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Bloemendaal AFT, Kamperman AM, Bonebakker AE, Kool N, Olff M, Mulder CL. Workplace trauma and professional quality of Life in clinical and forensic psychiatry: the CRITIC study. Front Psychiatry 2024; 15:1228335. [PMID: 38495910 PMCID: PMC10940400 DOI: 10.3389/fpsyt.2024.1228335] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/12/2024] [Indexed: 03/19/2024] Open
Abstract
Background Frontline staff in psychiatry need to perform at a very high professional level in order to ensure patient and community safety. At the same time they are exposed to high levels of stress and workplace trauma. This may have severe consequences for their professional quality of life. In addition, health care workers in general have higher incidence levels of childhood adversity than the general population. The CRITIC (CRITical Incidents and aggression in Caregivers) Study aims to improve increased understanding of the interaction between personal life history (childhood adversity and benevolence), individual capabilities, exposure to trauma and violence at work and Professional Quality of Life (ProQOL). Method The Critic Study is a cross-sectional survey of these aspects in frontline, treatment and administrative staff in clinical and forensic psychiatry. We aim to include 360 participants. Participants will be asked to complete questionnaires on childhood adversity and childhood benevolence (assessing personal life history), professional quality of life, current trauma and violence exposure, current mental health (depression, anxiety and stress), coping, social support, work engagement and resilience. In this study we will examine the moderating role of adverse and benevolent childhood experiences in the association between workplace trauma exposure and professional quality of life. Finally, a theoretical model on the relationships between trauma, stress and coping in the context of professional functioning will be tested using structural equation modelling. Discussion The CRITIC study examines which factors influence the complex relationship between childhood adversity and benevolence, and ProQOL in healthcare workers. It also aims to provide insight into the complex relationship between personal life history, individual characteristics, exposure to trauma and violence at work and ProQOL. The results can be used for designing interventions to increase resilience to trauma and to improve professional quality of life among health care professionals. Trial registration The CRITIC study has been approved by the Medical Ethical Committee of the Erasmus Medical Centre, under trial registration number NL73417.078.20.
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Affiliation(s)
- Anthony F. T. Bloemendaal
- Department of Psychiatry, Erasmus Medical Centre, Rotterdam, Netherlands
- Dual Disorder Treatment Centre, Fivoor, The Hague, Netherlands
| | | | | | - N. Kool
- Dual Disorder Treatment Centre, Fivoor, The Hague, Netherlands
| | - M. Olff
- Amsterdam University Medical Centre (UMC), Department of Psychiatry, University of Amsterdam, Amsterdam Neuroscience and Amsterdam Public Health & ARQ National Psychotrauma Centre, Diemen, Netherlands
| | - C. L. Mulder
- Department of Psychiatry, Erasmus Medical Centre, Rotterdam, Netherlands
- Dual Disorder Treatment Centre, Fivoor, The Hague, Netherlands
- Antes Psychiatric Care, Parnassia Group, Rotterdam, Netherlands
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Sivertsen DM, Andersen KV, Becker U, Lisby M, Andersen O, Brünes N, Kirk JW. Acceptability Among Frontline Staff Toward Distributing an Anonymous Alcohol Survey in Emergency Departments: A Mixed Methods Study. J Addict Nurs 2023; 34:E53-E64. [PMID: 37669345 PMCID: PMC10510809 DOI: 10.1097/jan.0000000000000538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
ABSTRACT Emergency departments (EDs) serve as the front line when patients encounter the hospital system. Limited data are available of patients' alcohol habits collected during Danish ED visits, and no studies have, to our knowledge, examined frontline staffs' (registered nurses and medical secretaries) acceptability to deliver anonymous alcohol surveys to patients. We aimed at examining the proportion of survey respondents and the prevalence of patients' alcohol habits and also exploring frontline staff acceptability of the distribution of an anonymous survey regarding patients' alcohol habits in EDs. Intendedly, all eligible patients ≥18 years old entering two EDs in March 2019 should receive a survey based on the Alcohol Use Disorder Identification Test. The study was an explanatory, sequential, mixed methods design, and results were analyzed with descriptive statistics and a deductive content analysis based on the theoretical framework of acceptability. In total, 15% (n = 1,305) of the total 8,679 patients in the EDs returned the survey. Qualitative analysis of interviews (n = 31) with staff showed that they had been reluctant to distribute the survey primarily because of ethical concerns of anonymity, freedom of choice, and being nonjudgmental toward patients. Hence, patients with no obvious alcohol problems were more likely to receive the survey. Still, we found that 23% of the respondents had an Alcohol Use Disorder Identification Test score ≥ 8. Results indicate that frontline staffs' recognition of patients' alcohol use is inadequate, and findings show a low degree of acceptability among staff to deliver an anonymous survey, which is in line with earlier described barriers toward screening activities in EDs.
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Mavragani A, Duan Y, Slubik S, Estabrooks CA. Impact of the COVID-19 Pandemic on Health, Well-being, and Quality of Work-Life Outcomes Among Direct Care Nursing Staff Working in Nursing Home Settings: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e40390. [PMID: 36853752 PMCID: PMC9976775 DOI: 10.2196/40390] [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] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Increased workload, lack of resources, fear of infection, and the suffering and loss of residents have placed a significant emotional burden on regulated and unregulated direct care nursing staff (eg, registered nurses, licensed practical nurses, and care aides) in nursing homes (residential long-term care homes). Psychological distress and burnout related to COVID-19 have been cited among direct care staff within nursing homes. Studies have also emphasized the resilience of direct care staff, who, despite the significant challenges created by the pandemic, remained committed to providing quality care. To date, only one nursing home-specific review has synthesized evidence from 15 studies conducted early in the pandemic, which reported anxiety, posttraumatic stress disorder, and depression among direct care staff. OBJECTIVE The objectives of this systematic review are to (1) synthesize all empirical evidence on the impact of the COVID-19 pandemic on direct care staffs' mental health, physical health, and work-life outcomes; (2) identify specific risks and protective factors; and (3) examine the effect of strategies or interventions that have been developed to improve these outcomes. METHODS We will include all study designs reporting objective or subjective measurements of direct care staffs' mental health, physical health, and quality of work-life in nursing home settings during the COVID-19 pandemic (January 2020 onward). We will search multiple databases (MEDLINE, CINAHL, Embase, Scopus, and PsycINFO) and gray literature sources with no language restrictions. Two authors will independently screen, assess data quality, and extract data for synthesis. Given the heterogeneity in research designs, we will use multiple data synthesis methods that are suitable for quantitative and qualitative studies. RESULTS As of December 2022, full text screening has been completed and data extraction is underway. The expected completion date is June 30, 2023. CONCLUSIONS This systematic review will uncover gaps in current knowledge, increase our understanding of the disparate findings to date, identify risks and factors that protect against the sustained effects of the pandemic, and elucidate the feasibility and effects of interventions to support the mental health, physical health, and quality of work-life of frontline nursing staff. This study will inform future research exploring how the health care system can be more proactive in improving quality of work-life and supporting the health and psychological needs of frontline staff amid extreme stressors such as the pandemic and within the wider context of prepandemic conditions. TRIAL REGISTRATION PROSPERO CRD42021248420; https://tinyurl.com/4djk7rpm. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40390.
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Affiliation(s)
| | - Yinfei Duan
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sydney Slubik
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Comtois KA, Mata-Greve F, Johnson M, Pullmann MD, Mosser B, Arean P. Effectiveness of Mental Health Apps for Distress During COVID-19 in US Unemployed and Essential Workers: Remote Pragmatic Randomized Clinical Trial. JMIR Mhealth Uhealth 2022; 10:e41689. [PMID: 36191176 PMCID: PMC9642829 DOI: 10.2196/41689] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/15/2022] [Accepted: 09/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the general public was concerned about the mental health impacts of unemployment due to COVID-19 and the stress essential workers experienced during this time. Several reports indicated that people in distress were turning to digital technology, but there was little evidence about the impact of these tools on mitigating distress. OBJECTIVE This study seeks to determine the acceptability, feasibility, usability, and effectiveness of mobile mental health apps for decreasing mental health symptoms in essential workers and unemployed individuals with suicide risk. METHODS We recruited participants who indicated that they were unemployed because of COVID-19 or were COVID-19-designated essential workers. Participants were randomized to 1 of 4 free commercial mobile apps for managing distress that were (1) highly rated by PsyberGuide and (2) met the criteria for intervention features these participants indicated were desirable in a previous survey. Participants used the apps for 4 weeks and completed baseline and 4-week self-assessments of depression, anxiety emotional regulation, and suicide risk. RESULTS We found no differences between the apps in any outcome but did find significant changes in depression and anxiety over time (Patient Health Questionnaire [PHQ]-9: estimate=-1.5, SE 0.2, 95% CI -1.1 to -1.8, P<.001; Generalized Anxiety Disorder Scale [GAD]-7: estimate=-1.3, SE 0.2, 95% CI -1.0 to -1.6, P<.001). We found no significant changes in suicidal behavior (Suicide Behaviors Questionnaire-Revised [SBQ-R]) or emotional regulation (Difficulties in Emotion Regulation Scale - Short Form [DERS-SF]) for the 4 weeks. We did find a significant dose-response pattern for changes in depression and anxiety. Using the app at least once a week resulted in greater improvements in treatment conditions over time on depression (estimate=-0.6, SE 0.2, 95% CI 1.0-0.2, P=.003) and anxiety (estimate=0.1, SE 0.2, 95% CI 0.4-0.6, P=.78). There was no association between app frequency and changes in suicidal behavior (SBQ-R) or emotional regulation (DERS-SF). We further found a significant difference between the conditions with regard to app usability, with the control app being the most usable (meanBeautiful Mood 72.9, SD 16.7; meanCOVID Coach 71.2, SD 15.4; meanCalm 66.8, SD 17.3; mean7 Cups 65.2, SD 17.7). We found no significant differences for app acceptability or appropriateness. CONCLUSIONS Few studies have evaluated prospectively the utility and usability of commercial apps for mood. This study found that free, self-guided commercial mobile mental health apps are seen as usable, but no one app is superior to the other. Although we found that regular use is indicated for effects on depression and anxiety to occur in those who are more symptomatic, regression to the mean cannot be ruled out. TRIAL REGISTRATION ClinicalTrials.gov NCT04536935; https://tinyurl.com/mr36zx3s.
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Affiliation(s)
- Katherine Anne Comtois
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Felicia Mata-Greve
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Morgan Johnson
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Michael D Pullmann
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Brittany Mosser
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
- Conducting Research to Enhance Assessment and Treatment Through Innovation in Mental Health Lab, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Patricia Arean
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
- Conducting Research to Enhance Assessment and Treatment Through Innovation in Mental Health Lab, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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Schlief M, Saunders KRK, Appleton R, Barnett P, Vera San Juan N, Foye U, Olive RR, Machin K, Shah P, Chipp B, Lyons N, Tamworth C, Persaud K, Badhan M, Black CA, Sin J, Riches S, Graham T, Greening J, Pirani F, Griffiths R, Jeynes T, McCabe R, Lloyd-Evans B, Simpson A, Needle JJ, Trevillion K, Johnson S. Synthesis of the Evidence on What Works for Whom in Telemental Health: Rapid Realist Review. Interact J Med Res 2022; 11:e38239. [PMID: 35767691 PMCID: PMC9524537 DOI: 10.2196/38239] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/20/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Telemental health (delivering mental health care via video calls, telephone calls, or SMS text messages) is becoming increasingly widespread. Telemental health appears to be useful and effective in providing care to some service users in some settings, especially during an emergency restricting face-to-face contact, such as the COVID-19 pandemic. However, important limitations have been reported, and telemental health implementation risks the reinforcement of pre-existing inequalities in service provision. If it is to be widely incorporated into routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach and when face-to-face care is needed. OBJECTIVE This rapid realist review aims to develop a theory about which telemental health approaches work (or do not work), for whom, in which contexts, and through what mechanisms. METHODS Rapid realist reviewing involves synthesizing relevant evidence and stakeholder expertise to allow timely development of context-mechanism-outcome (CMO) configurations in areas where evidence is urgently needed to inform policy and practice. The CMO configurations encapsulate theories about what works for whom and by what mechanisms. Sources included eligible papers from 2 previous systematic reviews conducted by our team on telemental health; an updated search using the strategy from these reviews; a call for relevant evidence, including "gray literature," to the public and key experts; and website searches of relevant voluntary and statutory organizations. CMO configurations formulated from these sources were iteratively refined, including through discussions with an expert reference group, including researchers with relevant lived experience and frontline clinicians, and consultation with experts focused on three priority groups: children and young people, users of inpatient and crisis care services, and digitally excluded groups. RESULTS A total of 108 scientific and gray literature sources were included. From our initial CMO configurations, we derived 30 overarching CMO configurations within four domains: connecting effectively; flexibility and personalization; safety, privacy, and confidentiality; and therapeutic quality and relationship. Reports and stakeholder input emphasized the importance of personal choice, privacy and safety, and therapeutic relationships in telemental health care. The review also identified particular service users likely to be disadvantaged by telemental health implementation and a need to ensure that face-to-face care of equivalent timeliness remains available. Mechanisms underlying the successful and unsuccessful application of telemental health are discussed. CONCLUSIONS Service user choice, privacy and safety, the ability to connect effectively, and fostering strong therapeutic relationships need to be prioritized in delivering telemental health care. Guidelines and strategies coproduced with service users and frontline staff are needed to optimize telemental health implementation in real-world settings. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO); CRD42021260910; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021260910.
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Affiliation(s)
- Merle Schlief
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Katherine R K Saunders
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rebecca Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Phoebe Barnett
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Norha Vera San Juan
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Una Foye
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rachel Rowan Olive
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Karen Machin
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Prisha Shah
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Beverley Chipp
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Natasha Lyons
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Camilla Tamworth
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Karen Persaud
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Monika Badhan
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Carrie-Ann Black
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jacqueline Sin
- Centre for Mental Health Research, City, University of London, London, United Kingdom
| | - Simon Riches
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Tom Graham
- Centre for Anxiety Disorders & Trauma, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jeremy Greening
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Farida Pirani
- Psychological Medicine & Older Adult Directorate, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Raza Griffiths
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Tamar Jeynes
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Rose McCabe
- Centre for Mental Health Research, City, University of London, London, United Kingdom
| | - Brynmor Lloyd-Evans
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Alan Simpson
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Justin J Needle
- Centre for Health Services Research, City, University of London, London, United Kingdom
| | - Kylee Trevillion
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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Chang Q, Su H, Xia Y, Gao S, Zhang M, Ma X, Liu Y, Zhao Y. Association Between Clinical Competencies and Mental Health Symptoms Among Frontline Medical Staff During the COVID-19 Outbreak: A Cross-Sectional Study. Front Psychiatry 2022; 13:760521. [PMID: 35558425 PMCID: PMC9086962 DOI: 10.3389/fpsyt.2022.760521] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background In China, mental health of frontline medical staff might be influenced by clinicians' ability to handle the outbreak of coronavirus disease 2019 (COVID-19). Few studies to-date have addressed the association between clinicians' competencies and mental health in this context. This cross-sectional study was to examine the prevalence of mental health symptoms among frontline medical staff that fought against the COVID-19 outbreak, and explore the associations between their competencies, and separate and concurrent depressive and anxiety symptoms. Methods A total of 623 frontline medical staff was included in this study. Competencies, depressive symptoms, and anxiety symptoms were assessed using a self-reported short form of the Chinese clinical physicians' competency model, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaire, respectively. Logistic regression models were used to evaluate the associations between one SD increase in competency scores and the prevalence of mental health problems. Results The prevalence of depressive, anxiety, and comorbid depressive and anxiety symptoms was 40.93, 31.78, and 26.00%, respectively. Among the medical staff with higher total competency scores, the prevalence of depressive [odds ratios (ORs) = 0.67, 95% confidence intervals (CIs): 0.55-0.81], anxiety (OR = 0.68, 95% CI: 0.56-0.83), and comorbid anxiety and depressive symptoms (OR = 0.69, 95% CI: 0.55-0.83) was lower than among their lower-scoring counterparts. Subgroup analyses stratified by core competency scores revealed similar associations as the main analyses. Conclusion The present findings highlight the association between high core competency scores and lower prevalence of depressive, anxiety, and comorbid anxiety and depressive symptoms.
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Affiliation(s)
- Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Graduate Medical Education, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Han Su
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shanyan Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming Zhang
- Office of Medical Administration and Management, Health Commission of Liaoning Province, Shenyang, China
| | - Xiaoyu Ma
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yashu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
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Teng Z, Su Y, Chen J, Wu R, Tang H, Wu H, Liu X, Ling H, Yuan H, Huang J. Sex Differences in Psychological Status and Fatigue of Frontline Staff After the COVID-19 Outbreak in China: A Cross-Sectional Study. Front Psychol 2021; 12:676307. [PMID: 34566755 PMCID: PMC8455985 DOI: 10.3389/fpsyg.2021.676307] [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: 03/05/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) is spreading globally, and it is significant to pay attention to the mental health of frontline staff in this pandemic. This study is aimed to explore the sex difference among the frontline staff in demographics, characteristics of mental state, and the potential relationship between them. Method: A total of 2,614 Chinese frontline staff were recruited. The Self-Rating Anxiety Scale (SAS) and the Patient Health Questionnaire-9 (PHQ-9) were used for assessing the mental status of frontline staff, and the Fatigue Self-Assessment Scale (FSAS) was used for detecting fatigue. Result: The prevalence rate of anxiety for female frontline staff is higher than that of male (P = 0.003), and the prevalence rate of depression is similar between them (P = 0.091). After comparing the risk factors of unhealthy mental state between different sexes, it is found that family income below 100,000 [depression: odds ratio (OR) 1.37; 95% CI, 1.08-1.73; anxiety: OR 1.99; 95% CI, 1.44-2.75], unsupported of family (depression: OR 10.94; 95% CI, 1.39-85.79; anxiety: OR 11.92; 95% CI, 3.80-37.36), and marriage (depression: OR 1.67; 95% CI, 1.15-2.43) are risk factors for male, and total fatigue (depression: OR 2.96; 95% CI, 1.46-6.02) is risk factor for female. Conclusions: This study found that depression and anxiety are widespread among the frontline staff of COVID-19, and anxiety showed a higher prevalence rate among female frontline staff. From the sex difference in risk factors, the focus of psychological interventions may differ between genders. Men with low family income, unsupported by family or marriage, and women with a high score of total fatigue required particular attention to their psychological status.
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Affiliation(s)
- Ziwei Teng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center for Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuhan Su
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center for Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Renrong Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center for Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Hui Tang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center for Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Haishan Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center for Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuming Liu
- Department of Intensive Care Unit, Hunan Provincial Hospital of Traditional Chinese Medicine, Zhuzhou, China
| | - Heqiao Ling
- Department of Psychiatry, Doumen Qiaoli Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Hui Yuan
- Department of Ultrasound Dltrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jing Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center for Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
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Abstract
There has been a substantial burden of healthcare worker infection during the current coronavirus (COVID-19) pandemic, likely due to a lack of adequate preparedness, suboptimal institutional infection control measures, atypical patient presentation, poor compliance with personal protective equipment (PPE) and exposure to high-risk aerosol generating procedures, such as endotracheal intubation. There is significant concern that developing countries will face heightened levels of staff exposure during the COVID-19 pandemic. To mitigate this exposure risk during procedures, such as endotracheal intubation, various “aerosol boxes” have been designed by frontline healthcare workers. However, in practice these boxes were found to hamper endotracheal intubation and other procedures due to the limited space and manoeuvrability they allow. To further reduce particle dispersion and to improve on the practicality and ergonomic design of the prototype “aerosol box”, the Intubox was developed by staff at the Charlotte Maxeke Johannesburg Academic Hospital after instituting several changes to the prototype design.
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Affiliation(s)
- Feroza Motara
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
| | - Abdullah E Laher
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
| | - Jana Du Plessis
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
| | - Muhammed Moolla
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
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O'Connell J, Shafran R, Pote H. A Randomized Controlled Trial Evaluating the Effectiveness of Face-to-Face and Digital Training in Improving Child Mental Health Literacy Rates in Frontline Pediatric Hospital Staff. Front Psychiatry 2020; 11:570125. [PMID: 33643077 PMCID: PMC7905032 DOI: 10.3389/fpsyt.2020.570125] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
Background: Children with chronic physical health conditions are up to six times more likely to develop a mental health condition than their physically well peers. Frontline pediatric hospital staff are in a good position to identify mental health problems and facilitate appropriate support for patients. To date, no evaluation of mental health literacy training has taken place with this professional group to enable early identification of difficulties. It is also not known whether face-to-face or digital training is more effective or preferable in this setting. To improve the skills of frontline hospital staff, a face-to-face and digital mental health literacy training course was delivered using MindEd content and evaluated in a randomized controlled trial. Method: Two-hundred and three frontline staff across different professions from a tertiary pediatric hospital were randomized to a face-to-face (n = 64), digital (n = 71), or waitlist control group (n = 68). Face-to-face training was two and a half hours and digital training took ~1 h. The effects of training were evaluated pre- and post-training and at two-week follow-up. Questionnaires assessed mental health knowledge, stigma, confidence in recognizing concerns and knowing what to do, actual helping behavior, as well as training delivery preference, completion rate, and satisfaction. Results: Both face-to-face and digital training increased mental health knowledge, confidence in recognizing mental health problems and knowing what to do compared to waitlist controls. Digital training increased actual helping behavior relative to the waitlist controls and stigma decreased across all groups. Staff were satisfied with both delivery methods but preferred face-to-face training. Conclusions: The results provide promising findings that digital content is an effective way of improving mental health literacy in frontline pediatric hospital staff. Providing digital training could be a time-efficient way of upskilling non-mental health professionals to identify mental health needs in a pediatric population and facilitate access to appropriate care.
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Affiliation(s)
- Jennifer O'Connell
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
| | - Roz Shafran
- UCL Institute of Child Health, London, United Kingdom
| | - Helen Pote
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
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Maddox S, Read DMY, Powell NN, Caton TJ, Dalton HE, Perkins DA. Reorientation of the Rural Adversity Mental Health Program: the value of a program logic model. Rural Remote Health 2019; 19:5217. [PMID: 31480849 DOI: 10.22605/rrh5217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
CONTEXT The Rural Adversity Mental Health Program (RAMHP) was founded in 2007 with the specific focus of responding to drought-related mental health needs among farmers in rural and remote New South Wales (NSW), Australia. Successive re-funding enabled the program to evolve strategically and increase its reach. Over a decade, the program's focus has expanded to include all people in rural and remote NSW in need of mental health assistance, and not just in times of adversity such as drought. ISSUE The program's longest re-funding period, 2016-2020, provided the opportunity for a comprehensive review and longer term planning. Several priorities influencing program renewal were evident at this time: the need to improve data collection and evaluation methods, a reassessment of the program's primary focus and the need to align with significant government mental health reforms. A program logic model (PLM) was developed, in collaboration with frontline RAMHP coordinators, to steer reorientation, clarify objectives, activities and outcomes, and improve data collection. A PLM is a graphic depiction of a program, showing the rationale of how inputs and activities lead to outcomes. LESSONS LEARNED Four key lessons were identified. (1) The development of the PLM in collaboration with the RAMHP coordinators (frontline staff) was found to be an important vehicle for ensuring their acceptance and adoption of strategic changes. (2) The collaborative development process also provided the opportunity to decide upon consistent terminology to describe the program, facilitating communication of the value of RAMHP to external stakeholders. (3) The PLM enabled a clear but flexible program structure that aligned with changes in the mental health system to be described. (4) The PLM provided the foundation for the development of an evaluation framework, including a mobile app, to aid data collection to underpin accountability. Investing in the development of a PLM early in program reorientation provided many benefits for RAMHP, including improved role clarity and communication, staff commitment to program changes and a foundation for comprehensive program evaluation that integrates with program planning. The PLM proved a key foundational tool to reorient RAMHP by producing a clear program structure that was agreed upon by all staff.
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Affiliation(s)
- Sarah Maddox
- Centre for Rural and Remote Mental Health, University of Newcastle, Bloomfield Hospital, PO Box 8043, Orange East, NSW 2800, Australia
| | - Donna M Y Read
- Centre for Rural and Remote Mental Health, University of Newcastle, Bloomfield Hospital, PO Box 8043, Orange East, NSW 2800, Australia
| | - Nicholas N Powell
- Centre for Rural and Remote Mental Health, University of Newcastle, Bloomfield Hospital, PO Box 8043, Orange East, NSW 2800, Australia
| | - Tessa J Caton
- Centre for Rural and Remote Mental Health, University of Newcastle, Bloomfield Hospital, PO Box 8043, Orange East, NSW 2800, Australia
| | - Hazel E Dalton
- Centre for Rural and Remote Mental Health, University of Newcastle, Bloomfield Hospital, PO Box 8043, Orange East, NSW 2800, Australia
| | - David A Perkins
- Centre for Rural and Remote Mental Health, University of Newcastle, Bloomfield Hospital, PO Box 8043, Orange East, NSW 2800, Australia
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Kristensen S, Túgvustein N, Zachariassen H, Sabroe S, Bartels P, Mainz J. The virgin land of quality management: a first measure of patient safety climate at the National Hospital of the Faroe Islands. Drug Healthc Patient Saf 2016; 8:49-57. [PMID: 27217800 PMCID: PMC4853140 DOI: 10.2147/dhps.s100575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE The Faroe Islands are formally part of the Kingdom of Denmark, but the islands enjoy extensive autonomy as home ruled. In Denmark, extensive quality management initiatives have been implemented throughout hospitals, this was not the case in the Faroese Islands in 2013. The purpose of this study is to investigate the patient safety culture in the National Hospital of the Faroe Islands prior to implementation of quality management initiatives. METHODS The Danish version of the Safety Attitudes Questionnaire (SAQ-DK) was distributed electronically to 557 staff members from five medical centers of the hospital, and one administrative unit. SAQ-DK has six cultural dimensions. The proportion of respondents with positive attitudes and mean scale scores were described, and comparison between medical specialties, and between clinical leaders and frontline staff was made using analysis of variance and chi-square test, respectively. RESULTS The response rate was 65.8% (N=367). Job satisfaction was rated most favorable, and the perceived culture of the top management least favorable. Safety climate was the dimension with the greatest variability across the 28 units. The diagnostic center had the most favorable culture of all centers. More leaders than frontline staff had positive attitudes toward teamwork and safety climate, and working conditions, respectively. Also, the leaders perceived these dimensions more positive than the frontline staff, P<0.05. Among three management levels, the unit management was perceived most favorable and the top management least favorable. CONCLUSION The management group is recommended to raise awareness of their role in supporting a safe and caring environment for patients and staff, moreover the leaders should ensure that every day work achieves its objectives; keeping the patients safe. Furthermore, following the development in patient safety culture over time is recommended.
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Affiliation(s)
- Solvejg Kristensen
- The Danish Clinical Registries, Aarhus, Denmark; Department of Health Science and Technology, Aalborg University, Denmark
| | | | | | - Svend Sabroe
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Paul Bartels
- The Danish Clinical Registries, Aarhus, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jan Mainz
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Aalborg University Hospital, Psychiatry, Aalborg, Denmark
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