCID: PMC11382715 DOI: 10.1080/20008066.2024.2395113] [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: 06/02/2024] [Revised: 08/08/2024] [Accepted: 08/12/2024] [Indexed: 09/07/2024] Open
Abstract
ABSTRACTBackground: First responders (FRs) are at high risk of being exposed to traumatic events in their occupational roles. Responding to critical incidents often involves exposure to life-threatening circumstances, dealing with fatalities and encountering highly stressful situations that may trigger traumatic responses. These experiences can lead to poor physical and mental health (MH) outcomes including post-traumatic stress disorder, co-morbid conditions such as depression, anxiety, substance abuse, insomnia, and suicidality. Little research has explored the perspectives and experiences of FRs in dealing with occupational trauma(s) and how best to meet their health needs.Objective: This study aimed to explore FRs' experiences of exposure to occupational trauma and its impact on their mental wellbeing. The wider objective was to investigate how FRs can be supported to access appropriate and relevant help, addressing barriers like stigma.Method: A qualitative research design using in-depth semi-structured interviews with FRs (n = 54) was adopted. Interviews were audio-recorded, transcribed and analysed using an inductive thematic approach.Results: Themes developed were: (1) the pervasive, cumulative and salient impact of occupational trauma on MH (micro-traumas, nightmares, flashbacks and reliving experiences); (2) the demands of the job exacerbating the adverse effects of trauma (self and others); (3) insufficient support and unhelpful ways of coping following exposure to trauma (lack of psychological safety); (4) stigma and fear of judgement as barriers to MH help-seeking; and (5) need for specific, accessible and credible trauma-focused interventions and workplace support.Conclusions: The implications of these findings are discussed at the individual, service provider and organisational level, emphasising the importance of implementing a strengths-based, non-pathologising and de-stigmatising approach to trauma in the workplace as experienced by FRs. Emphasis is placed on the importance of overcoming barriers to accessing MH support and improving access to evidence-based, trauma-focused psychological interventions and workplace support.
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Affiliation(s)
- Nicola Cogan
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Ashleigh Craig
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Lucy Milligan
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Robyn McCluskey
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Tara Burns
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Wiktoria Ptak
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Alison Kirk
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Christoph Graf
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Jolie Goodman
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Johannes De Kock
- University of the Highlands and Islands, Institute for Health Research and Innovation, Inverness, UK
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Pakou V, Tsartsalis D, Papathanakos G, Dragioti E, Gouva M, Koulouras V. Personality Traits, Burnout, and Psychopathology in Healthcare Professionals in Intensive Care Units-A Moderated Analysis. Healthcare (Basel) 2024; 12:587. [PMID: 38470698 PMCID: PMC10930981 DOI: 10.3390/healthcare12050587] [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: 01/27/2024] [Revised: 02/24/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
This study explored the associations between personality dimensions, burnout, and psychopathology in healthcare professionals in intensive care units (ICUs). This study further aimed to discern the differences in these relationships when considering the variables of critical care experience (less than 5 years, 5-10 years, and more than 10 years), profession (nurses versus intensivists), and the urban size of the city where the ICU is located (metropolitan cities versus smaller urban cities). This cross-sectional investigation's outcomes are based on data from 503 ICU personnel, including 155 intensivists and 348 nurses, in 31 ICU departments in Greece. Participants underwent a comprehensive assessment involving a sociodemographic questionnaire, the Eysenck Personality Questionnaire (EPQ), the Maslach Burnout Inventory (MBI), and the Symptom Checklist-90 (SCL-90). To analyze the interplay among critical care experience, burnout status, and psychopathology, a moderation analysis was conducted with personality dimensions (i.e., psychoticism, extraversion, and neuroticism) serving as the mediator variable. Profession and the urban size of the ICU location were considered as moderators influencing these relationships. Male healthcare professionals showed higher psychoticism levels than females, aligning with prior research. Experienced nurses reported lower personal achievement, hinting at potential motivation challenges for professional growth. Psychoticism predicted high depersonalization and low personal achievement. Neuroticism and psychoticism negatively impacted ICU personnel's mental well-being, reflected in elevated psychopathology scores and burnout status. Psychoticism appears to be the primary factor influencing burnout among the three personality dimensions, particularly affecting intensivists. In contrast, nurses are more influenced by their critical care experience on their mental health status.
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Affiliation(s)
- Varvara Pakou
- Intensive Care Unit, University Hospital of Ioannina, University of Ioannina, 45500 Ioannina, Greece; (V.P.); (G.P.); (V.K.)
| | - Dimitrios Tsartsalis
- Laboratory of Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece; (E.D.); (M.G.)
- Department of Clinical Physiology, Sundsvall Hospital, 85643 Sundsvall, Sweden
| | - Georgios Papathanakos
- Intensive Care Unit, University Hospital of Ioannina, University of Ioannina, 45500 Ioannina, Greece; (V.P.); (G.P.); (V.K.)
| | - Elena Dragioti
- Laboratory of Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece; (E.D.); (M.G.)
| | - Mary Gouva
- Laboratory of Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece; (E.D.); (M.G.)
| | - Vasilios Koulouras
- Intensive Care Unit, University Hospital of Ioannina, University of Ioannina, 45500 Ioannina, Greece; (V.P.); (G.P.); (V.K.)
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Witkowski K, Lofaro RJ, Headley AM, Contreras S, Remington CL, Ganapati NE. Understanding problematic substance use among first responders during the COVID-19 pandemic: A survey of law enforcement, fire, and EMS workers in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104261. [PMID: 38006639 DOI: 10.1016/j.drugpo.2023.104261] [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: 06/21/2023] [Revised: 09/27/2023] [Accepted: 11/09/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND First responders have experienced increased levels of stress, anxiety, and depression due to job-related pressures associated with the COVID-19 pandemic. However, little is known about the factors associated with first responder drug and alcohol use during this time. METHODS We conducted a nationwide survey of first responders (n = 2801) to understand the relationship between work pressures, workplace support strategies, and problematic substance use during the early stages of the COVID-19 pandemic. We employed structural equation modeling to analyze whether burnout mediated these relationships. RESULTS Descriptive statistics showed that 60.8 % reported no concerns with substance use. While general workplace support strategies were negatively associated with problematic substance use, specific COVID-related strategies, such as providing compensation during quarantine, were positively associated with problematic substance use. Burnout fully mediated relationships between workplace support strategies and problematic substance use. Finally, providing spaces at work to decompress was negatively associated with problematic substance use and burnout. CONCLUSION Although work pressures increased burnout and problematic substance use among first responders, general workplace support strategies (e.g., decompression spaces) reduced problematic substance use while some COVID-related strategies (e.g. compensation during quarantine) increased problematic substance use. Policy interventions to address problematic substance use should focus on providing spaces for first responders to decompress at work, as well as implementing strategies (e.g., access to mental health services, time off) to reduce burnout. However, organizations should be mindful that not all interventions will have their intended impact and some interventions may unintentionally contribute to negative employee outcomes.
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Affiliation(s)
- Kaila Witkowski
- Florida Atlantic University, Department of Public Administration, United States.
| | - Ryan J Lofaro
- Georgia Southern University, Department of Public and Nonprofit Studies, United States
| | | | - Santina Contreras
- University of Southern California, Department of Urban Planning and Spatial Analysis, United States
| | - Christa L Remington
- University of South Florida, Department of Public Administration, United States
| | - N Emel Ganapati
- Florida International University, Department of Public Policy and Administration, United States
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Baker JC, Bhola S, Tabares JV, Beckman D, Martin C, Khazem LR, Bryan AO, Bryan CJ. Impact of the COVID-19 Pandemic on Indicators of Psychological Health and Suicidal Ideation Within an Active Duty U.S. Military Population. Mil Med 2023; 188:450-456. [PMID: 37948266 DOI: 10.1093/milmed/usad200] [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: 12/02/2022] [Revised: 03/31/2023] [Accepted: 08/08/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has had a significant impact on the psychological health of individuals. The pandemic has contributed to increased anxiety, elevated rates of depression, and worsening suicidal ideation among civilians. Reported rates of burnout are also elevated as employees and employers adapted to ever-changing work environments, finding it increasingly difficult to maintain a work-life balance. The objective of this study is to determine how the COVID-19 pandemic impacted the psychological health and rates of suicidal ideation of active duty military personnel in the USA. MATERIALS AND METHODS A total of 2055 military personnel and military-adjacent employees stationed at a U.S. Air Force base completed a self-report survey that was administered six times from January 2020 to December 2021. Validated scales assessed measures of psychological health and suicidal ideation. General Estimating Equations were used to examine how indicators of time and psychological health predicted suicidal ideation in a military population. RESULTS Life satisfaction, happiness, feeling life is worthwhile, depression severity, and suicidal ideation did not statistically change across the six time points. Worry (P < .01) and depression (P < .001) did decrease significantly, while burnout (P = .01) significantly increased across these time points. Feeling life is worthwhile significantly predicted reduced suicidal ideation (B = -.19; SE = 0.05), while depression (B = 0.11; SE = 0.03), depression severity (B = 0.24; SE = 0.05), worry (B = 0.06; SE = 0.02), and burnout (B = 0.15; SE = 0.07) predicted increased suicidal ideation. CONCLUSIONS The rates of depression and worry decreased throughout the pandemic for those in the study while rates of suicidal ideation remained constant, demonstrating the potential resilience of military personnel and military-adjacent employees in response to the COVID-19 pandemic. However, burnout increased and significantly predicted elevated rates of suicidal ideation, highlighting the importance of focusing on reducing workplace stressors for military personnel.
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Affiliation(s)
- Justin C Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43214, USA
| | - Simran Bhola
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43214, USA
| | - Jeffrey V Tabares
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43214, USA
| | - Derek Beckman
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43214, USA
| | - Christiana Martin
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43214, USA
| | - Lauren R Khazem
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43214, USA
| | - AnnaBelle O Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43214, USA
| | - Craig J Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43214, USA
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Sampaio F, Coelho J, Gonçalves P, Sequeira C. Protective and Vulnerability Factors of Municipal Workers' Mental Health: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14256. [PMID: 36361136 PMCID: PMC9654518 DOI: 10.3390/ijerph192114256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Work is fundamental to an individual's mental health; however, an unfavourable work environment can lead to mental health problems. Despite existing studies addressing workers' mental health, it is essential to understand the reality of specific contexts to design effective tailored interventions. Thus, this study aimed to examine the influence of potential protective and vulnerability factors on municipal workers' depressive symptoms, anxiety and stress levels, and burnout. A cross-sectional study was conducted with data collection performed between July and December 2021 using online self-report measures. The sample comprised 115 municipal workers. The findings revealed that psychological vulnerability is a significant vulnerability factor for the presence of mental health symptoms. In addition, job satisfaction was found to be a significant protective factor for depressive symptoms, anxiety, and burnout of the municipal workers. The results of this study enhance the understanding of factors that influence worker mental health, which may facilitate the proper planning of specific interventions to promote mental health in the workplace.
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Affiliation(s)
- Francisco Sampaio
- Higher School of Health Fernando Pessoa, Rua Delfim Maia 334, 4200-253 Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Joana Coelho
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
- Northern School of Health of the Portuguese Red Cross, Rua da Cruz Vermelha Cidacos-Apartado 1002, 3720-126 Oliveira de Azeméis, Portugal
| | - Patrícia Gonçalves
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
- Institute of Health Sciences, Universidade Católica Portuguesa, Rua de Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Carlos Sequeira
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
- Nursing School of Porto, Rua Dr. António Bernardino de Almeida, 830, 844, 856, 4200-072 Porto, Portugal
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Winslow BD, Kwasinski R, Hullfish J, Ruble M, Lynch A, Rogers T, Nofziger D, Brim W, Woodworth C. Automated stress detection using mobile application and wearable sensors improves symptoms of mental health disorders in military personnel. Front Digit Health 2022; 4:919626. [PMID: 36082233 PMCID: PMC9445306 DOI: 10.3389/fdgth.2022.919626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
Leading causes in global health-related burden include stress, depression, anger, fatigue, insomnia, substance abuse, and increased suicidality. While all individuals are at risk, certain career fields such as military service are at an elevated risk. Cognitive behavioral therapy (CBT) is highly effective at treating mental health disorders but suffers from low compliance and high dropout rates in military environments. The current study conducted a randomized controlled trial with military personnel to assess outcomes for an asymptomatic group (n = 10) not receiving mental health treatment, a symptomatic group (n = 10) using a mHealth application capable of monitoring physiological stress via a commercial wearable alerting users to the presence of stress, guiding them through stress reduction techniques, and communicating information to providers, and a symptomatic control group (n = 10) of military personnel undergoing CBT. Fifty percent of symptomatic controls dropped out of CBT early and the group maintained baseline symptoms. In contrast, those who used the mHealth application completed therapy and showed a significant reduction in symptoms of depression, anxiety, stress, and anger. The results from this study demonstrate the feasibility of pairing data-driven mobile applications with CBT in vulnerable populations, leading to an improvement in therapy compliance and a reduction in symptoms compared to CBT treatment alone. Future work is focused on the inclusion of passive sensing modalities and the integration of additional data sources to provide better insights and inform clinical decisions to improve personalized support.
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Affiliation(s)
- Brent D. Winslow
- Design Interactive, Inc., Orlando, FL, United States
- Correspondence: Brent D. Winslow
| | | | | | | | - Adam Lynch
- Design Interactive, Inc., Orlando, FL, United States
| | - Timothy Rogers
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Debra Nofziger
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - William Brim
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Craig Woodworth
- Department of Behavioral Health, Brook Army Medical Center, Fort Sam Houston, TX, United States
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