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Lima-Setta F, de Moraes CL, Silami PHNC, Reichenheim ME, de Mello E Silva JF, Stochero L, de Oliveira MBG, Robaina JR, Rodrigues-Santos G, de Almeida CG, Amoretti CF, Bellinat APN, Brandão IB, de Carvalho PB, Falcão RV, Gregory SC, de Lorena Jacques M, Sapolnik R, Jae CML, Koliski A, Krauzer JRM, de Lima LFP, Lorenzo VB, Cobas Macedo JHG, Zaponi Melek SL, Fonseca da Mota IC, Neves CC, Castro MA, Rascão FL, Massaud-Ribeiro L, Riveiro PM, Rodrigues KA, Scarlato ACCP, Peres da Silva T, Souza ACMCFF, de Araújo Torreão L, de Seixas Zeitel R, Alves da Cunha AJL, Prata-Barbosa A, de Magalhães-Barbosa MC. Mental Health and Emotional Disorders During the COVID-19 Pandemics: Prevalence and Extent in PICU Staff. Pediatr Crit Care Med 2023; 24:277-288. [PMID: 36534761 PMCID: PMC10072053 DOI: 10.1097/pcc.0000000000003119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess the prevalence of burnout, anxiety and depression symptoms, and posttraumatic stress disorder (PTSD) in PICU workers in Brazil during the first peak of the COVID-19 pandemic. To compare the results of subgroups stratified by age, gender, professional category, health system, and previous mental health disorders. DESIGN Multicenter, cross-sectional study using an electronic survey. SETTING Twenty-nine public and private Brazilian PICUs. SUBJECTS Multidisciplinary PICU workers. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Self-reported questionnaires were used to measure burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), and PTSD (Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PCL-5]) in 1,084 respondents. Subjects were mainly young (37.1 ± 8.4 yr old) and females (85%), with a median workload of 50 hours per week. The prevalence of anxiety and depression was 33% and 19%, respectively, whereas PTSD was 13%. The overall median burnout scores were high in the emotional exhaustion and personal accomplishment dimensions (16 [interquartile range (IQR), 8-24] and 40 [IQR, 33-44], respectively) whereas low in the depersonalization one (2 [IQR, 0-5]), suggesting a profile of overextended professionals, with a burnout prevalence of 24%. Professionals reporting prior mental health disorders had higher prevalence of burnout (30% vs 22%; p = 0.02), anxiety (51% vs 29%; p < 0.001), and depression symptoms (32.5% vs 15%; p < 0.001), with superior PCL-5 scores for PTSD ( p < 0.001). Public hospital workers presented more burnout (29% vs 18.6%, p < 0.001) and more PTSD levels (14.8% vs 10%, p = 0.03). Younger professionals were also more burned out ( p < 0.05 in all three dimensions). CONCLUSIONS The prevalence of mental health disorders in Brazilian PICU workers during the first 2020 peak of COVID-19 was as high as those described in adult ICU workers. Some subgroups, particularly those reporting previous mental disorders and younger professionals, should receive special attention to prevent future crises.
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Affiliation(s)
- Fernanda Lima-Setta
- Department of Pediatrics, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
- Pediatric Intensive Care Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Claudia Leite de Moraes
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Family Health, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil
| | - Pedro Henrique Nunes Costa Silami
- Pediatric Intensive Care Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
- Pediatric Intensive Care Unit, Hospital Estadual da Criança, Rio de Janeiro, RJ, Brazil
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Luciane Stochero
- Sergio Arouca National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | | | | | | | | | | | | | | | - Ricardo Viana Falcão
- Pediatric Intensive Care Unit, Hospital Geral Dr. Waldemar Alcântara, Fortaleza, CE, Brazil
| | - Simone Camera Gregory
- Pediatric Intensive Care Unit, Hospital Estadual da Criança, Rio de Janeiro, RJ, Brazil
| | | | - Roberto Sapolnik
- Pediatric Intensive Care Unit, Hospital São Rafael, Salvador, BA, Brazil
| | - Claudia Mei Lan Jae
- Pediatric Intensive Care Unit, Hospital Santo Antonio/Obras Sociais Irmã Dulce, Salvador, BA, Brazil
| | - Adriana Koliski
- Pediatric Intensive Care Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | | | | | | | | | | | - Cinara Carneiro Neves
- Pediatric Intensive Care Unit, Hospital Infantil Albert Sabin, Fortaleza, CE, Brazil
| | - Mirela Alves Castro
- Pediatric Intensive Care Unit, Hospital Alvorada Moema, São Paulo, SP, Brazil
| | - Fernanda Lobo Rascão
- Pediatric Intensive Care Unit, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil
| | - Letícia Massaud-Ribeiro
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Paula Marins Riveiro
- Pediatric Intensive Care Unit, Hospital Caxias D'Or, Duque de Caxias, RJ, Brazil
| | | | | | | | | | | | - Raquel de Seixas Zeitel
- Pediatric Intensive Care Unit, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Antonio José Ledo Alves da Cunha
- Department of Pediatrics, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
- Department of Pediatrics, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Arnaldo Prata-Barbosa
- Department of Pediatrics, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
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Toro MS, Martínez JLV, Falcão RV, Prata-Barbosa A, Cunha AJLAD. Point-of-care ultrasound by the pediatrician in the diagnosis and follow-up of community-acquired pneumonia. J Pediatr (Rio J) 2021; 97:13-21. [PMID: 32781037 PMCID: PMC9432299 DOI: 10.1016/j.jped.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/05/2019] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To review, analyze, and present the available evidence on the usefulness of point-of-care pulmonary ultrasound in the diagnosis and monitoring of community-acquired pneumonia (CAP), aiming to facilitate its potential inclusion into pediatric clinical reference guidelines. SOURCE OF DATA A non-systematic research was carried out in the MEDLINE (PubMed), LILACS, and SciELO databases, from January 1985 to September 2019. The articles that were considered the most relevant were selected. SYNTHESIS OF DATA CAP is a relevant cause of morbidity and mortality in pediatrics and its clinical management remains a major challenge. The systematic use of chest X-ray for its diagnosis is controversial because it exposes the child to ionizing radiation and there are interobserver differences in its interpretation. Recently, the use of point-of-care pulmonary ultrasound by the pediatrician has been presented as an alternative for the diagnosis and monitoring of CAP. A great deal of evidence has disclosed its high sensitivity and diagnostic specificity, with the advantages of no ionizing radiation, relatively low cost, immediate results, portability, and the possibility of repetition according to the requirements of disease evolution. Moreover, its use can help rule out possible bacterial etiology and thus prevent inappropriate antibiotic treatments that favor bacterial resistance. CONCLUSIONS Point-of-care ultrasonography represents an opportunity to improve the diagnosis and monitoring of CAP. However, as an operator-dependent technique, training is required for adequate image acquisition, correct interpretation, and integration with clinical data for correct decision-making.
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Affiliation(s)
| | | | - Ricardo Viana Falcão
- Pediatric ICU, Hospital Geral Dr. Waldemar Alcântara (HGWA), Fortaleza, CE, Brazil
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