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Levy E, Herzog D, Ryder CH, Grunstein R, Gidron Y. Indirect Exposure to Atrocities and Post-Traumatic Stress Disorder Symptoms among Aid Workers: Hemispheric Lateralization Matters. J Clin Med 2024; 13:2373. [PMID: 38673646 PMCID: PMC11051319 DOI: 10.3390/jcm13082373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/13/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Humanitarian aid workers (HAWs) are indirectly exposed to atrocities relating to people of concern (POC). This may result in a risk of secondary traumatization demonstrated by post-traumatic stress symptoms (PTSSs). Previous studies have demonstrated that hemispheric lateralization (HL) moderates the relationship between threat exposure and post-traumatic stress symptoms (PTSSs). Aims: We hypothesized that indirect exposure to atrocities (IETA) would be positively correlated with PTSSs among HAWs with right and not left HL. Method: Fifty-four HAWs from several countries that provided humanitarian support in Greece and Colombia participated in this correlational and cross-sectional observation study. They completed scales relating to IETA, PTSSs were assessed using a brief, valid scale, and HL was measured. Results: IETA was positively and significantly related to PTSSs (r = 0.39, p < 0.005). Considering HL, IETA was unrelated to PTSSs among people with right HL (r = 0.29, p = 0.14), while IETA was related to PTSSs among people with left HL (r = 0.52, p = 0.008). Right HL emerged as a protective factor in the relationship between IETA and PTSS. Conclusions: An assessment of dominant HL can serve as one consideration among others when deploying HAWs in specific locations and roles, vis à vis IETA. Moreover, those found to have a higher risk for PTSSs based on their HL could be monitored more closely to prevent adverse reactions to IETA.
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Affiliation(s)
- Einav Levy
- Department of Social Work, Tel Hai College, Qiryat Shemona 1220800, Israel;
- Research Center for Innovation in Social Work, Tel Hai College, Qiryat Shemona 1220800, Israel
- The Israeli School of Humanitarian Action, Tel Aviv 4632825, Israel
| | | | - Chen Hanna Ryder
- Brain & Behavior Research Institute, Western Galilee Academic College, Akko 2412101, Israel;
| | - Rachel Grunstein
- Department of Social Work, Tel Hai College, Qiryat Shemona 1220800, Israel;
| | - Yori Gidron
- Department of Nursing, Haifa University, Haifa 3498838, Israel;
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Motlová LB, Vlčková K, Prokešová B, Suchánková E, Štirská L, Janoušková M. "I Didn't Expect to Be So Caught Up in It": a Qualitative Study of Experiences of Medical Students' Volunteering for Ukrainian Refugees. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:659-662. [PMID: 37991684 DOI: 10.1007/s40596-023-01903-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/04/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE Russia's invasion of Ukraine in February 2022 triggered a huge wave of migration, with thousands of refugees arriving at Prague's Central Station. With no medical service available, medical students started to volunteer and were running an infirmary available around the clock. The research aimed to explore medical students' professional experiences, emotionally challenging situations, and coping strategies in this demanding setting. METHODS The authors used a qualitative analysis of semi-structured in-depth interviews with 19 participants recruited through purposive sampling. Interviews took place between April and May 2022. Data were recorded, transcribed, and processed by using thematic qualitative analysis. RESULTS The research identified five emotionally challenging situations: caring for traumatized refugees, refusal of treatment, disruption of everyday life, independent decision-making, and complexity of voluntary work. Students adopted both adaptive and maladaptive coping strategies for dealing with stress and trauma. Almost half the students reported signs of secondary traumatization and moral distress; however, no one asked for psychological help. CONCLUSIONS Medical school curricula should cover trauma-informed approaches, healthy coping strategies, and destigmatization of psychological problems.
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Affiliation(s)
| | - Karolína Vlčková
- Charles University, Prague, Czech Republic
- Center for Palliative Care, Prague, Czech Republic
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Tessitore F, Caffieri A, Parola A, Cozzolino M, Margherita G. The Role of Emotion Regulation as a Potential Mediator between Secondary Traumatic Stress, Burnout, and Compassion Satisfaction in Professionals Working in the Forced Migration Field. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2266. [PMID: 36767632 PMCID: PMC9915968 DOI: 10.3390/ijerph20032266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Professionals working with refugees are vicariously exposed to complex traumatic experiences lived by forced migrants, which can lead to the risk of developing secondary traumatic stress, burnout, and a poor compassion satisfaction. The current study aimed to explore the effects of secondary traumatic stress on burnout and compassion satisfaction in 264 Italian professionals working with refugees and forced migrants. Moreover, it examined the mediating role of emotion regulation between secondary traumatic stress and both burnout and compassion satisfaction. METHODS A structural equation modeling (SEM) was performed to test the hypothesis. RESULTS The results showed that increased levels of secondary traumatic stress were associated with an increase of burnout both directly and indirectly through the mediation of emotion regulation. Emotion regulation also totally mediated the relationship between secondary traumatic stress and compassion satisfaction. CONCLUSIONS The results suggested that prevention or interventions programs targeting emotion regulation might be important to improve the professional quality of life of operators working with refugees and forced migrants.
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Affiliation(s)
- Francesca Tessitore
- Department of Humanities, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano, Italy
| | - Alessia Caffieri
- Department of Humanistic Studies, University of Naples Federico II, 80138 Naples, Italy
| | - Anna Parola
- Department of Humanistic Studies, University of Naples Federico II, 80138 Naples, Italy
| | - Mauro Cozzolino
- Department of Humanities, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano, Italy
| | - Giorgia Margherita
- Department of Humanistic Studies, University of Naples Federico II, 80138 Naples, Italy
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Ebren G, Demircioğlu M, Çırakoğlu OC. A neglected aspect of refugee relief works: Secondary and vicarious traumatic stress. J Trauma Stress 2022; 35:891-900. [PMID: 35201632 DOI: 10.1002/jts.22796] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 05/29/2021] [Accepted: 12/17/2021] [Indexed: 11/08/2022]
Abstract
The literature demonstrates evidence that secondary traumatic stress (STS) and vicarious traumatic stress (VTS) may adversely affect the well-being of refugee relief workers and, thus, the quality of their services. The present review offers an exploration of (a) the theoretical background of STS and VTS, (b) their appearance among refugee relief workers, (c) intervention studies available, (d) common points among intervention studies and guidelines on STS and VTS released by local and international nongovernmental organizations (NGOs), and (e) the potential problems that can be associated with the insufficiency of standardized intervention programs as assessed in effectiveness studies. This review may help mental health professionals in countries that host large numbers of refugees and asylum seekers, such as Turkey, Lebanon, and Jordan, to design more effective intervention programs targeting STS and VTS.
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Affiliation(s)
- Gökhan Ebren
- Stress Management Application and Research Center, Başkent University, Ankara, Turkey
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He Y, Liu Z, Zhang J, Yao J, Xiao H, Wan H. Validity and Reliability of the Secondary Traumatic Stress Scale—Chinese Version. Front Surg 2022; 9:882712. [PMID: 35433816 PMCID: PMC9010506 DOI: 10.3389/fsurg.2022.882712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesTo test the validity and reliability of the Secondary Traumatic Stress Scale—Chinese version in clinical nurses.MethodsAccording to the translation principles of the Brislin Scale, the original scale was translated, back translated and cross-culturally adapted to form the Chinese version of the Secondary Traumatic Stress Scale. Nurses in three general hospitals in Changsha, Hunan province were surveyed by convenient sampling method from July 2020 to September 2021. Exploratory factor analysis, confirmatory factor analysis, content validity and criterion validity was used to evaluate the validity of the scale. Internal consistency Cronbach's α coefficient, split-half reliability and test-retest reliability were used to evaluate the reliability of the scale.ResultsA total of 678 nurses were included in the study. There were 460 people in sample 1 and 218 people in sample 2. Two common factors were extracted by exploratory factor analysis. The cumulative contribution was 65.560%. The two-factor structure model was good (χ2/df = 3.137, CFI = 0.928, IFI = 0.929, GFI = 0.842, TLI = 0.917, RMSEA = 0.099). The I-CVI of the scale was 0.8–1.0. The S-CVI/Ave was 0.94. The Cronbach's alpha coefficient is 0.956. The broken half reliability is 0.920. The retest reliability is 0.910.ConclusionThis study identified two components of the Secondary Traumatic Stress Scale—Chinese version, which has 2 dimensions and 17 items. With good validity and reliability, it is suitable for the assessment of secondary traumatic stress among clinical nurses in the Chinese context.
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Affiliation(s)
- Yi He
- Department of Otolaryngology Head and Neck Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Zhiqun Liu
- Department of Respiratory Therapy, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Juan Zhang
- Department of Biliary Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Jiapei Yao
- Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Huan Xiao
- Department of Otolaryngology Head and Neck Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Huan Wan
- Department of Nursing, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
- *Correspondence: Huan Wan
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Secondary Traumatic Stress, Depression, and Anxiety Symptoms Among Service Providers Working with Syrian Refugees in Istanbul, Turkey. J Immigr Minor Health 2022; 24:1421-1430. [PMID: 35212824 DOI: 10.1007/s10903-022-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 10/19/2022]
Abstract
This paper examines the mental health of service providers working with Syrian refugees. Using the Professional Quality of Life framework, we hypothesize greater stress/less support from the work, person, client environment is associated with symptoms of STS, depression, and anxiety. We surveyed a sample of 104 service providers throughout Istanbul late 2018. Multivariable logistic regression examined associations between work (organizational support, caseload, supervision), person (perceived social support), client environment (trauma disclosure, percent Syrian refugees) on STS, depression, and anxiety. We found rates of moderate-to-severe STS to be 27.88%; depression 40.38%; and anxiety 29.81%. Our hypothesis was partially supported. Lower organizational support was associated with moderate-to-severe STS (aOR 0.91, 95% CI 0.84, 0.99) while lower social support with anxiety (aOR 0.89, 95% CI 0.81, 0.99). Caseload, supervision, trauma disclosure, percent refugees did not show significant associations. Organizations working with Syrian refugees may benefit from enhancing organizational support and promoting social support for staff.
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Geiling A, Knaevelsrud C, Böttche M, Stammel N. Psychological distress, exhaustion, and work-related correlates among interpreters working in refugee care: results of a nationwide online survey in Germany. Eur J Psychotraumatol 2022; 13:2046954. [PMID: 35401951 PMCID: PMC8986238 DOI: 10.1080/20008198.2022.2046954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Due to language barriers, interpreters are crucial for refugee care in the countries of resettlement. However, interpreters are often faced with distressing working conditions, such as precarious work circumstances, lack of supervision, or exposure to their clients' traumatic experiences. Recent studies examining interpreters' mental health focussed primarily on secondary traumatic stress. The present study aimed to gain a better understanding of psychological distress and exhaustion among interpreters in refugee care by examining these factors in the work context as well as their possible work-related correlates. METHOD An online survey was carried out in Germany, which included several standardized questionnaires regarding distress, work- and client-related exhaustion, job satisfaction, and trauma exposure (BSI-18, CBI, JSS, HTQ, PCL-5). Interpreters were recruited primarily through psychosocial treatment centres and interpreter pools in Germany. RESULTS In total, 164 interpreters were included in the analyses. The participants showed increased psychological distress, and around 7% screened positive for posttraumatic stress disorder (PTSD). In an exploratory regression analysis, younger age (β = -.25, p = .004) emerged as correlate of psychological distress, whereas dissatisfaction with payment (β = -.21, p = .04) and a higher amount of traumatic content (β = .22, p = .001) were associated with work-related exhaustion, and dissatisfaction with recognition was associated with client-related exhaustion (β = -.35, p = .001). CONCLUSION The results point to increased stress levels among interpreters for refugees. Moreover, they indicate that interpreters' distress is primarily correlated with work-related circumstances, thus suggesting the need for a greater work-related support structure for interpreters.
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Affiliation(s)
- Angelika Geiling
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.,Research Department, Zentrum Überleben, Berlin, Germany
| | - Christine Knaevelsrud
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Maria Böttche
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.,Research Department, Zentrum Überleben, Berlin, Germany
| | - Nadine Stammel
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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Mavratza T, Adamakidou T, Apostolara P, Fasoi G, Mantzorou M, Mantoudi A, Drakopoulou M, Misouridou E. Professional Quality of Life in Greek Health Professionals Working with Refugees and Migrants. Mater Sociomed 2021; 33:94-99. [PMID: 34483735 PMCID: PMC8385739 DOI: 10.5455/msm.2021.33.94-99] [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: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Expatriation and relocation into a new cultural context constitute a psychological journey marked by exposure to potentially traumatic events, the abandonment of the homeland and the effort of seeking safety and a new beginning at all levels. Objective: The aim of this study was to investigate the Professional Quality of Life in Greek health professionals working with refugees and migrants. Methods: The Professional Quality of Life Scale (ProQOL V) and a demographic and work-related characteristics questionnaire were distributed to 90 health professionals working with migrants and refugees. Results: 25.6% of participants reported high CF risk while 75.7% expressed high to moderate potential for CS. Awareness of the factors associated with CF may help health professionals to prevent or offset the development of this condition. Conclusion: A compassionate organizational culture, clinical supervision and on-going education may protect health professionals working with migrants and refugees from absorbing or internalizing unmanageable emotions which may lead to compassion fatigue and also help them to gain a deeper understanding of their communication and interactions during the emotionally laden moments of trauma care.
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Affiliation(s)
| | | | | | - Georgia Fasoi
- Nursing Department, University of West Attica, Athens, Greece
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