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Bellehsen MH, Cook HM, Shaam P, Burns D, D’Amico P, Goldberg A, McManus MB, Sapra M, Thomas L, Wacha-Montes A, Zenzerovich G, Watson P, Westphal RJ, Schwartz RM. Adapting the Stress First Aid Model for Frontline Healthcare Workers during COVID-19. Int J Environ Res Public Health 2024; 21:171. [PMID: 38397662 PMCID: PMC10887691 DOI: 10.3390/ijerph21020171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
The coronavirus pandemic has generated and continues to create unprecedented demands on our healthcare systems. Healthcare workers (HCWs) face physical and psychological stresses caring for critically ill patients, including experiencing anxiety, depression, and posttraumatic stress symptoms. Nurses and nursing staff disproportionately experienced COVID-19-related psychological distress due to their vital role in infection mitigation and direct patient care. Therefore, there is a critical need to understand the short- and long-term impact of COVID-19 stress exposures on nursing staff wellbeing and to assess the impact of wellbeing programs aimed at supporting HCWs. To that end, the current study aims to evaluate an evidence-informed peer support stress reduction model, Stress First Aid (SFA), implemented across units within a psychiatric hospital in the New York City area during the pandemic. To examine the effectiveness of SFA, we measured stress, burnout, coping self-efficacy, resilience, and workplace support through self-report surveys completed by nurses and nursing staff over twelve months. The implementation of SFA across units has the potential to provide the workplace-level and individual-level skills necessary to reduce stress and promote resilience, which can be utilized and applied during waves of respiratory illness acuity or any other healthcare-related stressors among this population.
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Affiliation(s)
- Mayer H. Bellehsen
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY 11021, USA; (M.H.B.); (P.S.); (D.B.); (A.G.); (A.W.-M.); (G.Z.); (R.M.S.)
- Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Glen Oaks, NY 11004, USA; (P.D.); (M.S.)
- Behavioral Health Service Line, Northwell Health, New York, NY 10022, USA;
| | - Haley M. Cook
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY 11021, USA; (M.H.B.); (P.S.); (D.B.); (A.G.); (A.W.-M.); (G.Z.); (R.M.S.)
- Department of Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY 11021, USA
| | - Pooja Shaam
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY 11021, USA; (M.H.B.); (P.S.); (D.B.); (A.G.); (A.W.-M.); (G.Z.); (R.M.S.)
- Department of Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY 11021, USA
| | - Daniella Burns
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY 11021, USA; (M.H.B.); (P.S.); (D.B.); (A.G.); (A.W.-M.); (G.Z.); (R.M.S.)
- Behavioral Health Service Line, Northwell Health, New York, NY 10022, USA;
| | - Peter D’Amico
- Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Glen Oaks, NY 11004, USA; (P.D.); (M.S.)
| | - Arielle Goldberg
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY 11021, USA; (M.H.B.); (P.S.); (D.B.); (A.G.); (A.W.-M.); (G.Z.); (R.M.S.)
- Behavioral Health Service Line, Northwell Health, New York, NY 10022, USA;
| | - Mary Beth McManus
- Behavioral Health Service Line, Northwell Health, New York, NY 10022, USA;
| | - Manish Sapra
- Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Glen Oaks, NY 11004, USA; (P.D.); (M.S.)
- Behavioral Health Service Line, Northwell Health, New York, NY 10022, USA;
| | - Lily Thomas
- Institute for Nursing, Northwell Health, New Hyde Park, NY 11042, USA;
| | - Annmarie Wacha-Montes
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY 11021, USA; (M.H.B.); (P.S.); (D.B.); (A.G.); (A.W.-M.); (G.Z.); (R.M.S.)
- Behavioral Health Service Line, Northwell Health, New York, NY 10022, USA;
| | - George Zenzerovich
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY 11021, USA; (M.H.B.); (P.S.); (D.B.); (A.G.); (A.W.-M.); (G.Z.); (R.M.S.)
- Behavioral Health Service Line, Northwell Health, New York, NY 10022, USA;
| | - Patricia Watson
- National Center for PTSD, White River Junction, VT 05009, USA;
| | | | - Rebecca M. Schwartz
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY 11021, USA; (M.H.B.); (P.S.); (D.B.); (A.G.); (A.W.-M.); (G.Z.); (R.M.S.)
- Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Glen Oaks, NY 11004, USA; (P.D.); (M.S.)
- Department of Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY 11021, USA
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Schwartz RM, Shaam P, Williams MS, McCann-Pineo M, Ryniker L, Debnath S, Zanos TP. Understanding Mental Health Needs and Gathering Feedback on Transcutaneous Auricular Vagus Nerve Stimulation as a Potential PTSD Treatment among 9/11 Responders Living with PTSD Symptoms 20 Years Later: A Qualitative Approach. Int J Environ Res Public Health 2022; 19:ijerph19084847. [PMID: 35457714 PMCID: PMC9029393 DOI: 10.3390/ijerph19084847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/05/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023]
Abstract
Posttraumatic stress disorder (PTSD) remains one of the most prevalent diagnoses of World Trade Center (WTC) 9/11 responders. Transcutaneous auricular vagus nerve stimulation (taVNS) is a potential treatment for PTSD, as it can downregulate activity in the brain, which is known to be related to stress responses and hyperarousal. To understand barriers and facilitators to engagement in mental health care and the feasibility and acceptability of using the taVNS device as a treatment for PTSD symptoms, a focus group was conducted among patients from the Queens WTC Health Program who had elevated symptoms of PTSD. The focus group discussion was recorded, transcribed, and analyzed. Three themes and subthemes emerged: (1) the continued prevalence of mental health difficulties and systematic challenges to accessing care; (2) positive reception toward the taVNS device as a potential treatment option, including a discussion of how to increase usability; and (3) feedback on increasing the feasibility and acceptance of the research methodology associated with testing the device in a pilot clinical trial. The findings highlight the need for additional treatment options to reduce PTSD symptoms in this population and provide key formative phase input for the pilot clinical trial of taVNS.
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Affiliation(s)
- Rebecca M. Schwartz
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, 175 Community Drive, Great Neck, NY 11021, USA; (R.M.S.); (M.M.-P.); (L.R.)
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY 11030, USA; (M.S.W.); (T.P.Z.)
- Center for Traumatic Stress, Resilience and Recovery, Northwell Health, 175 Community Drive, Great Neck, NY 11021, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, 500 Hofstra University, Hempstead, NY 11549, USA
| | - Pooja Shaam
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, 175 Community Drive, Great Neck, NY 11021, USA; (R.M.S.); (M.M.-P.); (L.R.)
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY 11030, USA; (M.S.W.); (T.P.Z.)
- Center for Traumatic Stress, Resilience and Recovery, Northwell Health, 175 Community Drive, Great Neck, NY 11021, USA
- Correspondence:
| | - Myia S. Williams
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY 11030, USA; (M.S.W.); (T.P.Z.)
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, 500 Hofstra University, Hempstead, NY 11549, USA
- Department of Medicine, Northwell Health, 600 Community Drive, Manhasset, NY 11030, USA
| | - Molly McCann-Pineo
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, 175 Community Drive, Great Neck, NY 11021, USA; (R.M.S.); (M.M.-P.); (L.R.)
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY 11030, USA; (M.S.W.); (T.P.Z.)
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, 500 Hofstra University, Hempstead, NY 11549, USA
| | - Laura Ryniker
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, 175 Community Drive, Great Neck, NY 11021, USA; (R.M.S.); (M.M.-P.); (L.R.)
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY 11030, USA; (M.S.W.); (T.P.Z.)
- Center for Traumatic Stress, Resilience and Recovery, Northwell Health, 175 Community Drive, Great Neck, NY 11021, USA
| | - Shubham Debnath
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY 11030, USA;
| | - Theodoros P. Zanos
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY 11030, USA; (M.S.W.); (T.P.Z.)
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, 500 Hofstra University, Hempstead, NY 11549, USA
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY 11030, USA;
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Williams MS, Ryniker L, Schwartz RM, Shaam P, Finuf KD, Corley SS, Parashar N, Young JQ, Bellehsen MH, Jan S. Physician challenges and supports during the first wave of the COVID-19 pandemic: A mixed methods study. Front Psychiatry 2022; 13:1055495. [PMID: 36569611 PMCID: PMC9780028 DOI: 10.3389/fpsyt.2022.1055495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, physicians encountered significant COVID-19-related negative experiences and psychological distress in both their personal and professional lives. To understand the factors that negatively impact physician well-being, a number of studies have pointed to multiple work system factors such as excessive workload and workflow interruptions. In addition, studies have shown that positive interpersonal relationships that provide social support may also serve as a buffering role against psychological distress. The aim of our study explores the challenges and sources of support for physicians relative to mental health symptoms. METHODS In this study, We used a cross-sectional study design with a convergent parallel mixed method approach combining both qualitative and quantitative data collected in parallel from a self-report questionnaire immediately following the first wave of COVID-19. The aim of our study explores the challenges and sources of support for physicians relative to mental health symptoms. RESULTS Of the 457 physicians in the study, the most frequently potential negative occupational experiences were, "Being at risk of contracting COVID-19 from patients/co-workers" (90.5%) and "Contact with distressed family members who cannot be with a loved one" (69.5%). We identified five common themes for main sources of social support (e.g. emotional support from family/friends) and six themes for challenges (e.g., work-related demands exacerbated by the pandemic). DISCUSSION Our study highlights COVID-19 and other pandemic-related challenges that negatively impacted the mental health of physicians. Interventions that provide targeted organizational supports (e.g. sufficient PPE and child support), as well as specific sources of support (e.g. family and emotional), can attenuate those challenges and stressors experienced during a pandemic.
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Affiliation(s)
- Myia S Williams
- Department of Medicine, Northwell Health, Manhasset, NY, United States.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, United States.,Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States
| | - Laura Ryniker
- Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States.,Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States.,Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, United States
| | - Rebecca M Schwartz
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, United States.,Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States.,Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States.,Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, United States
| | - Pooja Shaam
- Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States.,Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States.,Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, United States
| | - Kayla D Finuf
- Department of Medicine, Northwell Health, Manhasset, NY, United States.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, United States
| | - Samantha S Corley
- Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States.,Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States.,Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, United States
| | - Nidhi Parashar
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, United States.,Division of General Pediatrics, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, United States
| | - John Q Young
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, United States.,Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Glen Oaks, NY, United States
| | - Mayer H Bellehsen
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, United States.,Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Glen Oaks, NY, United States
| | - Sophia Jan
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, United States.,Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States.,Department of Psychiatry and Resident Mental Health Program, Lenox Hill Hospital, New York, NY, United States
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Corley SS, Gillezeau C, Molina L, Alpert N, Eugene A, Lieberman-Cribbin W, Rapp J, Ryniker L, Shaam P, Tuminello S, Gonzalez A, Taioli E, Schwartz RM. Using Rapid Research Implementation and Collaborations to Assess the Mental Health Impact of the COVID-19 Pandemic Among Community and Clinical Cohorts. Disaster Med Public Health Prep 2021; 16:1-5. [PMID: 33875039 PMCID: PMC8193192 DOI: 10.1017/dmp.2021.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/07/2022]
Abstract
A research initiative was launched during the initial coronavirus disease (COVID-19) outbreak by 3 New York metropolitan area institutions. Collaborators recruited community members and patients from previous research studies to examine COVID-19 experiences and mental health symptoms through self-report surveys. The current report descriptively presents findings from the initial survey characterized by both community and clinical cohorts, and discusses challenges encountered with rapid implementation. The clinical cohort exhibited higher rates of symptoms of mental health difficulties (depression, anxiety, and posttraumatic stress disorder [PTSD]) as compared to the community cohort. COVID-19 positivity rates were similar among both groups and lower than the national average. While both groups reported low rates of job loss, community members reported higher rates of financial difficulty resulting from the pandemic. Findings indicate the need for further collaborative research on the mental health impact of COVID-19.
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Affiliation(s)
- Samantha S. Corley
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY, USA
- The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Center for Traumatic Stress Resilience and Recovery, Northwell Health, New Hyde Park, NY, USA
| | - Christina Gillezeau
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lucero Molina
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Naomi Alpert
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adriana Eugene
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Wil Lieberman-Cribbin
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph Rapp
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laura Ryniker
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY, USA
- The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Center for Traumatic Stress Resilience and Recovery, Northwell Health, New Hyde Park, NY, USA
| | - Pooja Shaam
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY, USA
- The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Center for Traumatic Stress Resilience and Recovery, Northwell Health, New Hyde Park, NY, USA
| | - Stephanie Tuminello
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adam Gonzalez
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Emanuela Taioli
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rebecca M. Schwartz
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY, USA
- The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Joint Center for Disaster Health, Trauma and Resilience at Mount Sinai, Stony Brook University, Northwell Health, Stony Brook, NY, USA
- Center for Traumatic Stress Resilience and Recovery, Northwell Health, New Hyde Park, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
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