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Oskvarek JJ, Blutinger EJ, Pilgrim R, Joshi AU, Lin MP, Mazer-Amirshahi M, Miller G, Smiley A, Becker CW, Pines JM. Beyond the Four Walls: The American College of Emergency Physicians 2022 New Practice Models Task Force Report. Ann Emerg Med 2024; 83:250-271. [PMID: 37777937 DOI: 10.1016/j.annemergmed.2023.08.488] [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: 07/05/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 10/02/2023]
Abstract
Emergency physicians are highly trained to deliver acute unscheduled care. The emergency physician core skillset gained during emergency medicine residency can be applied to many other roles that benefit patients and extend and diversify emergency physician careers. In 2022, the American College of Emergency Physicians (ACEP) convened the New Practice Models Task Force to describe new care models and emergency physician opportunities outside the 4 walls of the emergency department. The Task Force consisted of 21 emergency physicians with broad experience and 2 ACEP staff. Fifty-nine emergency physician roles were identified (21 established clinical roles, 16 emerging clinical roles, 9 established nonclinical roles, and 13 emerging nonclinical roles). A strength-weakness-opportunity-threat (SWOT) analysis was performed for each role. Using the analysis, the Task Force made recommendations for guiding ACEP internal actions, advocacy, education, and research opportunities. Emphasis was placed on urgent care, rural medicine, telehealth/virtual care, mobile integrated health care, home-based services, emergency psychiatry, pain medicine, addiction medicine, and palliative care as roles with high or rising demand that draw on the emergency physician skillset. Advocacy recommendations focused on removing state and federal regulatory and legislative barriers to the expansion of new and emerging roles. Educational recommendations focused on aggregating available resources, developing a centralized resource for career guidance, and new educational content for emerging roles. The Task Force also recommended promoting research on potential advantages (eg, improved outcomes, lower cost) of emergency physicians in certain roles and new care models (eg, emergency physician remote supervision in rural settings).
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Affiliation(s)
- Jonathan J Oskvarek
- US Acute Care Solutions, Canton, OH; Department of Emergency Medicine, Summa Health System, Akron, OH.
| | - Erik J Blutinger
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Michelle P Lin
- Department of Emergency Medicine, Stanford University, Palo Alto, CA
| | | | | | - Abbey Smiley
- Department of Emergency Medicine, The Ohio State University, Columbus
| | | | - Jesse M Pines
- US Acute Care Solutions, Canton, OH; Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA
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Bové HM, Noer VR, Mousing CA. Being a Hospice Nurse in Times of the COVID-19 Pandemic: A Phenomenological Study of Providing End-of-Life Care. J Hosp Palliat Nurs 2023; 25:277-285. [PMID: 37302804 DOI: 10.1097/njh.0000000000000961] [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: 06/13/2023]
Abstract
End-of-life care changed during the COVID-19 pandemic, and the previous prevailing hospice philosophy and essential values of hospice care were suddenly under pressure. The aim was to explore hospice nurses' lived experience of providing end-of-life care to patients admitted in an out-hospital hospice setting during the COVID-19 pandemic. Data consist of 10 individual in-depth interviews of hospice nurses. A purposive sampling strategy was used, and the data collection and analysis was guided by a descriptive phenomenology. Providing end-of-life care was described through an existential dimension and a practical-related dimension. The pandemic and the ensuing constraints created an unfamiliar gap, triggering insecurity and unfamiliarity within nursing. Findings are elaborated in the following constituents: being a hospice nurse and providing end-of-life care. The latter constituent was further elucidated in additional perspectives: a new job position and bending the rules. Providing end-of-life care during the COVID-19 regime was a highly challenging and distressing experience due to the coercion of maintaining rules and restrictions as well as providing care. An experience of having to reinvent and work within a new agenda was present. Furthermore, the nurses experienced significant loss of job satisfaction and may be morally injured as well as highly exposed to secondary traumatization.
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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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Alshehri FF, Alghamdi SA, Alrashoudi AM, Albednah FA, Alotaibi AB, Alojayri AM, Aloushan AF, Ahmed G. Post-traumatic Stress Disorder and Its Associated Risk Factors Among Emergency Healthcare Workers: A Saudi Cross-Sectional Analytical Study. Cureus 2023; 15:e44327. [PMID: 37779819 PMCID: PMC10538461 DOI: 10.7759/cureus.44327] [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] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a psychiatric disease characterized by exposure to threatened death or serious injury and directly experiencing or witnessing the event. Many healthcare professionals have had PTSD, but emergency physicians may be particularly susceptible. To our knowledge, no study has been performed in Saudi Arabia to identify the prevalence and associated risk factors of PTSD among emergency staff. OBJECTIVE This study aims to determine the prevalence and risk factors of post-traumatic stress disorder (PTSD) among emergency healthcare workers (HCWs) in Saudi Arabia. METHODS A cross-sectional analytical study will be conducted in emergency departments around Saudi Arabia in all regions. The study population will include healthcare workers in emergency departments who work and presently live in Saudi Arabia. The survey was divided into two sections. The first section focuses on the emergency personnel's demographic data; the second concentrates on screening for post-traumatic stress disorder using the PTSD checklist for DSM-5 (PCL-5). RESULTS Our population included 519 emergency healthcare staff, including males (51.4%) and females (48.6%). Most emergency HCWs worked in the Ministry of Health Hospitals (58%). The highest diagnosed psychological disorders among emergency staff were anxiety (19.3%) and mood disorders (10.2%). The prevalence of PTSD among emergency workers in Saudi Arabia was 14.1%. The prevalence of PTSD was significantly higher among emergency HCWs who had chronic diseases, emergency workers with anxiety or mood disorders, emergency staff who were using psychiatric medication (p<0.001), and those with psychotic disorders (p=0.002). CONCLUSION The prevalence of PTSD among emergency healthcare workers in Saudi Arabia is estimated to be 14.1%, and pre-existing mental illnesses are associated with a higher risk of PTSD.
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Affiliation(s)
- Faisal F Alshehri
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Saleh A Alghamdi
- Department of Psychiatry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | | | - Fahed A Albednah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | | | - Abdullah M Alojayri
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Amairah F Aloushan
- Department of Emergency Medicine, King Abdulaziz Medical City (KAMC) and Ministry of National Guard Health Affairs (MNGHA), Riyadh, SAU
| | - Ghali Ahmed
- Department of Emergency Medicine, King Abdulaziz Medical City (KAMC) and Ministry of National Guard Health Affairs (MNGHA), Riyadh, SAU
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Van Puyvelde M, Van Herck J, Van den Bossche J, Goethals F, Gijbels D, Detaille F, Pattyn N. Walk the line: a systemic perspective on stress experienced by emergency medical personnel by comparing military and civilian prehospital settings. Front Public Health 2023; 11:1136090. [PMID: 37441639 PMCID: PMC10335750 DOI: 10.3389/fpubh.2023.1136090] [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: 01/02/2023] [Accepted: 03/15/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Emergency Medicine (EM) personnel in both military and civilian prehospital settings are often exposed to stressful and extreme events. Therefore, a cross-pollination between both contexts in terms of coping strategies may generate new information for purposes of training, prevention, and support programs. In the current study, we aimed at comparing both contexts to understand the type of stress events personnel experience; whether experience differs between civilian and military personnel; and how they cope with it. Methods We used a mixed method approach, combining the results of a quantitative questionnaire and a thematic analysis of 23 in-depth semi-structured interviews to gain additional qualitative information. Results Whereas the questionnaire pointed to a significant preference for task-oriented coping over avoidant and emotion-oriented coping, the interviews offered a more nuanced insight, showing a constant aim to position themselves on a continuum between emotional disconnection from the patient to preserve operationality on the one hand; and remaining enough empathic to preserve humanity on the other hand. We further identified an ambivalent awareness regarding emotions and stress, a vulnerable disbalance between an excessive passion for the job with the sacrifice of own's personal life (for a growing volatile and dangerous working environment) and a lack of recognition from both the patient and organizational environment. The combination of these factors may carry the risk for moral injury and compassion fatigue. Therefore, mutual trust between the organizational level and EM personnel as well as among team members is crucial. Discussion The results are discussed from a systemic SHELL perspective, indicating how the specific profile of EM personnel relates to the software, hardware, environmental and liveware components of their professional and private life. Trainings on stress- and risk awareness should be approached both on an individual and systemic level, knowing that there is clearly no "one-size-fits-all" manner.
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Affiliation(s)
- Martine Van Puyvelde
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Clinical and Lifespan Psychology, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Science, School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jolien Van Herck
- Clinical and Lifespan Psychology, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Frederic Goethals
- Comd Centre for Mental Health of the Military Hospital Queen Astrid, Brussels, Belgium
| | - Daisy Gijbels
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
| | - Frederic Detaille
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
| | - Nathalie Pattyn
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
- MFYS-BLITS, Human Physiology Department, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS NÎM, Montreal, QC, Canada
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Kobelski G, Naylor K, Ślusarz R, Wysokiński M. Post-Traumatic Stress Disorder among Polish Healthcare Staff in the Era of the COVID-19 Pandemic. J Clin Med 2023; 12:4072. [PMID: 37373764 DOI: 10.3390/jcm12124072] [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: 04/28/2023] [Revised: 06/04/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has brought many adverse phenomena, particularly in the area of health for both individuals and society as a whole. Healthcare staff also suffered dire consequences. AIM The aim of this study was to assess whether the COVID-19 pandemic increased the risk of post-traumatic stress disorder among healthcare professionals in Poland. MATERIAL AND METHOD The survey was conducted between 4 April 2022 and 4 May 2022. The study applied the Computer Assisted Web Interview (CAWI) technique using the standardised Peritraumatic Distress Inventory (PDI) questionnaire. RESULTS The average score obtained by the respondents on the PDI was 21.24 ± 8.97. There was a statistically significant difference between the average PDI score obtained based on the gender of the subject (Z = 3.873, p = 0.0001.) The score obtained amongst nurses was statistically significantly higher compared to the paramedic group (H = 6.998, p = 0.030). There was no statistically significant difference between the average PDI score obtained based on the age of the participants (F = 1.282, p = 0.281), nor with their length of service (F = 0.934, p = 0.424). A total of 82.44% of the respondents received 14 PDI points, the cut-off point indicating the risk of PTSD that was adopted in the study. It was concluded that 6.12% of respondents did not require intervention (<7 PDI score); 74.28% of respondents needed further follow-up for PTSD and a reassessment of the PDI approximately 6 weeks after the initial testing; and 19.59% required coverage for PTSD prevention and mitigation (>28 PDI score). CONCLUSIONS The study has shown a high risk of post-traumatic stress disorder among healthcare professionals in Poland. This risk is related to the gender of the respondents, with an indication of a higher risk of PTSD among women. The results have also shown a correlation between increased risk of post-traumatic stress disorder and occupation, with nurses being the most affected group. In contrast, no association has been found in terms of age and length of service for an increase in the risk of PTSD, following exposure to trauma in relation to healthcare services during the COVID-19 pandemic.
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Affiliation(s)
- Grzegorz Kobelski
- Institute of Medical Sciences, University College of Applied Sciences in Chelm, Pocztowa 54, 22-100 Chełm, Poland
| | - Katarzyna Naylor
- Chair and Department of Didactics and Medical Simulation, Faculty of Medical Sciences, Medical University of Lublin Poland, Chodźki 7, 20-093 Lublin, Poland
| | - Robert Ślusarz
- Neurological and Neurosurgical Nursing Department, Faculty of Health Science, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-821 Bydgoszcz, Poland
| | - Mariusz Wysokiński
- Department of Fundamentals of Nursing, Chair of Nursing Development, Faculty of Health Sciences, Medical University of Lublin Poland, 20-093 Lublin, Poland
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Bou Sanayeh E, El Chamieh C, Saade MC, Maalouf RG, Bizri M. Post-traumatic stress symptoms experienced by healthcare workers in Lebanon four months following Beirut’s ammonium nitrate explosion: a survey-based study. Arch Public Health 2022; 80:156. [PMID: 35715820 PMCID: PMC9204379 DOI: 10.1186/s13690-022-00911-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background On August 4, 2020, Lebanon faced one of the deadliest mass casualty explosions the world has witnessed during the twenty-first century. The human and emotional tolls were heavy on attending physicians, clinical fellows, residents, interns, medical students, and registered nurses, who were working in dramatic conditions, triaging, and treating thousands of blast-related casualties. We evaluated the risk of developing post-traumatic stress disorder symptoms (PTSS), among these healthcare workers (HCWs) from different Lebanese hospitals. Methods This is a multicentered, cross-sectional study that was conducted in December 2020, using an online questionnaire that evaluated the risk of developing PTSS based on the validated self-reported PTSD-Checklist for DSM-V (PCL-5). We also explored possible correlates with the participants’ socio-demographic characteristics, job profile, mental health, and blast-related events. Results Out of 519 participants, 44% were at high risk of developing PTSS following Beirut-blast. Nurses, attending physicians, fellows, and participants who are older in age, married, or working at specific hospitals, were at a higher risk. Those identified at higher risk of PTSS were surgeons, anesthesiologists, emergency medicine doctors, or radiologists; and they were more likely to be willing to migrate; having a prior history of psychiatric medication intake for PTSD treatment, a prior history of PTSD, or a personal history of seeking mental health service. At last, the latter two parameters as well as the number of examined injuries, severe home damage, and testing positive for the COVID-19 virus during the two weeks’ period that followed the blast were found to be predictors for the development of PTSS. Conclusion Lebanese in-hospital HCWs were found to be at a high risk of developing PTSS following the Beirut-Blast, thus we recommend public health authorities to provide adequate resources to avoid the emergence of mental illnesses among these rescuers.
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Andhavarapu S, Yardi I, Bzhilyanskaya V, Lurie T, Bhinder M, Patel P, Pourmand A, Tran QK. Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114890. [PMID: 36260970 PMCID: PMC9573911 DOI: 10.1016/j.psychres.2022.114890] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/02/2022] [Accepted: 10/06/2022] [Indexed: 01/05/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I2 >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I2 >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.
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Affiliation(s)
- Sanketh Andhavarapu
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Isha Yardi
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Vera Bzhilyanskaya
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Tucker Lurie
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mujtaba Bhinder
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Priya Patel
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, 22 South Greene Street, Suite T3N45, Baltimore, MD 21043, United States; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States.
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Zong Q, Li H, Jiang N, Gong Y, Zheng J, Yin X. Prevalence and determinants of smoking behavior among physicians in emergency department: A national cross-sectional study in China. Front Public Health 2022; 10:980208. [PMID: 36324466 PMCID: PMC9620959 DOI: 10.3389/fpubh.2022.980208] [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: 07/15/2022] [Accepted: 09/16/2022] [Indexed: 01/25/2023] Open
Abstract
Objectives To understand the current status of smoking behavior among emergency physicians in China and to explore its determinants. Background The emergency department is considered a more appropriate setting for tobacco interventions. However, the smoking behavior of emergency physicians can reduce the effectiveness of interventions for patient smoking behavior. Methods From July to August 2018, we conducted a structured online questionnaire among Chinese emergency medicine physicians. We used descriptive analysis with binary logistic regression to analyze the current smoking status of Chinese emergency physicians and its determinants. Results A total of 10,457 emergency physicians were included in this study. The prevalence of smoking among physicians was 25.35% (with 34.15 and 1.59% among male and female physicians, respectively). Results of logistic regression showed that postgraduate education (OR = 0.52, 95% CI: 0.41-0.66), chief-level title (OR = 0.79, 95% CI: 0.65-0.97), and regular exercise habits (OR = 0.83, 95% CI: 0.76-0.92) were associated with a lower risk of smoking behavior. However, being over 50 years old (OR = 1.71, 95% CI: 1.29-2.27), being fixed-term (OR = 1.25, 95% CI: 1.10-1.42), and having depressive symptoms (OR = 1.43, 95% CI: 1.28-1.61) were associated with a higher risk of smoking. Conclusion The prevalence of smoking behavior among emergency physicians in China is high. Hospital management could reduce the incidence of smoking behavior among emergency physicians by strengthening smoking cessation training, paying attention to physicians' psychological health, reducing pressure on physicians in fixed-term positions, and encouraging physicians to develop regular exercise habits.
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Affiliation(s)
- Qiao Zong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Li
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianwei Zheng
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Jianwei Zheng
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Xiaoxv Yin
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Ketterer AR, Austin AL. An Ethical Framework for Conducting Active-Shooter Simulation in the Healthcare Environment. Simul Healthc 2022; 17:270-274. [PMID: 35093977 DOI: 10.1097/sih.0000000000000632] [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: 11/25/2022]
Abstract
SUMMARY STATEMENT Active shooter events, although rare, are increasing in frequency in the United States, and healthcare settings are not immune to such events. Of the 277 active shooter events that took place in the United States between 2000 and 2019, 15 (4.5%) took place in healthcare facilities. Healthcare workers (HCWs) must be (1) well trained to respond to an active shooter event and (2) trained to respond to active shooter casualties. Educational activities related to active shooter events require a clear focus on goals and objectives, balanced to assure the physical and psychological safety of all participants. This article outlines how the recommendations of the National Association of School Psychologists might be adapted to conduct active shooter drills in the healthcare setting. This approach provides a framework for managing some of the ethical considerations in active shooter simulations.
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Affiliation(s)
- Andrew R Ketterer
- From the Department of Emergency Medicine (A.R.K.), Beth Israel Deaconess Medical Center-Harvard Medical School, Boston, MA; and Modeling Virtual Environments and Simulation (MOVES) Institute (A.L.A.), Naval Postgraduate School Healthcare Modeling and Simulation Program, Monterey, CA
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Zarska A, Barnicot K, Lavelle M, Dorey T, McCabe R. A Systematic Review of Training Interventions for Emergency Department Providers and Psychosocial Interventions delivered by Emergency Department Providers for Patients who self-harm. Arch Suicide Res 2022:1-22. [PMID: 35583506 DOI: 10.1080/13811118.2022.2071660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES People who self-harm frequently present to the emergency department (ED) and are treated by generalist healthcare staff with no specialist mental health training. We systematically reviewed (i) training interventions for generalist ED providers and (ii) psychosocial interventions delivered predominantly by generalist ED providers for people who self-harm. METHOD Five databases were searched for studies reporting on training interventions for generalist ED staff (at least 50% of the sample needed to be generalist ED staff) or psychosocial interventions for people who self-harm delivered predominantly by generalist ED staff. No limitations were placed regarding study design/country. Narrative synthesis was conducted. RESULTS Fifteen studies from high-income countries were included. Nine studies of moderate methodological quality evaluated training for generalist ED providers (n = 1587). Six studies of good methodological quality evaluated psychosocial interventions for adults who self-harm (n = 3133). Only one randomized controlled trial was identified. Training was linked with pre-post improvements in staff knowledge, and less consistently with improvement in skills, attitudes, and confidence. Evidence on patient outcomes was lacking. Patient-level interventions involving common suicide prevention strategies-safety planning and follow-up contact-were consistently linked to pre-post reductions in suicide attempts. Effects on treatment engagement and psychiatric admissions were unclear. CONCLUSIONS There is a clear need for further RCTs to improve the evidence base for ED generalist providers managing patients with self-harm. Evidence supports potential benefits of training for improving staff knowledge, attitudes, and skills, and of safety planning and follow-up contact for reducing repeat suicide attempts. HIGHLIGHTSMore RCTs are needed to improve the evidence base for ED providers managing self-harmSafety planning and follow up contacts are linked to reductions in repeat suicide attemptsFuture research should investigate the impact of staff training on patient outcomes.
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Matthews LR, Alden LE, Wagner S, Carey MG, Corneil W, Fyfe T, Randall C, Regehr C, White M, Buys N, White N, Fraess-Phillips A, Krutop E. PREVALENCE AND PREDICTORS OF POSTTRAUMATIC STRESS DISORDER, DEPRESSION, AND ANXIETY IN PERSONNEL WORKING IN EMERGENCY DEPARTMENT SETTINGS: A SYSTEMATIC REVIEW. J Emerg Med 2022; 62:617-635. [PMID: 35379514 DOI: 10.1016/j.jemermed.2021.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/15/2021] [Accepted: 09/11/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Professionals working in the emergency department (ED) are regularly exposed to traumatic events. Rates of posttraumatic mental health conditions vary widely in the literature and there is no agreement that rates in ED staff are elevated relative to other populations. OBJECTIVE We conducted a systematic review of international literature reporting prevalence of posttraumatic stress disorder (PTSD), depression, and anxiety in ED personnel to determine whether prevalence is elevated compared to the general community, and to evaluate convergent evidence across the literature for predictive factors. To our knowledge, there is no comprehensive review on this topic in the literature at this time. METHODS Seven databases were searched for studies reporting rates of PTSD, depression, and anxiety in ED personnel. Two independent researchers screened studies and assessed quality using Munn's Prevalence Critical Appraisal Instrument. Best-evidence synthesis determined whether conditions demonstrated elevated prevalence compared to the general population of Canada, a conservative benchmark. RESULTS Twenty-four studies from 12 countries and a combined sample size of 4768 were included. PTSD rates ranged from 0% to 23.6% (mean 10.47%), depression ranged from 0.7% to 77.1% (mean 24.8%), and anxiety rates ranged from 2.4% to 14.6% (mean 9.29%). Each condition was elevated compared to the general population. Sociodemographic variables were not consistent predictors. Elevated PTSD seemed most strongly related to workplace exposure and maladaptive coping. CONCLUSIONS ED professionals have an elevated risk of experiencing PTSD, depression, and anxiety. Identification of organizational and workplace predictors are needed to inform interventions that will reduce risk and provide optimal treatment and management of PTSD, depression, and anxiety in ED settings.
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Affiliation(s)
- Lynda R Matthews
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon Wagner
- College of Arts, Social and Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Mary G Carey
- School of Nursing, University of Rochester, Rochester, New York
| | - Wayne Corneil
- Interdisciplinary School of Health Sciences and Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Christine Randall
- School of Allied Health Sciences, Health Group, Menzies Health Institute of Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
| | | | - Marc White
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Buys
- Menzies Health Institute of Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
| | - Nicole White
- University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Alex Fraess-Phillips
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Elyssa Krutop
- Aligned Kamloops, Kamloops, British Columbia, Canada
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Lopes MCC, Oliva CCC, Bezerra NMS, Silva MT, Galvão TF. Relationship between depressive symptoms, burnout, job satisfaction and patient safety culture among workers at a university hospital in the Brazilian Amazon region: cross-sectional study with structural equation modeling. SAO PAULO MED J 2022; 140:412-421. [PMID: 35508009 PMCID: PMC9671242 DOI: 10.1590/1516-3180.2021.0614.15092021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/15/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Workplaces can be sources of mental distress. In healthcare services, this can also affect patients. OBJECTIVE To assess the prevalence of and factors associated with depressive symptoms, burnout, job satisfaction and patient safety culture and the relationships between these constructs, among healthcare workers. DESIGN AND SETTING Cross-sectional study in a university hospital in Manaus, Brazil. METHODS Randomly selected workers were interviewed based on Brazilian-validated tools. We calculated the prevalence ratio (PR) and 95% confidence interval (CI) of depressive symptoms and burnout using Poisson regression with robust variance; and the β-coefficient of safety culture and job satisfaction using linear regression. Outcome relationships were assessed using partial least-squares structural equation modeling. RESULTS 300 professionals were included; 67.3% were women. The prevalence of depressive symptom was 19.0% (95% CI: 14.5; 23.5%) and burnout, 8.7% (95% CI: 5.2; 12.3%). Lack of work stability increased depression (PR = 1.88; 95% CI: 1.17; 3.01) and burnout (PR = 2.17; 95% CI: 1.03; 4.57); and reduced job satisfaction (β = -11.93; 95% CI: -18.79; -5.07). Depressive symptoms and burnout were positively correlated, as also were job satisfaction and safety culture (P < 0.001); job satisfaction was negatively correlated with burnout (P < 0.001) and depression (P = 0.035). CONCLUSION Impermanent employment contracts increased depression and burnout and reduced job satisfaction. Job satisfaction reduced poor mental health outcomes and increased safety culture. Job satisfaction and safety culture were directly proportional (one construct increased the other and vice versa), as also were depression and burnout. Better working conditions can provide a virtuous cycle of patient safety and occupational health.
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Affiliation(s)
- Marcélia Célia Couteiro Lopes
- MSc. Pharmacist, Postgraduate Pharmaceutical Sciences Program, Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.
| | - Carmen Conceição Carrilho Oliva
- MSc. Pharmacist, Postgraduate Pharmaceutical Sciences Program, Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.
| | - Nádia Maria Soares Bezerra
- MBA. Health Inspector, Department of Health Surveillance, Municipal Health Department of Manaus, Manaus (AM), Brazil.
| | - Marcus Tolentino Silva
- MSc, PhD. Professor, Postgraduate Pharmaceutical Sciences Program, Universidade de Sorocaba (UNISO), Sorocaba (SP), Brazil.
| | - Tais Freire Galvão
- MSc, PhD. Professor, School of Pharmaceutical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
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Ayotte BJ, Schierberl Scherr AE, Kellogg MB. PTSD Symptoms and Functional Impairment among Nurses Treating COVID-19 Patients. SAGE Open Nurs 2022; 8:23779608221074651. [PMID: 35198734 PMCID: PMC8859481 DOI: 10.1177/23779608221074651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/23/2021] [Accepted: 01/01/2022] [Indexed: 12/30/2022] Open
Abstract
Introduction Nurses providing direct care for patients with COVID-19 may be at particular risk for developing symptoms of post-traumatic stress disorder (PTSD). However, little is known about how these symptoms are related to workplace and non-workplace impairment. Objective We examined if PTSD symptoms mediated the relationship between treating patients with COVID-19 and functional impairment. Methods An online survey collected data regarding demographic and workplace variables, PTSD symptoms, functional impairment, distracted practice, and if the nurse treated patients with confirmed COVID-19. Data collected in November 2020 from 218 primarily White and female nurses were analyzed. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines in reporting the methods and results. Results Analyses involved two steps: (a) calculating descriptive statistics, conducting univariate tests, and examining correlations among study variables; and (b) conducting a path analysis examining the mediating role of PTSD symptoms in the relationship between treating patients with COVID-19 and functional outcomes. Univariate tests found that nurses who had a diploma/associate's/bachelor's and nurses who treated patients with COVID-19 reported more PTSD symptoms, functional impairment, and distracted practice compared to nurses with graduate degrees and those who did not treat patients with COVID-19. Compared to nurses who reported having access to adequate PPE, nurses who reported not having access to adequate PPE reported more PTSD symptoms but lower functional impairment and distracted practice. Men reported lower distracted practice scores than women. In step two of the analyses, the path model suggested that treating patients with COVID-19 was indirectly related to both distracted practice and functional impairment through PTSD symptoms. Conclusion The probable PTSD symptoms and work- and non-work-related functional impairment of nurses working with patients with COVID-19 highlight the importance of developing interventions that help these essential workers address vulnerabilities associated with working during the COVID-19 pandemic.
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Affiliation(s)
- Brian J. Ayotte
- Department of Psychology, University of Massachusetts, Dartmouth, Dartmouth, MA, USA
| | - Anna E. Schierberl Scherr
- Department of Psychology, University of Massachusetts, Dartmouth, Dartmouth, MA, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Marni B. Kellogg
- Department of Community Health Nursing, University of Massachusetts, Dartmouth
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15
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Qian J, Wang W, Sun S, Liu L, Sun Y, Yu X. Interventions to reduce post-traumatic stress disorder symptoms in health care professionals from 2011 to 2021: a scoping review. BMJ Open 2022; 12:e058214. [PMID: 35058271 PMCID: PMC8783816 DOI: 10.1136/bmjopen-2021-058214] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES This scoping review aimed to describe available interventions for decreasing (post-traumatic stress disorder) PTSD symptoms among healthcare professionals in hospital care. METHOD A scoping review was conducted following Arksey and O'Malley's framework. PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Web of Science, Scopus and ProQuest were searched for original research published in English from 2011 to 2021, on 8 July 2021. We included studies that described interventions that focused on reducing the PTSD symptoms of healthcare professionals. A narrative synthesis was adopted to synthesise the data. RESULTS A total of eight studies out of 2558 articles were identified. Six used a quantitative study design and two adopted qualitative methods. cognitive behavioural therapy and mindfulness-based interventions were the most commonly adopted. Most studies used a combination of different intervention strategies. Trauma-related knowledge, emotion regulation and relaxation skill training, and psychological support from peers and psychologists were three core intervention components. The duration ranged from 2 weeks to 6 months. Healthcare professionals who participated in training programmes reported both positive experiences and suggestions for the improvement of PTSD-reducing interventions in their qualitative feedback. CONCLUSIONS The scoping review provides a practical summary of the intervention characteristics for reducing the PTSD symptoms of healthcare professionals. Hospitals and managers could use the overview of interventions to assist healthcare professionals with PTSD symptoms. More research investigating the effects of PTSD symptom-reducing interventions for healthcare professionals with appropriate follow-up assessments is needed in the future.
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Affiliation(s)
- Jialu Qian
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Weihong Wang
- Department of Obstetrics, Ninghai Maternal and Child Health Hospital, Ningbo, China
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Lu Liu
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaping Sun
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
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Duran ÉP, Hemanny C, Vieira R, Nascimento O, Machado L, de Oliveira IR, Demarzo M. A Randomized Clinical Trial to Assess the Efficacy of Online-Treatment with Trial-Based Cognitive Therapy, Mindfulness-Based Health Promotion and Positive Psychotherapy for Post-Traumatic Stress Disorder during the COVID-19 Pandemic: A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:819. [PMID: 35055641 PMCID: PMC8775699 DOI: 10.3390/ijerph19020819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/22/2021] [Accepted: 01/07/2022] [Indexed: 12/10/2022]
Abstract
BACKGROUND Research suggests the use of different forms of therapy as a way of decreasing dropout rates in the treatment of post-traumatic stress disorder (PTSD). The psychotherapies to be assessed in this study are trial-based cognitive therapy (TBCT), mindfulness-based health promotion (MBHP) and positive psychotherapy (PPT). OBJECTIVES (1) to assess the online efficacy of TBCT compared to MBHP and PPT to reduce the symptoms of PTSD in the context of the Coronavirus Disease 2019 (COVID-19) pandemic; (2) to compare the efficacy of these psychotherapies in improving anxiety, depression, guilt and in promoting well-being; and (3) to describe how professionals perceive online treatment. METHODS A randomized, multicenter, single-blind clinical trial will be conducted, with three separate arms. An estimated sample of 135 patients will receive either TBCT, MBHP or PPT and will be treated through online, individual, weekly visits, totaling 14 sessions. The primary outcome will be CAPS-5 and secondary outcomes will be HADS and WHO-5. The variables used to mediate these outcomes will be the Trauma-Related Guilt Inventory (TRGI), Negative Core Beliefs Inventory (NCBI) and the California Psychotherapy Alliance Scale (CALPAS-P). EXPECTED RESULTS PTSD symptoms are expected to be reduced after TBCT, MBHP and PPT. No statistical difference is expected to be found among the three. DISCUSSION The present study will evaluate and contribute towards the development of new psychotherapeutic options for patients with PTSD. The results of this study will allow the dissemination of new effective and adaptable interventions for patients with PTSD.
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Affiliation(s)
- Érica Panzani Duran
- Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador 40110-060, Brazil; (C.H.); (R.V.); (I.R.d.O.)
| | - Curt Hemanny
- Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador 40110-060, Brazil; (C.H.); (R.V.); (I.R.d.O.)
| | - Renata Vieira
- Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador 40110-060, Brazil; (C.H.); (R.V.); (I.R.d.O.)
| | - Orlando Nascimento
- Mente Aberta—Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), Sao Paulo 04753-060, Brazil; (O.N.); (M.D.)
| | - Leonardo Machado
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Center for Medical Sciences, Department of Neuropsychiatry, Federal University of Pernambuco (POSNEURO-CCM-UFPE), Recife 50070-460, Brazil;
| | - Irismar Reis de Oliveira
- Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador 40110-060, Brazil; (C.H.); (R.V.); (I.R.d.O.)
| | - Marcelo Demarzo
- Mente Aberta—Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), Sao Paulo 04753-060, Brazil; (O.N.); (M.D.)
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17
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McKeon G, Steel Z, Wells R, Fitzpatrick A, Vancampfort D, Rosenbaum S. Exercise and PTSD Symptoms in Emergency Service and Frontline Medical Workers: A Systematic Review. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Campbell J, Wasey A, Ozuturan IU, Jeanmonod R. Compassion Fatigue and Satisfaction among Turkish Emergency Medicine Residents Using the Professional Quality of Life Scale. J Emerg Trauma Shock 2022; 15:77-82. [PMID: 35910322 PMCID: PMC9336638 DOI: 10.4103/jets.jets_62_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/27/2021] [Accepted: 04/22/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Emergency medicine (EM) residents are at high risk for burnout syndrome. The professional quality of life scale (ProQOL) is a validated survey that measures compassion satisfaction (CS) and compassion fatigue, which is comprised of burnout and secondary traumatic stress (STS) scales. This study sought to evaluate CS and fatigue among Turkish EM residents using the ProQOL survey. Methods This was a cross-sectional study of Turkish EM residents who are part of the EM Residency Association of Turkey. The ProQOL survey version 5 was E-mailed in Turkish to all 150 EM residents. Participants were currently employed as EM residents. Demographics and satisfaction with quality of life were also collected. Results Eighty residents completed the survey. Almost half of the respondents were either very dissatisfied or dissatisfied with their overall quality of life. Turkish EM residents not only had moderate levels of CS (scoring 33.9 ± 7.9), but also suffered moderate burnout (27.0 ± 5.9) and STS (24.7 ± 5.3). Conclusions Turkish EM residents have moderate levels of CS and moderate levels of burnout and secondary traumatic stress.
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Affiliation(s)
- Joshua Campbell
- Department of Emergency Medicine, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | - Abdul Wasey
- Department of Emergency Medicine, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | | | - Rebecca Jeanmonod
- Department of Emergency Medicine, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA,Address for correspondence: Dr. Rebecca Jeanmonod, Department of Emergency Medicine, St. Luke's University Health Network, 801 Ostrum St, Bethlehem 18015, Pennsylvania, USA. E-mail:
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19
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Schein J, Houle C, Urganus A, Cloutier M, Patterson-Lomba O, Wang Y, King S, Levinson W, Guérin A, Lefebvre P, Davis LL. Prevalence of post-traumatic stress disorder in the United States: a systematic literature review. Curr Med Res Opin 2021; 37:2151-2161. [PMID: 34498953 DOI: 10.1080/03007995.2021.1978417] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study synthesized evidence regarding the prevalence of post-traumatic stress disorder (PTSD) in the United States (US). METHODS A systematic literature review (SLR) identified recently published (2015-2019) observational studies of PTSD prevalence in the US via the MEDLINE, EMBASE, and PsycINFO databases. Eligible studies' most recent data were collected no earlier than 2013. Data elements extracted included study design, sample size, location, data source/year(s), study population(s), traumatic event type, prevalance estimates with corresponding look-back periods, and clinical metrics. RESULTS Data from 38 identified articles were categorized by population, diagnostic criteria, and lookback period. Among civilians, point prevalence ranged from 8.0% to 56.7%, 1-year prevalence from 2.3% to 9.1%, and lifetime prevalence from 3.4% to 26.9%. In military populations, point prevalence ranged from 1.2% to 87.5%, 1-year prevalence from 6.7% to 50.2%, and lifetime prevalence from 7.7% to 17.0%. Within these ranges, several estimates were derived from relatively high quality data; these articles are highlighted in the review. Prevalence was elevated in subpopulations including emergency responders, refugees, American Indian/Alaska Natives, individuals with heavy substance use, individuals with a past suicide attempt, trans-masculine individuals, and women with prior military sexual trauma. Female sex, lower income, younger age, and behavioral health conditions were identified as risk factors for PTSD. CONCLUSIONS PTSD prevalence estimates varied widely, partly due to different study designs, populations, and methodologies, and recent nationally representative estimates were lacking. Efforts to increase PTSD screening and improve disease awareness may allow for a better detection and management of PTSD.
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Affiliation(s)
- Jeffrey Schein
- Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, USA
| | | | | | | | | | - Yao Wang
- Analysis Group, Inc, Boston, MA, USA
| | | | | | | | | | - Lori L Davis
- Tuscaloosa Veteran Affairs Medical Center, Tuscaloosa, AL, USA
- Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama School of Medicine, Birmingham, AL, USA
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20
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Kalyanaraman M, Sankar A, Timpo E, McQueen D, Morparia K, Bergel M, Rosenblatt J. Posttraumatic Stress Namong Pediatric Critical Care Physicians in the United States in Association with Coronavirus Disease 2019 Patient Care Experiences. J Intensive Care Med 2021; 37:510-517. [PMID: 34812079 DOI: 10.1177/08850666211059385] [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: 11/16/2022]
Abstract
Posttraumatic stress among pediatric critical care physicians in the United States in association with coronavirus disease 2019 patient care experiences. Our objective was to assess the prevalence of posttraumatic stress (PTS) and its association with COVID-19 patient care experiences among pediatric critical care physicians. Our study was a cross-sectional study of pediatric critical care physicians in the United States. We measured PTS which included posttraumatic stress disorder (PTSD) and subthreshold posttraumatic stress disorder (SubPTSD) using validated PTSD Checklist- 5 survey tool. Association of PTS with COVID-19 patient care experiences was analyzed using regression analysis. Prevalence of PTS was noted in 120 among 294 pediatric critical care physicians (41%; 95% CI, 35-47%). The predominant symptoms were that of hyperarousal and feelings of negative cognition and mood. Among our physicians with PTS, 19% had PTSD and 81% had SubPTSD. Demographic and practice characteristics were not significant for increased PTS on regression analysis. Posttraumatic stress was significantly associated with physicians testing positive or taking time off for COVID-19 illness, self-isolation, fear of infecting their loved ones, families scared of being infected, feeling helpless, patients expressing fears of dying, having pre-existing depression, anxiety, or insomnia, working beyond comfort level of training and having thoughts of quitting (p < 0.05). Thoughts of quitting was associated with the highest significant increase in PTS scores (coefficient:11.643; 95% CI:8.551,14.735; P < 0.01) followed by feeling of helplessness (coefficient:11.055; 95% CI: 8.484,13.624; P < 0.01) and need for additional medications for depression, anxiety and insomnia (coefficient: 10.980; 95% CI: 4.970, 16.990; P < 0.01). Posttraumatic stress is high in pediatric critical care physicians and is associated with various COVID-19 patient care experiences. Thoughts of quitting was associated with highest increase in posttraumatic stress score which could have major implications for the workforce in the future. Subthreshold posttraumatic stress disorder should be recognized, and mental health issues of pediatric critical care physicians addressed.
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Affiliation(s)
- Meena Kalyanaraman
- Children's Hospital of New Jersey at Newark Beth Israel Medical Center, Newark, NJ, USA
| | - Ashwini Sankar
- Carlson School of Management, 311816University of Minnesota, Minneapolis, MN, USA
| | - Edem Timpo
- Children's Hospital of New Jersey at Newark Beth Israel Medical Center, Newark, NJ, USA
| | - Derrick McQueen
- Children's Hospital of New Jersey at Newark Beth Israel Medical Center, Newark, NJ, USA
| | - Kavita Morparia
- Children's Hospital of New Jersey at Newark Beth Israel Medical Center, Newark, NJ, USA
| | - Maria Bergel
- Children's Hospital of New Jersey at Newark Beth Israel Medical Center, Newark, NJ, USA
| | - Joshua Rosenblatt
- Children's Hospital of New Jersey at Newark Beth Israel Medical Center, Newark, NJ, USA
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21
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Melemeni D, Mantzouranis K, Georgakopoulou VE, Tarantinos K, Garmpis N, Damaskos C, Sklapani P, Chlapoutakis S, Trakas N, Tsiafaki X, Papathanasiou IV. Depression, Anxiety and Quality of Life in Staff of a Hospital in Athens: A Study in the Aftermath of the Debt Crisis Era. Acta Med Litu 2021; 28:230-239. [PMID: 35637938 PMCID: PMC9133613 DOI: 10.15388/amed.2021.28.2.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/22/2022] Open
Abstract
Background Several studies investigated the mental health needs of hospital staff in Greece during the debt crisis era. Yet, no relevant data are available regarding the mental health of hospital staff after this period. The aims of this study are: 1) To investigate the prevalence of clinically significant depression and anxiety in healthcare workers in a general hospital in Athens, Greece; 2) to search for the association of quality of life with anxiety and depression in those workers; 3) to investigate the association of sociodemographic characteristics with those parameters. Methods The Zung Depression Rating Scale, the Zung Anxiety Rating Scale, the Short-Form Survey-12, assessing quality of life, and sociodemographic assessments were administrated in 110 workers of a public hospital in Athens, Greece. The assessments were completed during January, 2020. Results Of the study participants, 38.2% had clinically significant anxiety and 6.4% had clinically signifi-cant depression. Males had lower scores of depression compared to females (p=0.003). As for the effects of educational level, differences were noted in psychological quality of life between secondary education participants when compared to tertiary education (Mean Difference -3.527, p=0.021), post-graduate (Mean Difference -3.937, p=0.012) and PhD participants (Mean Difference -5.100, p=0.007). Quality of life and its psychological and physical health subscales had strong inverse associations with depression and anxiety (p=0.000). Conclusions Relevant interventions are necessary to decrease anxiety in hospital staff, which is elevated in the aftermath of the debt crisis period. In addition, health policy makers have to reduce the gender gap in mental health between male and female workers, since the latter had higher levels of depression.
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Affiliation(s)
| | | | | | | | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School,
National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical
School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
| | - Xanthi Tsiafaki
- 1 Pulmonology Department Sismanogleio Hospital, Athens, Greece
| | - Ioanna V. Papathanasiou
- Faculty of Nursing, University of Thessaly, Larissa, Greece Hellenic Open University,
Patras, Greece
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22
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Carmassi C, Malacarne P, Dell'oste V, Bertelloni CA, Cordone A, Foghi C, Dell'osso L. Post-traumatic stress disorder, burnout and their impact on global functioning in Italian emergency healthcare workers. Minerva Anestesiol 2021; 87:556-566. [PMID: 33432793 DOI: 10.23736/s0375-9393.20.14853-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and burnout are severe and frequent conditions among emergency healthcare workers exposed to repeated work-related traumatic experiences. The aim of the present study was to investigate PTSD, burnout and global functioning in a sample of emergency healthcare workers (HCWs) of a major university hospital in Italy, exploring possible correlations between the two constructs. METHODS The study sample included 137 medical and nursing Emergency Room and Intensive Care Unit staff members of a major University Hospital in Italy (Pisa), all assessed by means of the Trauma and Loss Spectrum - Self Report (TALS-SR), for post-traumatic stress spectrum, the Professional Quality of Life Scale - Revision IV (ProQOL R-IV), for burnout related to work activities, and the Work and Social Adjustment Scale (WSAS), for global functioning. RESULTS Forty-nine subjects reported a full (18, 14.3%) or partial (31, 24.6%) symptomatological DSM-5 PTSD. HCWs with PTSD reported significantly higher burnout scores and global functioning impairment compared to those without PTSD. Mean to good significant correlations emerged between the TALS-SR total and domains scores, the ProQOL subscales and the WSAS scores. CONCLUSIONS This work, conducted before the COVID-19 pandemic, underlines a positive correlation between burnout and post-traumatic stress spectrum symptoms in emergency HCWs, showing the need for a deeper assessment of work-related post-traumatic stress symptoms in such population in order to improve the well-being and to prevent burnout.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paolo Malacarne
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
| | - Valerio Dell'oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy -
| | - Carlo A Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Awan S, Diwan MN, Aamir A, Allahuddin Z, Irfan M, Carano A, Vellante F, Ventriglio A, Fornaro M, Valchera A, Pettorruso M, Martinotti G, Di Giannantonio M, Ullah I, De Berardis D. Suicide in Healthcare Workers: Determinants, Challenges, and the Impact of COVID-19. Front Psychiatry 2021; 12:792925. [PMID: 35185638 PMCID: PMC8850721 DOI: 10.3389/fpsyt.2021.792925] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/21/2021] [Indexed: 12/16/2022] Open
Abstract
The Coronavirus disease-19 (COVID-19), which first appeared in Wuhan, China, and was later declared a pandemic, has caused significant morbidity and mortality worldwide. Numerous efforts have been made worldwide to understand the disease's physical manifestation. However, less emphasis has been placed on the pandemic's mental health challenges for healthcare workers (HCWs) who played a critical role in fighting the disease. Existing literature shows the detrimental psychological impact and increased incidence of depression and anxiety among HCWs. It is expected that the mental health crisis will become a serious issue affecting HCWs, with long-term negative consequences following COVID. Physicians and nurses already represent the highest risk groups of suicide among the general population, and suicide can be regarded as an occupational hazard in the healthcare industry. Increased workload, burnout and fatigue, multifaceted challenges women HCWs, and increased substance abuse are contributing factors to suicide ideation. In this article, we identify the risk factors of suicide among HCWs, discuss mental health challenges exacerbated by the pandemic and its impact on suicide ideation.
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Affiliation(s)
- Sana Awan
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | | | - Alifiya Aamir
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | - Zoha Allahuddin
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Alessandro Carano
- Department of Mental Health, Azienda Sanitaria Unica Regionale 5 Marche, San Benedetto Del Tronto, Italy
| | - Federica Vellante
- Department of Mental Health, Mental Health Center of Ortona, Azienda Sanitaria Locale Chieti, Chieti, Italy
| | | | - Michele Fornaro
- Laboratory of Molecular and Translational Psychiatry, Unit of Treatment-Resistant Psychosis, Section of Psychiatry, University of Naples Federico II, Naples, Italy
| | - Alessandro Valchera
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Domenico De Berardis
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy.,Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
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Keith KC, Smith E, Reddy S, Bourne CL. Lifestyle Factors and Other Influences on Medical Students Choosing a Career in Emergency Medicine. AEM EDUCATION AND TRAINING 2021; 5:37-42. [PMID: 33521489 PMCID: PMC7821054 DOI: 10.1002/aet2.10440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/09/2020] [Accepted: 02/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The purpose of this study was to determine which lifestyle factors influence medical students who choose a career in emergency medicine (EM). METHODS Final-year medical students from 10 medical schools were surveyed after the National Residency Match Program match but prior to graduation regarding preferred medical specialty and lifestyle preferences. Responses from students pursuing EM regarding importance of lifestyle factors were compared to students interested in other specialties. RESULTS A total of 453 of 1,575 invited medical students completed an electronic survey. EM was the third most preferred specialty. Students selecting EM were less likely to endorse "having control of work schedule" as being important (p < 0.005), but more likely to endorse "having time off work" as important (p < 0.05). When students were asked what specific factors were important in choosing a specialty, EM students differed from other students in the importance of flexible work schedule, time outside of work, and balance between work and personal life (p < 0.001). Fewer EM students endorsed that having a "low-stress work day" was an important consideration in their specialty choice (p < 0.001). CONCLUSIONS In this study representing 10 medical schools, graduating medical students who prefer EM as opposed to other specialties exhibit differences in lifestyle factors deemed important when choosing a specialty as a physician. Further investigation regarding any potential link to these factors and career longevity is warranted.
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Affiliation(s)
- Kevin C. Keith
- Department of PediatricsDuke University School of MedicineDurhamNC
- College of MedicineMedical University of South CarolinaCharlestonSC
| | - Elizabeth Smith
- College of MedicineMedical University of South CarolinaCharlestonSC
| | - Shalini Reddy
- Department of MedicineJohn H. Stroger Hospital of Cook County HealthChicagoIL
- University of ChicagoChicagoIL
| | - Christina L. Bourne
- College of MedicineMedical University of South CarolinaCharlestonSC
- Department of Emergency MedicineMedical University of South CarolinaCharlestonSC
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Sun Z, Yu C, Zhou Y, Liu Z. Psychological Interventions for Healthcare Providers With PTSD in Life-Threatening Pandemic: Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:697783. [PMID: 34393858 PMCID: PMC8358144 DOI: 10.3389/fpsyt.2021.697783] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aims to evaluate the effect of psychological interventions on healthcare providers (HCP) with post-traumatic stress disorder (PTSD) due to their necessary exposure in life-threatening pandemic. Methods: We performed a systematic research on Medline, Embase, Cochrane Central, PsycInfo, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, ProQuest PTSD Pubs ProQuest Dissertations & Theses Global, and other gray databases by January 2021. Randomized controlled trials involving therapeutic interventions for HCP with PTSD were included. The primary outcome was PTSD symptom severity. Summary standardized mean differences (SMDs) and 95% confidence intervals were estimated using inverse variance meta-analysis with fixed effects. Risks of bias were assessed using Cochrane methods. Results: Among 773 citations, this review includes six studies, randomizing 810 participants. A meta-analysis of the effect of interventions compared to placebo showed a significant reduction of PTSD symptom severity: Cognitive Behavioral Therapy-Brief (CBT-B) (M = 27.80, 95% CI: 17.12, 38.48), Cognitive Behavioral Therapy-Long (CBT-L) (M = 26.50, 95% CI: 15.75, 37.25), and Mindfulness-Based Stretching and Deep Breathing Exercise (MBX) (M = 17.2, 95% CI: 6.57, 27.83). CBT-L and CBT-B also showed a significant effect on depression severity. Conclusions: The most effective and feasible treatment option for HCP with PTSD is still unclear, but CBT and MBX have displayed the most significant effects based on current limited evidence. Future research in this area-preferably large robust randomized controlled trials-is much needed.
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Affiliation(s)
- Zeyuan Sun
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Chuan Yu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Yue Zhou
- Harvard Law School, Harvard University, Cambridge, MA, United States
| | - Zhenmi Liu
- West China School of Public Health, Sichuan University, Chengdu, China
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26
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Marco CA, Larkin GL, Feeser VR, Monti JE, Vearrier L. Post-traumatic stress and stress disorders during the COVID-19 pandemic: Survey of emergency physicians. J Am Coll Emerg Physicians Open 2020; 1:1594-1601. [PMID: 33392568 PMCID: PMC7771764 DOI: 10.1002/emp2.12305] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/03/2020] [Accepted: 10/12/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Emergency physicians routinely encounter stressful clinical situations, including treating victims of crime, violence, and trauma; facing the deaths of patients; and delivering bad news. During a pandemic, stress may be increased for healthcare workers. This study was undertaken to identify symptoms of post-traumatic stress disorder (PTSD) among emergency physicians during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This cross-sectional survey was developed using the Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (DSM-5) and the PTSD Checklist for DSM-5 (PCL-5). The survey was distributed to members of the American College of Emergency Physicians from May 21, 2020, through June 22, 2020. RESULTS Among 1300 emergency physicians, a significant number of participants (22.3%; 95% confidence interval, 20.3-24.3%) reported symptoms of stress consistent with PTSD (PCL score ≥ 33). Higher PCL-5 scores were associated with age younger than 50 years (P < 0.05) and <10 years in practice (P < 0.05). The major sources of stress identified by participants included disinformation about COVID-19, computer work/electronic medical record, personal protective equipment concerns, and workload. The most common consequences of workplace stress were feeling distant or cut off from other people and sleep disturbance, such as trouble falling or staying asleep. CONCLUSIONS A significant number of emergency physicians reported symptoms of stress consistent with PTSD. Higher PCL-5 scores were associated with age younger than 50 years and <10 years in practice.
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Affiliation(s)
- Catherine A. Marco
- Department of Emergency MedicineWright State University Boonshoft School of MedicineDaytonOhioUSA
| | - Gregory L. Larkin
- Department of Emergency MedicineNortheast Ohio Medical University and US Acute Care SolutionsAkronOhioUSA
| | - V. Ramana Feeser
- Department of Emergency MedicineVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - James E. Monti
- Department of Emergency MedicineAlpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Laura Vearrier
- Department of Emergency MedicineUniversity of Mississippi Medical CenterJacksonMississippiUSA
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What Can COVID-19 Teach Us about Using AI in Pandemics? Healthcare (Basel) 2020; 8:healthcare8040527. [PMID: 33271960 PMCID: PMC7711608 DOI: 10.3390/healthcare8040527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic put significant strain on societies and their resources, with the healthcare system and workers being particularly affected. Artificial Intelligence (AI) offers the unique possibility of improving the response to a pandemic as it emerges and evolves. Here, we utilize the WHO framework of a pandemic evolution to analyze the various AI applications. Specifically, we analyzed AI from the perspective of all five domains of the WHO pandemic response. To effectively review the current scattered literature, we organized a sample of relevant literature from various professional and popular resources. The article concludes with a consideration of AI’s weaknesses as key factors affecting AI in future pandemic preparedness and response.
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28
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D'Ettorre G, Pellicani V, Ceccarelli G. Post-traumatic stress disorder symptoms in healthcare workers: a ten-year systematic review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020009. [PMID: 33263341 PMCID: PMC8023102 DOI: 10.23750/abm.v91i12-s.9459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/06/2020] [Indexed: 12/26/2022]
Abstract
Background and aims: Healthcare workers (HCWs) employed in hospital settings frequently experience many occupational stressors leading to post-traumatic stress disorder (PTSD) symptoms. Literature has increasingly highlighted PTSD as a major issue that involves both staff and healthcare organizations; the consequences of PTSD may include medication errors and lower standards of care. The current COVID-19 pandemic poses the need for preventing PTSD in HCWs working closely with COVID-19 patients. The purpose of this systematic review was to analyze the latest developments in assessing and managing the occupational risk of PTSD symptoms in hospital HCWs. Methods: We searched for publications in MEDLINE/Pubmed using selected keywords. Each article was reviewed and categorized into one or more of the following four categories based on its subject matter: risk assessment, risk management and occurrence rates. Results: Our search resulted in a total of 32 publications that matched our inclusion criteria. Increased years of service, older age, previous year exposure to violence, personality traits (i.e. neuroticism), history of mental disorders, being non-graduates, were found to be workers’ pre-trauma factors predicting PTSD symptoms. Conclusions: The findings suggest the need to prioritize preventative interventions aimed to anticipate the effects of traumatic exposure by training HCWs in evidence based anticipatory methods of coping with stressful events. With regard to the current COVID-19 pandemic, we found evidence of the need to strength social support and training targeted at psychological skills of medical staff who treated COVID-19 patients. (www.actabiomedica.it)
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Affiliation(s)
| | | | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Azienda Policlinico Umberto I, Rome, Italy..
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Carmassi C, Foghi C, Dell'Oste V, Cordone A, Bertelloni CA, Bui E, Dell'Osso L. PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID-19 pandemic. Psychiatry Res 2020; 292:113312. [PMID: 32717711 PMCID: PMC7370915 DOI: 10.1016/j.psychres.2020.113312] [Citation(s) in RCA: 363] [Impact Index Per Article: 90.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/18/2020] [Accepted: 07/18/2020] [Indexed: 12/13/2022]
Abstract
The COronaVIrus Disease-19 (COVID-19) pandemic has highlighted the critical need to focus on its impact on the mental health of Healthcare Workers (HCWs) involved in the response to this emergency. It has been consistently shown that a high proportion of HCWs is at greater risk for developing Posttraumatic Stress Disorder (PTSD) and Posttraumatic Stress Symptoms (PTSS). The present study systematic reviewed studies conducted in the context of the three major Coronavirus outbreaks of the last two decades to investigate risk and resilience factors for PTSD and PTSS in HCWs. Nineteen studies on the SARS 2003 outbreak, two on the MERS 2012 outbreak and three on the COVID-19 ongoing outbreak were included. Some variables were found to be of particular relevance as risk factors as well as resilience factors, including exposure level, working role, years of work experience, social and work support, job organization, quarantine, age, gender, marital status, and coping styles. It will be critical to account for these factors when planning effective intervention strategies, to enhance the resilience and reduce the risk of adverse mental health outcomes among HCWs facing the current COVID-19 pandemic.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Biotechnology Chemistry and Pharmacy, University of Siena, Siena, Italy.
| | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Eric Bui
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Pallas J. The Acute Incident Response Program: A Framework Guiding Multidisciplinary Responses to Acutely Traumatic or Stress-Inducing Incidents in the ED Setting. J Emerg Nurs 2020; 46:579-589.e1. [DOI: 10.1016/j.jen.2020.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 12/27/2022]
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Hüfner A, Dudeck M, Zellner J, Mahr D. Gewalt und Aggression im Krankenhaus – Was, wenn das Personal Hilfe braucht? Unfallchirurg 2020; 123:424-434. [DOI: 10.1007/s00113-020-00806-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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