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Ding C, Wang L, Guo Z, Chen Y, Jin J. Psychological care needs for frontline nurses during the COVID-19 pandemic: A qualitative study. Front Public Health 2022; 10:1043515. [PMID: 36438213 PMCID: PMC9686294 DOI: 10.3389/fpubh.2022.1043515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Background In the course of the COVID-19 pandemic, nurses have played vital roles in clinical treatment. Their success in providing adequate care services depends on their psychological state, which determines their physical health, work status, therapeutic outcomes, and response to public health emergencies. However, a limited number of studies have evaluated psychological care needs from the perspective of nurses. This study aimed to describe the psychological care needs for frontline nurses in the course of the COVID-19 pandemic. Methods This was a qualitative descriptive study. Data were collected through semi-structured in-depth interviews with 15 frontline nurses who had been involved in the care of COVID-19 positive patients during the COVID-19 pandemic, and received psychological care. The conventional content analysis was used to identify themes from the interview transcripts. Results Four major themes about the psychological care needs of frontline nurses were identified: (1) psychological service providers (categories: professional service team, trustworthy person or group, ability to empathize with nurses); (2) problems with psychological care (categories: lack of universal screening and focused attention, online group counseling lacks targeting, psychological interventions lack individualization); (3) psychological care content (categories: mental health-related education, recognition of nurses' contributions, problem-solving therapy, psychological counseling and venting); (4) organization and management of psychological services (categories: focus on the psychological care needs of frontline nurses, build a standardized psychological service process system). Conclusion It is important to understand individual psychological care needs of frontline nurses and to provide them with tailor-made psychological care that meet their needs. This will improve their mental health, promote clinical care and quality responses to public health emergencies.
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Affiliation(s)
- Chuanqi Ding
- Department of Emergency, Changxing County People's Hospital, Huzhou, China
| | - Limin Wang
- Department of Nursing, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiting Guo
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Yun Chen
- Department of Public Health, Changxing County People's Hospital, Huzhou, China
| | - Jingfen Jin
- Department of Emergency, Changxing County People's Hospital, Huzhou, China,Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of the Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, China,*Correspondence: Jingfen Jin
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Lawrance EL, Thompson R, Newberry Le Vay J, Page L, Jennings N. The Impact of Climate Change on Mental Health and Emotional Wellbeing: A Narrative Review of Current Evidence, and its Implications. Int Rev Psychiatry 2022; 34:443-498. [PMID: 36165756 DOI: 10.1080/09540261.2022.2128725] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Converging global evidence highlights the dire consequences of climate change for human mental health and wellbeing. This paper summarises literature across relevant disciplines to provide a comprehensive narrative review of the multiple pathways through which climate change interacts with mental health and wellbeing. Climate change acts as a risk amplifier by disrupting the conditions known to support good mental health, including socioeconomic, cultural and environmental conditions, and living and working conditions. The disruptive influence of rising global temperatures and extreme weather events, such as experiencing a heatwave or water insecurity, compounds existing stressors experienced by individuals and communities. This has deleterious effects on people's mental health and is particularly acute for those groups already disadvantaged within and across countries. Awareness and experiences of escalating climate threats and climate inaction can generate understandable psychological distress; though strong emotional responses can also motivate climate action. We highlight opportunities to support individuals and communities to cope with and act on climate change. Consideration of the multiple and interconnected pathways of climate impacts and their influence on mental health determinants must inform evidence-based interventions. Appropriate action that centres climate justice can reduce the current and future mental health burden, while simultaneously improving the conditions that nurture wellbeing and equality. The presented evidence adds further weight to the need for decisive climate action by decision makers across all scales.
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Affiliation(s)
- Emma L Lawrance
- Institute of Global Health Innovation, Imperial College London, UK.,Mental Health Innovations, UK.,Grantham Institute of Climate and the Environment, Imperial College London, UK
| | | | | | - Lisa Page
- Brighton & Sussex Medical School, UK
| | - Neil Jennings
- Grantham Institute of Climate and the Environment, Imperial College London, UK
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Prevalence and Predictors of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray Five Years after the Devastating Wildfires. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Natural disasters adversely impact individuals living in places where they occur, resulting in emotional distress. The wildfire that occurred in Fort McMurray (FMM), Alberta in 2016 is no different. Objective: This study aims to identify the prevalence and predictors of Generalized Anxiety Disorder (GAD) symptoms in residents of FMM five years after the devastating wildfires. Methods: Data for the study were collected through a cross-sectional survey conducted online from the 24th of April to the 2nd of June 2021. A validated instrument, the GAD-7 scale, was used to collect information on anxiety. Results: This study involved 186 residents of FMM, of which the majority were females (85.5%), employed (94.1%), working at school boards (50.0%), and were either married, cohabiting, or partnered (71.0%). The prevalence of likely GAD among the study sample was 42.5%. Unemployed respondents were seventeen times more likely to develop GAD symptoms (OR = 16.62; 95% C.I. 1.23–223.67) while respondents who would like to receive mental health counseling were five times more likely to experience GAD symptoms (OR = 5.35; 95% C.I. 2.03–14.15). Respondents who suffered a loss of property because of the wildfire were two times more likely to develop GAD symptoms (OR = 2.36; 95% C.I. 1.01–22.62). Conclusion: Policymakers may mitigate GAD symptoms, particularly after natural disasters, by making long-term mental health counseling available and a key component of post-disaster management, and by investing in the social capital of the people to build resilience and support to deal with the post-disaster mental health effects.
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Mitchell JT. Continuum of care for disasters and catastrophes. Int Rev Psychiatry 2021; 33:728-739. [PMID: 35412427 DOI: 10.1080/09540261.2022.2030678] [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] [Indexed: 10/18/2022]
Abstract
Disasters and their more extensive and more serious variant, catastrophes, are different than most human experiences. They are inherently quite complex. Extensive and diverse resources are required to assist disaster survivors as well as disaster response personnel, and hospital medical staffs. Except for warfare, there are few other human predicaments that require such a massive and highly coordinated response. Traditional psycho-therapeutic interventions have little chance of being helpful in the acute stages of a disaster. Research demonstrates that selected crisis intervention processes provided by crisis-trained psychological support personnel have been quite successful in assisting both the survivors and responders in coping with disasters and catastrophes. Assistance to military personnel, emergency operations personnel, and survivors must be carefully crafted to assure that the right type of help is provided at the right time by the most appropriate, well-trained, and experienced personnel. This paper employed a scoping review methodology synthesizing the lessons gleaned from wars and past disasters beginning in the late 1800's up to the present. It sets a course for the appropriate management of the psychological impacts of future disasters and catastrophes. Evidence suggests effective psychiatric and psychological services provided during and in the aftermath of a disaster must be simple, brief, immediate, practical, and innovative. Most importantly, disaster mental health support services must consist of an integrated and comprehensive continuum of mental health services spanning all levels of intensity of support and care.
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Affiliation(s)
- Jeffrey T Mitchell
- Emergency Health Services, University of Maryland, Baltimore County, Baltimore, MD, USA
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Affiliation(s)
- George S Everly
- The Johns Hopkins Bloomberg School of Public Health and The Johns Hopkins University School of Medicine
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Castellano C. Applications of peer support in disasters: connecting in times of disaster. Int Rev Psychiatry 2021; 33:677-681. [PMID: 35412428 DOI: 10.1080/09540261.2021.2011160] [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] [Indexed: 10/19/2022]
Abstract
Disasters invariably result in a surge in demand for mental health services, and this surge quickly exceeds available mental health resources. The pursuit of alternative sources of psychological support for communities adversely affected by disasters has therefore been necessitated. This paper describes the application of an awarding-winner, empirically validated, model for psychological support and its applicability for enhancing community disaster mental health resources that are consistent with United Nations' recommendations for a "whole society" approach to disaster mental health. The model utilises the concept of peer-based psychological support. Peer psychological support is defined as the utilisation of individuals specially trained in the provision of acute psychological crisis interventions and psychological first aid, but who do not possess professional-level training or licensure in one of the mental health disciplines. These peer-based crisis intervention services may be delivered telephonically, via the internet, or face-to-face. This model, referred to as Reciprocal Peer Support (RPS), is the peer support activity provided at Rutgers University Behavioural HealthCare (UBHC) National Center for Peer Support in a variety of peer programs. More than 20 years of peer support interventions have been reviewed and assessed to clarify the lessons learned for the application of RPS as a prime exemplar for the utilization of peer support during and after a disaster. The Cop 2 Cop, NJ Vet 2 Vet, and several other UBHC peer support programs, which conform to best practices criteria, have been created, sustained, and expanded based on the RSP principles discussed in this article. RPS and derivative applications for human-made disasters such as the terrorist events of 9/11/2001 as well as natural disasters such as Hurricane Katrina or the COVID- 19 pandemic represent platforms for the implementation of peer psychological support and the establishment of a peer-based continuum of psychological connection.
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Baldaçara L, da Silva AG, Pereira LA, Malloy-Diniz L, Tung TC. The Management of Psychiatric Emergencies in Situations of Public Calamity. Front Psychiatry 2021; 12:556792. [PMID: 33643085 PMCID: PMC7905390 DOI: 10.3389/fpsyt.2021.556792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022] Open
Abstract
The prevalence of mental health problems in the general population during a public calamity is high. In calamities, the number of patients who present with mental disorder outbreaks or crises may increase, but the necessary support systems to help them may be impaired if they have not been planned for. Although there are several models for addressing psychiatric emergencies, the general rules are the same, especially when it comes to making these services easily available to the affected population. In this article, we seek to review and present recommendations for the management of psychiatric emergencies in situations of public calamity, including disasters, physical and medical catastrophes, epidemics, and pandemics.
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Affiliation(s)
- Leonardo Baldaçara
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Medicine, Universidade Federal do Tocantins, Palmas, Brazil
| | - Antônio Geraldo da Silva
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Lucas Alves Pereira
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Departamento de Psiquiatria, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Leandro Malloy-Diniz
- Mental Health Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Psychology Department, Universidade FUMEC, Belo Horizonte, Brazil
| | - Teng Chei Tung
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Universidade de São Paulo, São Paulo, Brazil
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Haleemunnissa S, Didel S, Swami MK, Singh K, Vyas V. Children and COVID19: Understanding impact on the growth trajectory of an evolving generation. CHILDREN AND YOUTH SERVICES REVIEW 2021; 120:105754. [PMID: 33281255 PMCID: PMC7695548 DOI: 10.1016/j.childyouth.2020.105754] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 05/05/2023]
Abstract
The COVID19 pandemic has forced the world to be closed in a shell. It has affected large population worldwide, but studies regarding its effect on children very limited. The majority of the children, who may not be able to grasp the entire emergency, are at a bigger risk with other problems lurking behind the attack of SARS-CoV-2 virus. The risk of infection in children was 1.3%, 1.5%, and 1.7% of total confirmed COVID-19 cases in China, Italy and United States respectively which is less compared to 2003 epidemic of severe acute respiratory syndrome (SARS), when 5-7% of the positive cases were children, with no deaths reported while another recent multinational multicentric study from Europe which included 582 PCR (polymerase chain reaction) confirmed children of 0-18 year of age, provide deeper and generalize incite about clinical effects of COVID19 infection in children. According to this study 25% children have some pre-existing illness and 8% required ICU (intensive care unit) admission with 0.69% case fatality among all infected children. Common risk factor for serious illness as per this study are younger age, male sex and pre-existing underlying chronic medical condition. However, we need to be more concerned about possible implications of indirect and parallel psychosocial and mental health damage due to closure of schools, being in confinement and lack of peer interaction due to COVID19 related lockdown and other containment measures. The effects can range from mood swings, depression, anxiety symptoms to Post Traumatic Stress Disorder, while no meaningful impact on COVID19 related mortality reduction is evident with school closure measures. The objective of this paper is to look at both the positive & negative effects in children due to COVID19 related indirect effects following lockdown and other containment measures. There is a need to gear up in advance with psychological strategies to deal with it post the pandemic by involving all stakeholders (parents, teachers, paediatricians, psychologists, psychiatrists, psychiatric social workers, counsellors), proposing an integrated approach to help the children to overcome the pandemic aftermath.
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Affiliation(s)
- S Haleemunnissa
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, India
| | - Siyaram Didel
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India
| | - Mukesh Kumar Swami
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India
| | - Varuna Vyas
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India
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Xi Y, Chen R, Gillespie AL, He Y, Jia C, Shi K, Yao Y, Ma X, Liu W, Chan EYY. Mental health workers perceptions of disaster response in China. BMC Public Health 2019; 19:11. [PMID: 30606149 PMCID: PMC6318987 DOI: 10.1186/s12889-018-6313-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 12/10/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The post-disaster mental health crisis intervention (MHCI) system in China remains immature and unsystematic. We aim to report the perceptions of a large sample of MHCI workers and government administrators and provide recommendations for developing a national mental health disaster response management plan in China. METHODS An in-depth qualitative study was conducted, collecting data from 20 focus-group discussions and 25 key stakeholder interviews. These recruited participants who had been involved in different types of disaster rescue across 7 provinces/cities where disasters have recently occurred. We used thematic analysis to analyze the data and relevant findings were extracted for policy recommendation. RESULTS Mental health workers' perspectives were examined in detailed according to four core themes: forms of organization, intervention pathway, intervention strategy and technique, and public health information. Post-disaster MHCI should be approached in teams that are integrated with emergency medicine systems, and be led by unified command management. All levels of local health and family planning commission should prepare post-disaster MHCI work plans and build response teams/emergency centres. Future training for MHCI workers should focus on: building a sense of trust within the team; clarifying each member's role; strengthening the screening, assessment and referrals training for psychological professionals; and providing psychological intervention training for Chinese psychiatrists. It is necessary to set up guiding principles for disaster research ethics, mental health rehabilitation and media interaction. CONCLUSIONS Through exploring and analyzing the perceptions of current disaster response mental health workers and government administrators, our findings provide essential recommendations for developing a national to county level post-disaster MHCI emergency management plan and can guide the formulation of relevant laws and regulation in China.
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Affiliation(s)
- Yingjun Xi
- The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Runsen Chen
- The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
- Department of Psychiatry, University of Oxford, Oxford, UK
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | | | - Yuyang He
- The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chihua Jia
- The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Kuo Shi
- The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
- Department of Psychology of China Rehabilitation Research Center, Beijing, China
| | - Yiming Yao
- The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xin Ma
- The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wei Liu
- The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN UK
- Francois-Xavier Bagnound Center for Health and Human Rights, Harvard University, Boston, MA 02138 USA
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Brandrud AS, Bretthauer M, Brattebø G, Pedersen MJ, Håpnes K, Møller K, Bjorge T, Nyen B, Strauman L, Schreiner A, Haldorsen GS, Bergli M, Nelson E, Morgan TS, Hjortdahl P. Local emergency medical response after a terrorist attack in Norway: a qualitative study. BMJ Qual Saf 2017; 26:806-816. [PMID: 28676492 DOI: 10.1136/bmjqs-2017-006517] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/24/2017] [Accepted: 04/30/2017] [Indexed: 11/03/2022]
Abstract
INTRODUCTION On 22 July 2011, Norway suffered a devastating terrorist attack targeting a political youth camp on a remote island. Within a few hours, 35 injured terrorist victims were admitted to the local Ringerike community hospital. All victims survived. The local emergency medical service (EMS), despite limited resources, was evaluated by three external bodies as successful in handling this crisis. This study investigates the determinants for the success of that EMS as a model for quality improvement in healthcare. METHODS We performed focus group interviews using the critical incident technique with 30 healthcare professionals involved in the care of the attack victims to establish determinants of the EMS' success. Two independent teams of professional experts classified and validated the identified determinants. RESULTS Our findings suggest a combination of four elements essential for the success of the EMS: (1) major emergency preparedness and competence based on continuous planning, training and learning; (2) crisis management based on knowledge, trust and data collection; (3) empowerment through multiprofessional networks; and (4) the ability to improvise based on acquired structure and competence. The informants reported the successful response was specifically based on multiprofessional trauma education, team training, and prehospital and in-hospital networking including mental healthcare. The powerful combination of preparedness, competence and crisis management built on empowerment enabled the healthcare workers to trust themselves and each other to make professional decisions and creative improvisations in an unpredictable situation. CONCLUSION The determinants for success derived from this qualitative study (preparedness, management, networking, ability to improvise) may be universally applicable to understanding the conditions for resilient and safe healthcare services, and of general interest for quality improvement in healthcare.
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Affiliation(s)
- Aleidis S Brandrud
- Quality Department, Vestre Viken HF, Drammen, Buskerud, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Michael Bretthauer
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine and K G Jebsen Center for Colorectal Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Guttorm Brattebø
- Norwegian National Advisory Unit on Trauma, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - May Jb Pedersen
- Department of General and Orthopedic Surgery, Obstetrics, Anaesthesia and Intensive Care, Ringerike Hospital, Vestre Viken HF, Drammen, Buskerud, Norway
| | - Kent Håpnes
- Division of Mental Health and Addiction, Ringerike DPS, Vestre Viken HF, Drammen, Buskerud, Norway
| | - Karin Møller
- Department of Medicine, Municipality of Ringerike, Honefoss, Buskerud, Norway
| | - Trond Bjorge
- Department of Pulmonary Diseases, Ostfold Hospital, Kalnes, Ostfold, Norway
| | - Bjørnar Nyen
- Department of Medicine, Municipality of Porsgrunn, Porsgrunn, Norway
| | - Lars Strauman
- Department of Medicine, Nordland Hospital, Lofoten, Nordland, Norway
| | - Ada Schreiner
- Norwegian Federation of Organizations of Disabled People, Oslo, Norway
| | - Gro S Haldorsen
- Department of Quality, Medicine and Patient Safety, South-Eastern Norway Regional Health Authority, Hamar, Norway
| | - Maria Bergli
- Quality Department, Vestre Viken HF, Drammen, Buskerud, Norway
| | - Eugene Nelson
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Tamara S Morgan
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Per Hjortdahl
- Department of Family Medicine, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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11
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Lucchini RG, Hashim D, Acquilla S, Basanets A, Bertazzi PA, Bushmanov A, Crane M, Harrison DJ, Holden W, Landrigan PJ, Luft BJ, Mocarelli P, Mazitova N, Melius J, Moline JM, Mori K, Prezant D, Reibman J, Reissman DB, Stazharau A, Takahashi K, Udasin IG, Todd AC. A comparative assessment of major international disasters: the need for exposure assessment, systematic emergency preparedness, and lifetime health care. BMC Public Health 2017; 17:46. [PMID: 28061835 PMCID: PMC5219808 DOI: 10.1186/s12889-016-3939-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 12/13/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The disasters at Seveso, Three Mile Island, Bhopal, Chernobyl, the World Trade Center (WTC) and Fukushima had historic health and economic sequelae for large populations of workers, responders and community members. METHODS Comparative data from these events were collected to derive indications for future preparedness. Information from the primary sources and a literature review addressed: i) exposure assessment; ii) exposed populations; iii) health surveillance; iv) follow-up and research outputs; v) observed physical and mental health effects; vi) treatment and benefits; and vii) outreach activities. RESULTS Exposure assessment was conducted in Seveso, Chernobyl and Fukushima, although none benefited from a timely or systematic strategy, yielding immediate and sequential measurements after the disaster. Identification of exposed subjects was overall underestimated. Health surveillance, treatment and follow-up research were implemented in Seveso, Chernobyl, Fukushima, and at the WTC, mostly focusing on the workers and responders, and to a lesser extent on residents. Exposure-related physical and mental health consequences were identified, indicating the need for a long-term health care of the affected populations. Fukushima has generated the largest scientific output so far, followed by the WTCHP and Chernobyl. Benefits programs and active outreach figured prominently in only the WTC Health Program. The analysis of these programs yielded the following lessons: 1) Know who was there; 2) Have public health input to the disaster response; 3) Collect health and needs data rapidly; 4) Take care of the affected; 5) Emergency preparedness; 6) Data driven, needs assessment, advocacy. CONCLUSIONS Given the long-lasting health consequences of natural and man-made disasters, health surveillance and treatment programs are critical for management of health conditions, and emergency preparedness plans are needed to prevent or minimize the impact of future threats.
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Affiliation(s)
- Roberto G. Lucchini
- Icahn School of Medicine at Mount Sinai, New York, NY USA
- University of Brescia, Brescia, Italy
| | - Dana Hashim
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | | | | | | | - Michael Crane
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | - William Holden
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | | | | | | | - James Melius
- New York State Laborers’ Health and Safety Trust Fund, New York, NY USA
| | - Jacqueline M. Moline
- Hofstra North Shore-LIJ School of Medicine at Hofstra University, Hempstead, NY USA
| | - Koji Mori
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - Joan Reibman
- New York University School of Medicine, New York, NY USA
| | - Dori B. Reissman
- National Institute for Occupational Safety and Health, Atlanta, Georgia USA
| | | | - Ken Takahashi
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - Andrew C. Todd
- Icahn School of Medicine at Mount Sinai, New York, NY USA
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MCCormick LC, Tajeu GS, Klapow J. Mental health consequences of chemical and radiologic emergencies: a systematic review. Emerg Med Clin North Am 2014; 33:197-211. [PMID: 25455669 DOI: 10.1016/j.emc.2014.09.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This article reviews the literature pertaining to psychological impacts in the aftermath of technological disasters, focusing on the immediate psychological and mental health consequences emergency department physicians and first responders may encounter in the aftermath of such disasters. First receivers see a wide spectrum of psychological distress, including acute onset of psychiatric disorders, the exacerbation of existing psychological and psychiatric conditions, and widespread symptomatology even in the absence of a diagnosable disorder. The informal community support systems that exist after a natural disaster may not be available to communities affected by a technological disaster leading to a need for more formal mental health supportive services.
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Affiliation(s)
- Lisa C MCCormick
- Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health, RPHB 330, 1720 Second Avenue South, Birmingham, AL 35294-0022, USA.
| | - Gabriel S Tajeu
- Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health, RPHB 330, 1720 Second Avenue South, Birmingham, AL 35294-0022, USA
| | - Joshua Klapow
- Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health, RPHB 330, 1720 Second Avenue South, Birmingham, AL 35294-0022, USA; Chip Rewards, Inc, 2901 2nd Avenue South, Suite 210, Birmingham, AL 35233, USA
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Guimaro MS, Steinman M, Kernkraut AM, Santos OFPD, Lacerda SS. Psychological distress in survivors of the 2010 Haiti earthquake. EINSTEIN-SAO PAULO 2013; 11:11-4. [PMID: 23579738 PMCID: PMC4872962 DOI: 10.1590/s1679-45082013000100004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 03/13/2012] [Indexed: 12/02/2022] Open
Abstract
Objective: To investigate the presence of depression and anxiety symptoms in survivors of the Haiti earthquake who were assisted by a healthcare team from the Hospital Israelita Albert Einstein, and to evaluate the impact that losing a family member during this catastrophe could have on the development of these symptoms. Methods: Forty survivors of the Haiti earthquake who were assisted by the healthcare team between February and March of 2010 were included in this study. All subjects underwent a semi-structured interview. The group was divided into Group A (individuals who had some death in the family due to the disaster) and Group B (those who did not lose any family member). Results: A total of 55% of the subjects had depression symptoms whereas 40% had anxiety symptoms. The individuals who lost a family member were five times more likely to develop anxiety and depression symptoms than those who did not. Conclusion: Catastrophe victims who lost at least one family member due to the disaster were more likely to develop anxiety and depression symptoms. To these individuals, as well as others showing psychological distress, should be offered early mental health care to help them cope with the great emotional distress inherent in these situations.
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Abstract
Climate change is an emerging challenge to the mental health of entire humanity. Several studies, in recent times, have brought to light the adverse public mental health outcomes of extreme weather events for the suffering communities. The general public and the policy making bodies need to gain awareness about these impacts. Through such awareness, communities and their governments can institutionalize mechanisms to provide psychological support to the populations affected by climate change, before it becomes a massive public health challenge and starts affecting the social and vocational lives of people. There is an urgent need for addressing these impacts. The aim of this paper is to provide an overview of the deleterious effects of climate change related extreme weather events on mental health, the worldwide response of several communities to such events, and preparedness of the public and government to deal with these adverse mental health impacts. Policy imperatives to prevent and mitigate these impacts have been suggested. It is hoped that the psychologists, governments, and communities will act earnestly to prevent the impending harm to human mental health due to climate change.
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Sands N, Elsom S, Marangu E, Keppich-Arnold S, Henderson K. Mental health telephone triage: managing psychiatric crisis and emergency. Perspect Psychiatr Care 2013; 49:65-72. [PMID: 23293999 DOI: 10.1111/j.1744-6163.2012.00346.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The study aims to identify and articulate how mental health telephone triage (MHTT) clinicians manage psychiatric crisis and emergency via the telephone. DESIGN AND METHODS An observational design was employed in the study. Wireless headsets were used to observe 197 occasions of MHTT. FINDINGS Clinicians use a range of practical strategies, therapeutic skills, and psychosocial interventions to manage psychiatric crises and emergencies via the telephone. PRACTICE IMPLICATIONS The evidence base for managing psychiatric crisis/emergency in MHTT is minimal. These findings contribute to the MHTT knowledge base and provide evidence-based strategies for high-quality emergency mental health care.
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Affiliation(s)
- Natisha Sands
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
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Sands N, Elsom S, Gerdtz M, Henderson K, Keppich-Arnold S, Droste N, Prematunga RK, Wereta ZW. Identifying the core competencies of mental health telephone triage. J Clin Nurs 2012; 22:3203-16. [PMID: 22860919 DOI: 10.1111/j.1365-2702.2012.04093.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. BACKGROUND Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. DESIGN An observational design was employed to address the research aims. METHODS Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. RESULTS The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. CONCLUSIONS The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. RELEVANCE TO CLINICAL PRACTICE The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to improve the quality, consistency and accuracy of telephone-based mental health triage assessment.
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Affiliation(s)
- Natisha Sands
- Authors:Natisha Sands, RN, BN, PhD, Associate Professor and Campus Leader, School of Nursing and Midwifery, Deakin University Waterfront Campus, Geelong; Stephen Elsom, RN, MHN, BA, MNurs, PhD, Associate Professor and Director, Centre for Psychiatric Nursing, The University of Melbourne, Melbourne; Marie Gerdtz, BN, PhD, RN, A&ECert, GDAET, Associate Professor, The University of Melbourne, Melbourne; Kathryn Henderson, RN, GDACN, Hospital and Emergency Psychiatry Nurse Manager, Alfred Psychiatry, The Alfred Hospital, Melbourne; Sandra Keppich-Arnold, RN, GDHE&P, Associate Director of Nursing & Operations, Alfred Psychiatry, The Alfred Hospital, Melbourne; Nicolas Droste, BBehSc, Research Assistant, School of Nursing and Midwifery, Deakin University, Melbourne; Roshani Kanchana Prematunga, MPH, PG DipSci-Statistics, BCOM., Research Assistant, Centre for Psychiatric Nursing, The University of Melbourne, Melbourne; Zewdu W Wereta, BSc, MA, PhD, Research Assistant, Centre for Psychiatric Nursing, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Andrew SA, Kendra JM. An adaptive governance approach to disaster-related behavioural health services. DISASTERS 2012; 36:514-532. [PMID: 22066735 DOI: 10.1111/j.1467-7717.2011.01262.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper explores the provision of disaster-related behavioural and mental health (DBH) services as a problem of institutional collective action in the United States. This study reviews the challenges that providers have in surmounting multi-organizational disconnects, unstable professional legitimacy, ambiguous information, and shifting disaster needs in developing a system for delivering DBH services. Based on the adaptive governance framework, it argues that existing protocols such as the National Incident Management System (NIMS) and Incident Command System (ICS) may be helpful in advancing collective action, but that real progress will depend on a recognition of norms, expectations, and credentials across many spheres-in other words, on the ability of responders to continuously adjust their procedures and administrative boundaries for behavioural health institutions.
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Affiliation(s)
- Simon A Andrew
- Department of Public Administration, University of North Texas, United States
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Okada N, Ishii N, Nakata M, Nakayama S. Occupational Stress among Japanese Emergency Medical Technicians: Hyogo Prefecture. Prehosp Disaster Med 2012; 20:115-21. [PMID: 15898491 DOI: 10.1017/s1049023x00002296] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroduction:As prehospital care became emphasized in emergency medical services in Japan, qualification as a “paramedic” was established in 1991 as a requirement for national qualification as a emergency medical technician (EMT).With recent increases in emergency transportation, the responsibilities of paramedics have become more complex and demand a higher level of competency; however, no method of evaluating occupational stress among Japanese EMTs currently exists.Methods:A questionnaire survey of the working conditions and health of 2,017 EMTs in Hyogo Prefecture was conducted. To analyze stress levels among these EMTs, the survey was divided into two categories: (1) physical stress; and (2) mental stress.Results:The number of responses was 1,551 (76.9%) and the average age of the respondents was 35.4 years. The lower back, neck, and shoulders were most frequently subjected to physical stress, which was related to the daily operations as an EMT. Mental stress was reported more frequently by those who were older or qualified paramedics.Discussion:The high frequency of lower back pain suggests the need for improvement in the work environment and periodic education.Conclusions:Although job satisfaction among paramedics was high, they were exposed to greater mental stress. Therefore, systematic management of stress must be developed and established.
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Affiliation(s)
- Naoki Okada
- Department of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, Japan.
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Rodriguez SR, Tocco JS, Mallonee S, Smithee L, Cathey T, Bradley K. Rapid Needs Assessment of Hurricane Katrina Evacuees—Oklahoma, September 2005. Prehosp Disaster Med 2012; 21:390-5. [PMID: 17334185 DOI: 10.1017/s1049023x0000409x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIntroduction:On 04 September 2005, 1,589 Hurricane Katrina evacuees from the New Orleans area arrived in Oklahoma. The Oklahoma State Department of Health conducted a rapid needs assessment of the evacuees housed at a National Guard training facility to determine the medical and social needs of the population in order to allocate resources appropriately.Methods:A standardized questionnaire that focused on individual and household evacuee characteristics was developed. Households from each shel-ter building were targeted for surveying, and a convenience sample was used.Results:Data were collected on 197 households and 373 persons. When com-pared with the population of Orleans Parish, Louisiana, the evacuees sampled were more likely to be male, black, and 45–64 years of age. They also were less likely to report receiving a high school education and being employed pre-hurricane. Of those households of <1 persons, 63% had at least one missing household member. Fifty-six percent of adults and 21% of children reported having at least one chronic disease. Adult women and non-black persons were more likely to report a pre-existing mental health condition. Fourteen percent of adult evacuees reported a mental illness that required medication pre-hur-ricane, and eight adults indicated that they either had been physically or sex-ually assaulted after the hurricane. Approximately half of adults reported that they had witnessed someone being severely injured or dead, and 10% of per-sons reported that someone close to them (family or friend) had died since the hurricane. Of the adults answering questions related to acute stress disor-der, 50% indicated that they suffered at least one symptom of the disorder.Conclusions:The results from this needs assessment highlight that the evac-uees surveyed predominantly were black, of lower socio-economic status, and had substantial, pre-existing medical and mental health concerns. The evac-uees experienced multiple emotional traumas, including witnessing grotesque scenes and the disruption of social systems, and had pre-existing psy-chopathologies that predisposed this population to post-traumatic stress dis-order (Post-traumatic Stress Disorder).x When disaster populations are displaced, mental health and social service providers should be available immediately upon the arrival of the evacuees, and should be integrally coordinated with the relief response. Because the displaced population is at high risk for disaster-related mental health problems, it should be monitored closely for persons with PTSD. This displaced population will likely require a substantial re-establishment of financial, medical, and educational resources in new communities or upon their return to Louisiana.
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Affiliation(s)
- Sara Russell Rodriguez
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Earthquake in L'Aquila: The Lombardy 1-1-8 System Response. Prehosp Disaster Med 2010. [DOI: 10.1017/s1049023x00022901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Cyclone Nargis: A Wake Up Call. Prehosp Disaster Med 2010. [DOI: 10.1017/s1049023x00022913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Bishop LC, Thornby J. Psychiatric consultation with medical evacuees of Hurricane Katrina. Wilderness Environ Med 2009; 20:1-5. [PMID: 19364161 DOI: 10.1580/06-weme-or-040.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To study the scope of clinical activities and the postoperational attitudes of mental health professionals responding emergently to a mass urban evacuation. METHODS Eleven mental health care providers participating in a reception team for medical evacuees after Hurricane Katrina were asked to complete a survey seeking data regarding cases encountered, psychopharmacologic interventions, and mental health support for evacuated medical personnel. Participants rated their levels of agreement with statements characterizing various aspects of the clinical experience. RESULTS Nine of 11 providers returned surveys, for a response rate of 82%. Among 35 evacuees requiring immediate psychiatric consultation, acute stress disorder and dementia, equally represented among these cases, accounted for half the diagnoses. Medication interventions were relatively uncommon. Consultants provided mental health support to 14 evacuated medical professionals. Although somewhat uncertain about their role, psychiatric consultants strongly agreed that they would be willing to serve in future disaster operations of this type. CONCLUSIONS In major disasters, psychiatric consultants are likely to play a critical role in providing emergency mental health services for both medical evacuees and evacuated medical professionals.
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Affiliation(s)
- Leigh C Bishop
- Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
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Wahlström L, Michélsen H, Schulman A, Backheden M. Different types of exposure to the 2004 tsunami are associated with different levels of psychological distress and posttraumatic stress. J Trauma Stress 2008; 21:463-70. [PMID: 18956445 DOI: 10.1002/jts.20360] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The impact of traumatic exposure on psychological distress and posttraumatic stress was investigated at 14 months through self-report in 1,505 Swedish tourists who survived the 2004 Indian Ocean Tsunami. Exposure, differentiated in single and multiple types, was associated with different levels of impaired mental health measured by General Health Questionnaire (GHQ) and Impact of Event Scale-Revised (IES-R). Additionally, having sole exposure to subjective life threat brought about specific psychological effects. Some demographic factors are associated with outcome on either the GHQ or the IES-R. Identifying specific types of exposure of disaster survivors may be a way to identify individuals who could be screened for psychological ill health at a later point in time.
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Affiliation(s)
- Lars Wahlström
- Center for Family and Community Medicine, Karolinska Institutet, Stockholm
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Cunha S, Soares-Oliveira M, Pereira N. Early psychological intervention in prehospital emergency care systems. J Emerg Med 2008; 36:404-6. [PMID: 18385002 DOI: 10.1016/j.jemermed.2007.10.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 08/16/2007] [Accepted: 10/12/2007] [Indexed: 11/25/2022]
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Hawley SR, Hawley GC, Romain TS, Ablah E. Quantitative Impact of Mental Health Preparedness Training for Public Health Professionals. Biosecur Bioterror 2007; 5:347-52. [DOI: 10.1089/bsp.2007.0031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Suzanne R. Hawley
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Wichita
| | - Gary C. Hawley
- Robert J. Dole Medical Center, Department of Veterans Affairs, Wichita
| | - Theresa St. Romain
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Wichita
| | - Elizabeth Ablah
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Wichita
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Soares-Oliveira M, Cunha S, Rosado S, Faria J, Salazar G, Pereira N. Supportive needs of people confronted with sudden unexpected death: a task for the psychologist. Resuscitation 2007; 76:315. [PMID: 17764808 DOI: 10.1016/j.resuscitation.2007.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Accepted: 07/19/2007] [Indexed: 10/22/2022]
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Mitchell CS, Gochfeld M, Shubert J, Kipen H, Moline J, Langlieb A, Everly GS, Udasin I, Wartenberg D, Paulson G. Surveillance of Workers Responding Under the National Response Plan. J Occup Environ Med 2007; 49:922-7. [PMID: 17693791 DOI: 10.1097/jom.0b013e318145b2b0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The National Response Plan (NRP) establishes the framework for the nation's response to major disasters. We offer seven recommendations related to surveillance of workers who respond to events under the NRP. These recommendations address the rationale for and principles of medical surveillance in the context of large-scale disasters and the NRP; means of identifying and registering the populations that should be included in surveillance activities; the role of exposure assessment in medical surveillance; behavioral health issues; and principles regarding the communication and use of surveillance data.
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Affiliation(s)
- Clifford S Mitchell
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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Hawley SR, Ablah E, Hawley GC, Cook DJ, Orr SA, Molgaard CA. Terrorism and mental health in the rural Midwest. Prehosp Disaster Med 2007; 21:383-9. [PMID: 17334184 DOI: 10.1017/s1049023x00004088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Since the terrorist attacks of 11 September 2001, the amount of terrorism preparedness training has increased substantially. However, gaps continue to exist in training for the mental health casualties that result from such events. Responders must be aware of the mental health effects of terrorism and how to prepare for and buffer these effects. However, the degree to which responders possess or value this knowledge has not been studied. METHODS Multi-disciplinary terrorism preparedness training for healthcare professionals was conducted in Kansas in 2003. In order to assess knowledge and attitudes related to mental health preparedness training, post-test surveys were provided to 314 respondents 10 months after completion of the training. Respondents returned 197 completed surveys for an analysis response rate of 63%. RESULTS In general, the results indicated that respondents have knowledge of and value the importance of mental health preparedness issues. The respondents who reported greater knowledge or value of mental health preparedness also indicated significantly higher ability levels in nationally recognized bioterrorism competencies (p < 0.001). CONCLUSIONS These results support the need for mental health components to be incorporated into terrorism preparedness training. Further studies to determine the most effective mental health preparedness training content and instruction modalities are needed.
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Affiliation(s)
- Suzanne R Hawley
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, Wichita, KS 67214-3199, USA.
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Abstract
Perceived poisoning may manifest in numerous ways; however, all cases share certain characteristics. All are fostered by the wide availability of unreliable information about chemical safety, poor understanding of scientific principles, and ineffective risk communication. Although this problem is still incompletely understood, some approaches have been demonstrated to be useful, such as education about risk, appropriate reassurance, and empathy on the part of the practitioner. Successful management may curtail the spread or exacerbation of symptoms, whereas unsuccessful treatment may cause the problems to escalate, with detrimental effects on both society and patient.
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Affiliation(s)
- Kristine A Nañagas
- Division of Medical Toxicology, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46206-1367, USA.
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