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Aghaei A, Qiao S, Chi Tam C, Yuan G, Li X. Role of self-esteem and personal mastery on the association between social support and resilience among COVID-19 long haulers. Heliyon 2024; 10:e31328. [PMID: 38818142 PMCID: PMC11137413 DOI: 10.1016/j.heliyon.2024.e31328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024] Open
Abstract
Although the COVID-19 mortality rate is declining, the number of individuals dealing with persistent COVID-19 symptoms is increasing worldwide, making long COVID a global public health concern. People with long COVID (long haulers) often deal with physical and mental stressors. Long haulers' psychological resilience could play a key role in coping with these stressors in intercorrelation with psychosocial resources. The current study aims to test a hypothesized relationship between social support and its functions (i.e., instrumental and emotional) and the resilience of long haulers through serial mediation by personal mastery and self-esteem. A cross-sectional and self-administered online survey was conducted among 460 individuals with long COVID recruited from COVID-19 Facebook support groups in the United States. Analyzing data indicated a positive correlation between social support and the resilience of long haulers. Structural equation modeling suggested that self-esteem and personal mastery fully mediated the association between social (instrumental) support and resilience. Personal mastery also mediated the association between self-esteem and resilience in social (instrumental) support models. However, in the emotional support model, the indirect effect was non-significant for the mediation by personal mastery and self-esteem. Findings suggest that social support, mainly instrumental support, may protect long haulers by promoting their resilience through self-esteem and personal mastery. This study emphasizes the importance of including social support services in designing programs for COVID-19 long haulers.
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Affiliation(s)
- Atefeh Aghaei
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center of Healthcare Quality, Columbia, SC, USA
| | - Shan Qiao
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center of Healthcare Quality, Columbia, SC, USA
| | - Cheuk Chi Tam
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center of Healthcare Quality, Columbia, SC, USA
| | - Guangzhe Yuan
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center of Healthcare Quality, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center of Healthcare Quality, Columbia, SC, USA
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Azoulay E, Pochard F, Argaud L, Cariou A, Clere-Jehl R, Guisset O, Labbé V, Tamion F, Bruneel F, Jourdain M, Reuter D, Klouche K, Kouatchet A, Souppart V, Lautrette A, Bohé J, Vieillard Baron A, Dellamonica J, Papazian L, Reignier J, Barbier F, Dumas G, Kentish-Barnes N. Resilience and Mental-Health Symptoms in ICU Healthcare Professionals Facing Repeated COVID-19 Waves. Am J Respir Crit Care Med 2024; 209:573-583. [PMID: 38163380 PMCID: PMC10919111 DOI: 10.1164/rccm.202305-0806oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024] Open
Abstract
Rationale: Psychological resilience (the ability to thrive in adversity) may protect against mental-health symptoms in healthcare professionals during coronavirus disease (COVID-19) waves. Objectives: To identify determinants of resilience in ICU staff members. Methods: In this cross-sectional survey in 21 French ICUs, staff members completed the 10-item Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale, and Impact of Event Scale-Revised (for post-traumatic stress disorder [PTSD]). Factors independently associated with resilience were identified. Measurements and Main Results: The response rate was 73.1% (950 of 1,300). The median 10-item Connor-Davidson Resilience Scale score was 29 (interquartile range, 25-32). Symptoms of anxiety, depression, and PTSD were present in 61%, 39%, and 36% of staff members, respectively. Distress associated with the COVID-19 infodemic was correlated with symptoms of depression and PTSD. More resilient respondents less often had symptoms of anxiety, depression, and PTSD. Greater resilience was independently associated with male sex, having provided intensive care during the early waves, having managed more than 50 patients with COVID-19, and, compared with earlier waves, working longer hours, having greater motivation, and more often involving families in end-of-life decisions. Independent risk factors for lower resilience were having managed more than 10 patients who died of COVID-19, having felt frightened or isolated, and greater distress from the COVID-19 infodemic. Conclusions: This study identifies modifiable determinants of resilience among ICU staff members. Longitudinal studies are needed to determine whether prior resilience decreases the risk of mental ill health during subsequent challenges. Hospital and ICU managers, for whom preserving mental well-being among staff members is a key duty, should pay careful attention to resilience.
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Affiliation(s)
- Elie Azoulay
- Medical Intensive Care Unit, Saint Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Cité University, Paris, France; FAMIREA study group
| | - Frédéric Pochard
- Medical Intensive Care Unit, Saint Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Cité University, Paris, France; FAMIREA study group
| | - Laurent Argaud
- Medical Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Alain Cariou
- Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Cité University, Paris, France
| | | | - Olivier Guisset
- Medical Intensive Care Unit, Saint-André Hospital, Bordeaux, France
| | - Vincent Labbé
- Medical Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Tenon University Hospital, Paris, France
| | - Fabienne Tamion
- Medical Intensive Care Unit, Rouen University Hospital, Rouen, France
| | - Fabrice Bruneel
- Intensive Care Unit, André Mignot Hospital, Le Chesnay, France
| | - Mercé Jourdain
- Intensive Care Unit, Lille University Hospital-Roger Salengro Site, INSERM, Lille, France
| | - Danielle Reuter
- Medical-Surgical Intensive Care Unit, Sud Francilien Hospital, Corbeil, France
| | - Kada Klouche
- Medical Intensive Care Unit, Lapeyronie University Hospital, Montpellier, France
| | - Achille Kouatchet
- Medical Intensive Care Unit, Angers University Hospital, Angers, France
| | - Virginie Souppart
- Medical Intensive Care Unit, Saint Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Cité University, Paris, France; FAMIREA study group
| | | | - Julien Bohé
- Medical Intensive Care Unit, Hôpital Lyon Sud, Lyon, France
| | - Antoine Vieillard Baron
- Intensive Care Unit, Ambroise-Paré University Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France
| | - Jean Dellamonica
- Medical Intensive Care Unit, UR2CA Clinical Research Unit, Côte d'Azur University, Nice, France
- Nice University Hospital, Nice, France
| | - Laurent Papazian
- Respiratory and Infectious Diseases Intensive Care Unit, Marseille-Nord University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Jean Reignier
- Medical Intensive Care Unit, UR 4334 Movement-Interactions-Performance Research Unit, Nantes University Hospital, Nantes, France; and
| | - Francois Barbier
- Medical Intensive Care Unit, La Source Hospital, Orléans Regional Hospital, Orléans, France
| | - Guillaume Dumas
- Medical Intensive Care Unit, Saint Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Cité University, Paris, France; FAMIREA study group
| | - Nancy Kentish-Barnes
- Medical Intensive Care Unit, Saint Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Cité University, Paris, France; FAMIREA study group
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Yildirim D, Şenyuva E, Kaya E. Turkish nurses' psychological resilience and burnout levels during the COVID-19 pandemic: A correlational study. Int J Nurs Pract 2024:e13239. [PMID: 38308441 DOI: 10.1111/ijn.13239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/29/2023] [Accepted: 01/06/2024] [Indexed: 02/04/2024]
Abstract
AIMS To investigate the relationship between the psychological resilience and burnout of nurses caring for COVID-19 patients and to determine the factors that affect their psychological resilience and burnout. BACKGROUND In pandemic diseases such as COVID-19, nurses experience burnout due to long working hours, decreased quality of life and anxiety/fear about their own/families' health. Psychological resilience helps to control burnout in nurses and prevent the development of a global nurse shortage. DESIGN This was a descriptive, correlational study. METHODS The sample of this study included 201 nurses in a Training and Research Hospital. The study used the Brief Resilience Scale and the Burnout Measure Short Version. Data were collected between 4 May and 1 June 2020. Statistical analysis was made with Pearson/Spearman, independent sample t test, one-way analysis of variance (ANOVA) test. RESULTS Nurses reported moderate burnout and psychological resilience, with a negative and highly significant correlation between psychological resilience and burnout levels. CONCLUSIONS In order to increase the quality of patient care/treatment, nurse managers need to reduce nurses' burnout and increase their psychological resilience. Nurses are recommended to adopt a healthy lifestyle, organize training programmes and implement psychological resilience interventions to prevent sleep disorders. Giving nurses the tools to understand what they need to manage within their locus of control will allow them to find a new sense of resilience, preventing potential burnout.
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Affiliation(s)
- Deniz Yildirim
- Graduate Education Institute, Istanbul University Cerrahpaşa, Istanbul, Turkey
| | - Emine Şenyuva
- Florence Nightingale Faculty of Nursing, Nursing Education Department, Istanbul University Cerrahpaşa, Istanbul, Turkey
| | - Ender Kaya
- Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Psychiatry, Istanbul, Turkey
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Laposa JM, Cameron D, Corace K, Quick N, Rowa K, Kogan C, Carter S, Milosevic I, de la Salle S, Stergiopoulos V, Pellizzari J, Haber E, Kurdyak P, McCabe RE. A Rapid Access Brief Psychotherapy Intervention to Respond to Healthcare Workers in Ontario Whose Mental Health was Negatively Impacted During the COVID-19 Pandemic. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:89-99. [PMID: 37448375 PMCID: PMC10345831 DOI: 10.1177/07067437231187462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Although the coronavirus disease 2019 (COVID-19) pandemic has had widespread negative impacts on the mental health of healthcare workers (HCWs), there has been little research on psychological interventions during the pandemic for this population. The current study examines whether a brief coping-focused treatment intervention delivered in a virtual individual format would be associated with positive changes in Canadian HCWs' mental health during the pandemic. METHOD Three hundred and thirty-three HCWs receiving the intervention at 3 large specialty tertiary care hospitals in Ontario, Canada, completed measures of anxiety, depression, perceived stress, work/social impairment, insomnia and fear of COVID-19. After completing treatment, HCWs rated their satisfaction with the treatment. RESULTS The intervention was associated with large effect size improvements in anxiety, depression, perceived stress, insomnia and fear of COVID-19, and moderate effect size improvements in work/social impairment. At treatment session 1, prior mental health diagnosis and treatment were both significantly correlated with depression, anxiety, and work/social impairment scores. Secondary analyses of data from one of the sites revealed that treatment-related changes in anxiety, depression, perceived stress and work/social impairment were independent of age, gender, occupational setting, profession and the presence of a previous mental health diagnosis or treatment, with the exception that nurses improved at a slightly greater rate than other professions in terms of work/social impairment. HCWs were highly satisfied with the treatment. CONCLUSIONS A large number of HCWs experiencing significant distress at baseline self-referred for assistance. Timely and flexible access to a brief virtual coping-focused intervention was associated with improvements in symptoms and impairment, and treatment response was largely unrelated to demographic or professional characteristics. Short-term psychological interventions for HCWs during a pandemic may have a highly positive impact given their association with improvement in various aspects of HCWs' mental health improvement.
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Affiliation(s)
- Judith M. Laposa
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
- Department of Psychiatry, University of Toronto, Canada
| | | | - Kim Corace
- Royal Ottawa Mental Health Centre, Canada
- Department of Psychiatry, University of Ottawa, Canada
| | - Natalie Quick
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
| | - Karen Rowa
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Cary Kogan
- Royal Ottawa Mental Health Centre, Canada
- Department of Psychiatry, University of Ottawa, Canada
| | - Stephanie Carter
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
| | - Irena Milosevic
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | | | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Joseph Pellizzari
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Erika Haber
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Paul Kurdyak
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
- Department of Psychiatry, University of Toronto, Canada
- ICES, Canada
| | - Randi E. McCabe
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
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Ang WHD, Lim ZQG, Lau ST, Dong J, Lau Y. Unpacking the Experiences of Health Care Professionals About the Web-Based Building Resilience At Work Program During the COVID-19 Pandemic: Framework Analysis. JMIR MEDICAL EDUCATION 2024; 10:e49551. [PMID: 38294866 PMCID: PMC10867752 DOI: 10.2196/49551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/21/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in a greater workload in the health care system. Therefore, health care professionals (HCPs) continue to experience high levels of stress, resulting in mental health disorders. From a preventive perspective, building resilience has been associated with reduced stress and mental health disorders and promotes HCPs' intent to stay. Despite the benefits of resilience training, few studies provided an in-depth understanding of the contextual factors, implementation, and mechanisms of impact that influences the sustainability of resilience programs. Therefore, examining target users' experiences of the resilience program is important. This will provide meaningful information to refine and improve future resilience programs. OBJECTIVE This qualitative study aims to explore HCPs' experiences of participating in the web-based Building Resilience At Work (BRAW) program. In particular, this study aims to explore the contextual and implementational factors that would influence participants' interaction and outcome from the program. METHODS A descriptive qualitative approach using individual semistructured Zoom interviews was conducted with participants of the web-based resilience program. A framework analysis was conducted, and it is guided by the process evaluation framework. RESULTS A total of 33 HCPs participated in this qualitative study. Three themes depicting participants' experiences, interactions, and impacts from the BRAW program were elucidated from the framework analysis: learning from web-based tools, interacting with the BRAW program, and promoting participants' workforce readiness. CONCLUSIONS Findings show that a web-based asynchronous and self-paced resilience program is an acceptable and feasible approach for HCPs. The program also led to encouraging findings on participants' resilience, intent to stay, and employability. However, continued refinements in the components of the web-based resilience program should be carried out to ensure the sustainability of this intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT05130879; https://clinicaltrials.gov/ct2/show/NCT05130879.
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Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhi Qi Grace Lim
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jie Dong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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Jing S, Dai Z, Wu Y, Liu X, Ren T, Liu X, Zhang L, Fu J, Chen X, Xiao W, Wang H, Huang Y, Qu Y, Wang W, Gu X, Ma L, Zhang S, Yu Y, Li L, Han Z, Su X, Qiao Y, Wang C. Prevalence and influencing factors of depressive and anxiety symptoms among hospital-based healthcare workers during the surge period of the COVID-19 pandemic in the Chinese mainland: a multicenter cross-sectional study. QJM 2023; 116:911-922. [PMID: 37561096 DOI: 10.1093/qjmed/hcad188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/06/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND From November 2022 to February 2023, the Chinese mainland experienced a surge in COVID-19 infection and hospitalization, and the hospital-based healthcare workers (HCWs) might suffer serious psychological crisis during this period. This study aims to assess the depressive and anxiety symptoms among HCWs during the surge of COVID-19 pandemic and to provide possible reference on protecting mental health of HCWs in future infectious disease outbreaks. METHODS A multicenter cross-sectional study was carried out among hospital-based HCWs in the Chinese mainland from 5 January to 9 February 2023. The PHQ-9 (nine-item Patient Health Questionnaire) and GAD-7 (seven-item Generalized Anxiety Disorder Questionnaire) were used to measure depressive and anxiety symptoms. Ordinal logistic regression analysis was performed to identify influencing factors. RESULTS A total of 6522 hospital-based HCWs in the Chinse mainland were included in this survey. The prevalence of depressive symptoms among the HCWs was 70.75%, and anxiety symptoms was 47.87%. The HCWs who perceived higher risk of COVID-19 infection and those who had higher work intensity were more likely to experience depressive and anxiety symptoms. Additionally, higher levels of mindfulness, resilience and perceived social support were negatively associated with depressive and anxiety symptoms. CONCLUSION This study revealed that a high proportion of HCWs in the Chinese mainland suffered from mental health disturbances during the surge of the COVID-19 pandemic. Resilience, mindfulness and perceived social support are important protective factors of HCWs' mental health. Tailored interventions, such as mindfulness practice, should be implemented to alleviate psychological symptoms of HCWs during the COVID-19 pandemic or other similar events in the future.
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Affiliation(s)
- S Jing
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Z Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - T Ren
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - J Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - W Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - H Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Qu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - W Wang
- School of Nursing, Jining Medical University, Jining, Shandong, China
| | - X Gu
- Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China
| | - L Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - S Zhang
- Henan Cancer Hospital, Affiliate Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Y Yu
- The First Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia Autonomous Region, China
| | - L Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong, China
| | - Z Han
- China Foreign Affairs University, Beijing, China
| | - X Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - C Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Chinese Academy of Engineering, Beijing, China
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Maunder RG, Kiss A, Heeney N, Wallwork E, Hunter JJ, Johnstone J, Wiesenfeld L, Jeffs L, McGeer A, Lee K, Loftus C, Ginty L, Wilkinson K, Merkley J. Randomized trial of personalized psychological feedback from a longitudinal online survey and simultaneous evaluation of randomized stepped wedge availability of in-person peer support for hospital staff during the COVID-19 pandemic. Gen Hosp Psychiatry 2023; 84:31-38. [PMID: 37327633 PMCID: PMC10250283 DOI: 10.1016/j.genhosppsych.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE We tested if automated Personalized Self-Awareness Feedback (PSAF) from an online survey or in-person Peer Resilience Champion support (PRC) reduced emotional exhaustion among hospital workers during the COVID-19 pandemic. METHOD Among a single cohort of participating staff from one hospital organization, each intervention was evaluated against a control condition with repeated measures of emotional exhaustion at quarterly intervals for 18 months. PSAF was tested in a randomized controlled trial compared to a no-feedback condition. PRC was tested in a group-randomized stepped-wedge design, comparing individual-level emotional exhaustion before and after availability of the intervention. Main and interactive effects on emotional exhaustion were tested in a linear mixed model. RESULTS Among 538 staff, there was a small but significant beneficial effect of PSAF over time (p = .01); the difference at individual timepoints was only significant at timepoint three (month six). The effect of PRC over time was non-significant with a trend in the opposite direction to a treatment effect (p = .06). CONCLUSIONS In a longitudinal assessment, automated feedback about psychological characteristics buffered emotional exhaustion significantly at six months, whereas in-person peer support did not. Providing automated feedback is not resource-intensive and merits further investigation as a method of support.
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Affiliation(s)
| | - Alex Kiss
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Canada
| | | | | | | | | | | | - Lianne Jeffs
- Lunenfeld-Tannenbaum Research Institute, Sinai Health, Canada
| | - Allison McGeer
- Microbiology and Lunenfeld-Tannenbaum Research Institute, Sinai Health, Canada
| | - Kyla Lee
- Psychiatry, Sinai Health, Canada
| | | | - Leanne Ginty
- Nursing Education and Academic Affairs, Sinai Health, Canada
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Mickey W. Critical care medicine training in the age of COVID-19. J Osteopath Med 2023; 123:427-434. [PMID: 37307290 DOI: 10.1515/jom-2022-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/15/2023] [Indexed: 06/14/2023]
Abstract
CONTEXT The COVID-19 pandemic caused the largest disruption to graduate medical education in modern history. The danger associated with SARS-CoV-2 necessitated a paradigm shift regarding the fundamental approach to the education of medical residents and fellows. Whereas prior work has examined the effect of the pandemic on residents' experiences during training, the effect of the pandemic on academic performance of critical care medicine (CCM) fellows is not well understood. OBJECTIVES This study examined the relationship between CCM fellow's lived experiences during the COVID-19 pandemic and performance on in-training examinations. METHODS This mixed-methods study consisted of a quantitative retrospective analysis of critical care fellows' in-training examination scores and a qualitative, interview-based phenomenological examination of fellows' experiences during the pandemic while training in a single large academic hospital in the American Midwest. Quantitative: Prepandemic (2019 and 2020) and intrapandemic (2021 and 2022) in-training examination scores were analyzed utilizing an independent samples t test to determine whether a significant change occurred during the pandemic. Qualitative: Individual semi-structured interviews were conducted with CCM fellows exploring their lived experiences during the pandemic and their perception of the effect on their academic performance. Transcribed interviews were analyzed for thematic patterns. These themes were coded and categorized, and subcategories were developed as indicated during the analysis. The identified codes were then analyzed for thematic connections and apparent patterns. Relationships between themes and categories were analyzed. This process was continued until a coherent picture could be assembled from the data to answer the research questions. Analysis was performed from a phenomenological perspective with an emphasis on interpretation of the data from the participants' perspectives. RESULTS Quantitative: Fifty-one in-training examination scores from 2019 to 2022 were obtained for analysis. Scores from 2019 to 2020 were grouped as prepandemic scores, while scores from 2021 to 2022 were grouped as intrapandemic scores. Twenty-four prepandemic and 27 intrapandemic scores were included in the final analysis. A significant difference was found between mean total prepandemic and intrapandemic in-service examination scores (t 49=2.64, p=0.01), with mean intrapandemic scores being 4.5 points lower than prepandemic scores (95 % CI, 1.08-7.92). Qualitative: Interviews were conducted with eight CCM fellows. Thematic analysis of the qualitative interviews revealed three main themes: psychosocial/emotional effects, effects on training, and effects on health. The factors that most effected participants' perceptions of their training were burnout, isolation, increased workload, decreased bedside teaching, decreased formal academic training opportunities, decreased procedural experience, a lack of an external reference point for normal training in CCM, fear of spreading COVID-19, and neglect of personal health during the pandemic. CONCLUSIONS In-training examination scores decreased significantly during the COVID-19 pandemic for CCM fellows in this study. The fellows in this study reported perceived effects of the pandemic on their psychosocial/emotional well-being, medical training, and health.
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Nishimoto D, Kodama S, Shimoshikiryo I, Ibusuki R, Nerome Y, Takezaki T, Nishio I. Association Between Nursing Discussions, Resilience, Workplace Social Support and Burnout: A Quantitative Study in Japan. Yonago Acta Med 2023; 66:355-364. [PMID: 37621976 PMCID: PMC10444590 DOI: 10.33160/yam.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/11/2023] [Indexed: 08/26/2023]
Abstract
Background Although it is known that resilience is negatively associated with burnout, and that certain interventions can effectively increase resilience, little is known about online resilience-enhancing interventions during the COVID-19 crisis. The aim of this study was to identify the association between an online resilience-enhancing intervention and workplace social support, and burnout among nurses working in the mainland and remote islands of Japan during the COVID-19 crisis. Methods Pretest-posttest was conducted between April 2020 and February 2021, and the questionnaire survey included the bidimensional resilience scale, the Japanese version of Pine's Burnout Measure, and the workplace social support scale. Changes in burnout, resilience, and social support and the associations with nursing discussions as intervention were analyzed. Participants were 98 Nurses with 1 to 10 years of experience from Japan's mainland and remote island hospitals of Kagoshima Prefecture participated in a baseline survey in April 2020. Of these, 76 participated in a secondary survey in September 2020, and 69 participated in the intervention program and a third survey in February 2021. The online intervention over Zoom consisted of small-group nursing discussions based on the broaden-and-build theory. Results Changes in burnout showed a significant negative association with change in workplace social support (Coef. = -0.019, 95% CI -0.035- -0.003), as did the interaction between change in acquired resilience and intervention (Coef. = -0.088, 95% CI -0.164- -0.011). Conclusion Change in workplace social support was significantly negatively associated with changes in burnout, as was the interaction of intervention and acquired resilience. Promotion of this intervention and making workplace social support more accessible may contribute to reduce burnout in nurses.
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Affiliation(s)
- Daisaku Nishimoto
- Department of Nursing, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
| | - Shimpei Kodama
- Department of Nursing, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan
| | - Ippei Shimoshikiryo
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
- Environmental Epidemiology Section, Health and Environmental Risk Division, National Institute for Environmental Studies, Tsukuba 305-8506, Japan
| | - Rie Ibusuki
- Department of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
| | - Yasuhito Nerome
- Department of Nursing, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan
| | - Toshiro Takezaki
- Community Medicine Support Center, Kagoshima University Hospital, Kagoshima 890-8520, Japan
| | - Ikuko Nishio
- Department of Nursing, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan
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10
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Sinclair RR, Sawhney G, Jones KO, Pittman MA, Watson GP, Bitner M. Resilience-Related Resources Predict Physicians' Fatigue, Job Search Behavior, and Productivity Outcomes. J Occup Environ Med 2023; 65:292-299. [PMID: 36728183 DOI: 10.1097/jom.0000000000002793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this research was to assess the relative contribution of three resilience-related dispositional resources (trait mindfulness, core self-evaluations, and optimism) to emergency medicine physicians' fatigue, retention, and productivity. METHODS We surveyed emergency physicians employed by a national (US) medical staffing organization. The survey included measures of work stressors, resilience resources, job search behavior, and fatigue. We linked the survey responses to objective demographic and productivity measures from the organization's records. RESULTS A total of 371 respondents completed the survey. Multiple regression analyses demonstrated support for each of the three resilience-related resources as predictors. Relative weights analyses showed that resilience accounted for 14% and 62% of the outcome variance, whereas work demands accounted for between 32% and 56%. CONCLUSIONS Multiple facets of dispositional resilience are important predictors of emergency medicine physicians' occupational health, retention, and productivity.
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Affiliation(s)
- Robert R Sinclair
- From the Department of Psychology, Clemson University, Clemson, South Carolina (R.R.S., G.P.W.); Department of Psychological Sciences, Auburn University, Auburn, Alabama (G.S.); School of Nursing, Clemson University, Clemson, South Carolina (K.O.J.); Department of Emergency Medicine, Prisma Health, Greenville, South Carolina (M.A.P., M.B.)
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11
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Pilot Study on the Impact of Gratitude Journaling or Cognitive Strategies on Health Care Workers. J Pediatr Health Care 2023:S0891-5245(23)00029-9. [PMID: 36882351 PMCID: PMC9985770 DOI: 10.1016/j.pedhc.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has significantly impacted the mental well-being of health care workers (HCWs). This study assessed the feasibility, acceptability, and preliminary efficacy of two psychological interventions, gratitude journaling or cognitive strategies, on pediatric HCWs. METHOD A pilot randomized parallel repeated measures design was used, with a convenience sample of 59 HCWs. Data were collected before and after the intervention period, 2 weeks after, and again 6 months later. Outcomes included depression, anxiety, meaning and purpose, feasibility, and acceptability. RESULTS Thirty-seven participants completed the study. The majority were nurses (registered nurses and advanced practice registered nurses) and physicians. In both groups, depression and anxiety scores diminished, but changes were not statistically significant. The study was feasible to conduct, and subjects reported high acceptability. DISCUSSION Gratitude journaling and cognitive strategies may help mental well-being in HCWs; however, future studies with larger samples are needed.
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12
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Wiederhold BK. Helping the Helpers: Improving Caretaker Resilience with Psychological First Aid Training. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:71-72. [PMID: 36724302 DOI: 10.1089/cyber.2023.29266.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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13
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Çağış ZG, Yıldırım M. Understanding the effect of fear of COVID-19 on COVID-19 burnout and job satisfaction: a mediation model of psychological capital. PSYCHOL HEALTH MED 2023; 28:279-289. [PMID: 35579863 DOI: 10.1080/13548506.2022.2077970] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Healthcare professionals are more at risk than others of being affected by the negative psychological consequences of COVID-19. Therefore, it is necessary to determine the factors protecting healthcare professionals from the negative psychological consequences of the pandemic. The purpose of the present study is to examine the mediating role of psychological capital in the relationship of fear of COVID-19 with COVID-19 burnout and job satisfaction among Turkish healthcare professionals. Participants included 313 healthcare professionals (52.7% females) ranged in age between 22 and 59 years (mean age = 34.41 ± 6.59) and completed measures of fear of COVID-19, psychological capital, job satisfaction and burnout. A mediation model indicated that fear of COVID-19 was negatively associated with psychological capital and job satisfaction but positively associated with COVID-19 burnout. The model also indicated that psychological capital was negatively associated with COVID-19 burnout and positively associated with job satisfaction. Additionally, psychological capital mitigated the effect of fear of COVID-19 on COVID-19 burnout. Finally, the results indicated that fear of COVID-19 did not only have a direct effect on reduced job satisfaction but also had an indirect effect on it through increased psychological capital. Findings elucidate our understanding of the role of psychological capital in the relationship between fear of COVID-19 and COVID-19 burnout and job satisfaction. The results are useful for developing and implementing intervention programs to reduce the negative psychological effects of COVID-19 on healthcare professionals.
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Affiliation(s)
- Zafer Güney Çağış
- Department of Psychology, Faculty of Science and Letters, Ağrı İbrahim Çeçen University, Ağrı, Turkey
| | - Murat Yıldırım
- Department of Psychology, Faculty of Science and Letters, Ağrı İbrahim Çeçen University, Ağrı, Turkey.,Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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14
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Ury E. Mental health conditions of pandemic healthcare workers: findings from a systematic review and meta-analysis. Evid Based Nurs 2023; 26:27. [PMID: 36104157 DOI: 10.1136/ebnurs-2022-103552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Ela Ury
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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15
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Kemel PN, Porter JE, Coombs N. The Potential Barriers and Benefits of an Online Physical Activity Program during the COVID-19 Restrictions: Latrobe Virtual Streetgames. A Qualitative Study. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2142338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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16
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Zarowsky Z, Rashid T. Resilience and Wellbeing Strategies for Pandemic Fatigue in Times of Covid-19. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2022; 8:1-36. [PMID: 36196257 PMCID: PMC9523176 DOI: 10.1007/s41042-022-00078-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic is truly one of the greatest collective health crises in history which have altered our life and living. For years, people have felt fatigued from following public health directives such as social distancing, wearing masks, washing hands frequently, and working or studying remotely without in-person interactions. In this paper, we explore strategies for resilience and wellbeing which can mitigate pandemic-caused stress and behavioural fatigue. We start with individual level strategies including reworking stress appraisals, the importance of psychological flexibility, reducing loneliness through adaptive online platform use, optimizing familial relationships when living in close quarters for a prolonged period, reducing symptoms of burnout and using adaptive distractions, using specific evidence-based resilience strategies. We discuss specific considerations which tap on our shared identities and shared responsibilities which can enhance a sense of community, especially for individuals from marginalized backgrounds and how suicide risks can be minimized.
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Affiliation(s)
- Zachary Zarowsky
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trial, Toronto, ON M1C 1A4 Canada
| | - Tayyab Rashid
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trial, Toronto, ON M1C 1A4 Canada
- Centre for Wellbeing Science, Melbourne Graduate School of Education, Melbourne, Australia
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17
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Use of Mobile Apps and Online Programs of Mindfulness and Self-Compassion Training in Workers: A Scoping Review. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 7:477-515. [PMID: 36091081 PMCID: PMC9444703 DOI: 10.1007/s41347-022-00267-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022]
Abstract
Mindfulness and self-compassion interventions are two strategies helpful in preventing and reducing burnout and work stress. However, professionals with overburdened schedules can experience obstacles in learning and practicing these interventions, originally taught with lengthy programs. The use of digital technologies could make these interventions more accessible to workers, as studied in a recent, growing body of evidence. The evidence available is diverse in terms of interventions, designs, outcomes, and populations. This calls for a review that can take into consideration this diversity while still rigorously synthesize it. Scoping reviews are designed to examine emerging evidence and summarize the evidence on a specific topic of interest. The present scoping review aims to assess the current state of the literature on the use of online programs and mobile applications of self-compassion, mindfulness, and meditation (digital mindfulness-based interventions; dMBIs) by workers. More specifically, information on the type of intervention, population, advantages, and disadvantages, measured outcomes, and advice for future research are gathered. MEDLINE (PubMed; Ovid), PsychInfo (Ovid), and Web of Science (Clarivate) were searched to identify all relevant articles. The screening process resulted in 56 articles being included in this scoping review. Inclusion criteria were (1) participants are workers; (2) the intervention is individual, digital, and mindfulness/self-compassion/meditation-based; and (3) articles were available in French or English language at the time of the review. Interventions used were mostly mindfulness-based, equally categorized under web-based and app-based interventions. Most interventions included information on mindfulness, meditation or self-compassion, meditation exercises, other types of exercises, instructions on how to use, and reminders. dMBIs are often studied in the healthcare population and predominantly in female samples. Although dMBIs present advantages (low cost, accessibility, practicality, feasibility), obstacles can arise in their implementation (low engagement and motivation, concerns about confidentiality). Included articles measured outcomes related to work, mindfulness or self-compassion, and other psychological variables (stress/anxiety, depression, resilience, wellbeing). Articles provided important directions to further research on dMBIs regarding methodological aspects, modality and intervention, and individual and organizational questions. dMBIs are becoming more popular and interventions are diverse. Although not without limitations, this scoping provided a synthesis on different aspects of the use of dMBIs within workers and highlighted pertinent future research directions.
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Curtin M, Richards HL, Fortune DG. Resilience among health care workers while working during a pandemic: A systematic review and meta synthesis of qualitative studies. Clin Psychol Rev 2022; 95:102173. [PMID: 35636130 PMCID: PMC9126830 DOI: 10.1016/j.cpr.2022.102173] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 12/23/2022]
Abstract
Background Aim Method Results Conclusion
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Affiliation(s)
- Mariah Curtin
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland
| | - Helen L Richards
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland; Department of Clinical Health Psychology, Mercy University Hospital, Cork T12 WE28, Ireland
| | - Donal G Fortune
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland; Clinical Psychology, Health Service Executive, CHO3 Mid West, Ireland.
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19
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Mangialavori S, Riva F, Froldi M, Carabelli S, Caimi B, Rossi P, Delle Fave A, Calicchio G. Psychological Distress and Resilience among Italian Healthcare Workers of Geriatric Services during the COVID-19 Pandemic. Geriatr Nurs 2022; 46:132-136. [PMID: 35700680 PMCID: PMC9135690 DOI: 10.1016/j.gerinurse.2022.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic exposed healthcare workers (HW) to heavy workload and psychological distress. This study was aimed to investigate distress levels among Italian physicians, nurses, rehabilitation professionals and healthcare assistants working in geriatric and long-term care services, and to explore the potential role of resilience as a protective resource. The General Health Questionnaire-12, the Connor-Davidson Resilience Scale, and a demographic survey were completed by 708 Italian HWs. Distress and resilience levels were compared between professionals through ANOVA; the contribution of sex, age, professional role, and resilience to distress was explored through regression analyses. Physicians reported significantly higher resilience and distress levels than rehabilitation professionals and healthcare assistants respectively. Women, HWs aged above 45, physicians, and participants reporting low resilience levels were at higher risk for distress. Findings suggest the importance of supporting HW's resilience to counterbalance the pandemic related distress.
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Affiliation(s)
- Sonia Mangialavori
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| | - Fabiana Riva
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Marco Froldi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy; Department of Clinical and Community Sciences, Università degli Studi di Milano, Milan, Italy
| | - Simona Carabelli
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Barbara Caimi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Pierluigi Rossi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Calicchio
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy; Department of Clinical and Community Sciences, Università degli Studi di Milano, Milan, Italy
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