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Seidman AJ, Born W, Corriveau E. First Responders During COVID-19: Career Calling, PTSD, and Work Self-Efficacy. Am J Prev Med 2024; 66:1017-1023. [PMID: 38211731 DOI: 10.1016/j.amepre.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
INTRODUCTION During the COVID-19 pandemic, first responders were identified as a high-risk group for developing symptoms of post-traumatic stress disorder (PTSD) and depression, which are commonly associated with negative thoughts about oneself. This may pose risk to perceptions of work self-efficacy, an integral component of employee well-being and occupational functioning. In line with the Job Demands-Resources Model (Demerouti et al., 2001), the present study examined whether the degree to which first responders' perceived career calling (i.e., a "summons" to work) served as a protective factor in the relationship between PTSD symptoms associated with the COVID-19 pandemic and perceptions of self-efficacy in the workplace. METHODS Participants were 138 first responders from local county police and fire departments who completed online screening measures for probable PTSD and depression, as well as self-reports of work self-efficacy and career calling, between May and June 2020. Statistical analysis occurred between 2020 and 2021. RESULTS Moderation analysis, controlling for depression and relevant covariates, revealed an interaction between PTSD symptoms and career calling, ΔR2=0.04, p=0.017. At low levels of career calling, there was a significant and negative relationship between PTSD symptoms and work self-efficacy (b=‒0.14, p=0.023), but not among first responders with average or high calling (p's>0.58). Positive screening rates were 22% for probable PTSD and 19% for depression. CONCLUSIONS Perceiving a career calling may help protect first responders during COVID-19 from the deleterious effects of PTSD symptomatology on work self-efficacy. Prevention efforts targeting first responders with low calling strength may be warranted.
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Affiliation(s)
| | - Wendi Born
- Department of Psychiatry, University of Kansas School of Medicine, Kansas City, Kansas
| | - Erin Corriveau
- Department of Family Medicine & Community Health, University of Kansas School of Medicine, Kansas City, Kansas
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Barrett JW, Eastley KB, Herbland A, Owen P, Naeem S, Mortimer C, King J, Foster T, Rees N, Rosser A, Black S, Bell F, Fothergill R, Mellett-Smith A, Jackson M, McClelland G, Gowens P, Spaight R, Igbodo S, Brown M, Williams J. The COVID-19 ambulance response assessment (CARA) study: a national survey of ambulance service healthcare professionals' preparedness and response to the COVID-19 pandemic. Br Paramed J 2024; 8:10-20. [PMID: 38445107 PMCID: PMC10910287 DOI: 10.29045/14784726.2024.3.8.4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
Background The COVID-19 pandemic placed significant demand on the NHS, including ambulance services, but it is unclear how this affected ambulance service staff and paramedics in other clinical settings (e.g. urgent and primary care, armed services, prisons). This study aimed to measure the self-perceived preparedness and impact of the first wave of the pandemic on paramedics' psychological stress and perceived ability to deliver care. Methods Ambulance clinicians and paramedics working in other healthcare settings were invited to participate in a three-phase sequential online survey during the acceleration (April 2020), peak (May 2020) and deceleration (September/October 2020) phases of the first wave of COVID-19 in the United Kingdom. Recruitment used social media, Trust internal bulletins and the College of Paramedics' communication channels, employing a convenience sampling strategy. Data were collected using purposively developed open- and closed-ended questions and the validated general health questionnaire-12 (GHQ-12). Data were analysed using multi-level linear and logistic regression models. Results Phase 1 recruited 3717 participants, reducing to 2709 (73%) by phase 2 and 2159 (58%) by phase 3. Participants were mostly male (58%, n = 2148) and registered paramedics (n = 1992, 54%). Mean (standard deviation) GHQ-12 scores were 16.5 (5.2) during phase 1, reducing to 15.2 (6.7) by phase 3. A total of 84% of participants (n = 3112) had a GHQ-12 score ≥ 12 during the first phase, indicating psychological distress. Participants that had higher GHQ-12 scores were feeling unprepared for the pandemic, and reported a lack of confidence in using personal protective equipment and managing cardiac arrests in confirmed or suspected COVID-19 patients. Conclusions Most participants reported psychological distress, the reasons for which are multi-factorial. Ambulance managers need to be aware of the risks to staff mental health and take action to mitigate these, to support staff in the delivery of unscheduled, emergency and urgent care under these additional pressures.
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Affiliation(s)
- Jack William Barrett
- South East Coast Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-0040-537X
| | | | - Anthony Herbland
- University of Hertfordshire ORCID iD: https://orcid.org/0000-0001-6182-4191
| | - Peter Owen
- South East Coast Ambulance Service NHS Foundation Trust
| | - Salman Naeem
- Barts Health NHS Trust ORCID iD: https://orcid.org/0000-0002-0153-1669
| | - Craig Mortimer
- South East Coast Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0001-6989-2244
| | - James King
- University of Hertfordshire ORCID iD: https://orcid.org/0000-0001-9259-0957
| | - Theresa Foster
- East of England Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0002-6395-0885
| | - Nigel Rees
- Welsh Ambulance Services NHS Trust ORCID iD: https://orcid.org/0000-0001-8799-5335
| | - Andy Rosser
- West Midlands Ambulance Service University NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-5477-4269
| | - Sarah Black
- South Western Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0001-6678-7502
| | - Fiona Bell
- Yorkshire Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-4503-1903
| | - Rachael Fothergill
- London Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-1341-6200
| | - Adam Mellett-Smith
- London Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0002-6157-8979
| | | | - Graham McClelland
- North East Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-4502-5821
| | - Paul Gowens
- Scottish Ambulance Service ORCID iD: https://orcid.org/0000-0002-9311-3885
| | - Robert Spaight
- East Midlands Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-4361-5876
| | - Sandra Igbodo
- North West Ambulance Service NHS Trust ORCID iD: https://orcid.org/0009-0001-8290-0912
| | - Martina Brown
- South Central Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0003-3083-8958
| | - Julia Williams
- South East Coast Ambulance Service NHS Foundation Trust; University of Hertfordshire; College of Paramedics ORCID iD: https://orcid.org/0000-0003-0796-5465
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Su Z, McDonnell D, Bentley BL, Cheshmehzangi A, Ahmad J, Šegalo S, da Veiga CP, Xiang YT. Pandemic Volunteers: The Imperative for Regulations and Training. Disaster Med Public Health Prep 2024; 18:e36. [PMID: 38410072 DOI: 10.1017/dmp.2023.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Affiliation(s)
- Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
- Institute for Human Rights, Southeast University, Nanjing, China
| | - Dean McDonnell
- Department of Humanities, South East Technological University, Carlow, Ireland
| | - Barry L Bentley
- Cardiff School of Technologies, Cardiff Metropolitan University, Cardiff, United Kingdom
- Collaboration for the Advancement of Sustainable Medical Innovation, University College London, London, United Kingdom
| | - Ali Cheshmehzangi
- Center of Innovation for Education and Research (CIER), Qingdao City University, Qingdao, Zhejiang, China
- Network for Education and Research on Peace and Sustainability, Hiroshima University, Hiroshima, Japan
| | - Junaid Ahmad
- School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Sabina Šegalo
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, University of Macau, Macao SAR, China
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Witkowski K, Lofaro RJ, Headley AM, Contreras S, Remington CL, Ganapati NE. Understanding problematic substance use among first responders during the COVID-19 pandemic: A survey of law enforcement, fire, and EMS workers in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104261. [PMID: 38006639 DOI: 10.1016/j.drugpo.2023.104261] [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: 06/21/2023] [Revised: 09/27/2023] [Accepted: 11/09/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND First responders have experienced increased levels of stress, anxiety, and depression due to job-related pressures associated with the COVID-19 pandemic. However, little is known about the factors associated with first responder drug and alcohol use during this time. METHODS We conducted a nationwide survey of first responders (n = 2801) to understand the relationship between work pressures, workplace support strategies, and problematic substance use during the early stages of the COVID-19 pandemic. We employed structural equation modeling to analyze whether burnout mediated these relationships. RESULTS Descriptive statistics showed that 60.8 % reported no concerns with substance use. While general workplace support strategies were negatively associated with problematic substance use, specific COVID-related strategies, such as providing compensation during quarantine, were positively associated with problematic substance use. Burnout fully mediated relationships between workplace support strategies and problematic substance use. Finally, providing spaces at work to decompress was negatively associated with problematic substance use and burnout. CONCLUSION Although work pressures increased burnout and problematic substance use among first responders, general workplace support strategies (e.g., decompression spaces) reduced problematic substance use while some COVID-related strategies (e.g. compensation during quarantine) increased problematic substance use. Policy interventions to address problematic substance use should focus on providing spaces for first responders to decompress at work, as well as implementing strategies (e.g., access to mental health services, time off) to reduce burnout. However, organizations should be mindful that not all interventions will have their intended impact and some interventions may unintentionally contribute to negative employee outcomes.
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Affiliation(s)
- Kaila Witkowski
- Florida Atlantic University, Department of Public Administration, United States.
| | - Ryan J Lofaro
- Georgia Southern University, Department of Public and Nonprofit Studies, United States
| | | | - Santina Contreras
- University of Southern California, Department of Urban Planning and Spatial Analysis, United States
| | - Christa L Remington
- University of South Florida, Department of Public Administration, United States
| | - N Emel Ganapati
- Florida International University, Department of Public Policy and Administration, United States
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Chung S, Lee HS, Jang S, Shin YW, Kim JH, Jun JY. Pandemic Grief Reaction and Intolerance of Uncertainty on the Cognitive-Behavioral Model of COVID-Related Hypochondriasis Among Firefighters. Psychiatry Investig 2023; 20:826-833. [PMID: 37794664 PMCID: PMC10555506 DOI: 10.30773/pi.2023.0165] [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: 05/17/2023] [Accepted: 06/18/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE This study aimed to explore the feasibility of cognitive-behavioral model hypochondriasis regarding coronavirus disease-2019 (COVID-19) among firefighters. In addition, we examined the possible role of their grief reaction and intolerance of uncertainty in the model of COVID-related hypochondriasis. METHODS An anonymous online survey was done on October 27-28, 2022, among firefighters who witnessed people's death. Demographic characteristics were collected, and their psychological states were assessed using rating scales such as the Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Fear of COVID-19 Scale (FCV-19S), Pandemic Grief Scale (PGS), and Intolerance of Uncertainty Scale-12 (IUS-12). RESULTS Their OCS score was expected by the CRBS (β=0.30, p<0.001), FCV-19S (β=0.10, p<0.001), PGS (β=0.29, p<0.001), and IUS12 (β=0.04, p=0.024) (F=134.5, p<0.001). The COVID-related cognitive-behavioral model of hypochondriasis was feasible among firefighters who witnessed people's death. Their pandemic grief reaction and intolerance of uncertainty directly influenced their preoccupation with coronavirus, and viral anxiety and coronavirus reassurance-seeking behavior mediated the relationship. CONCLUSION Firefighters' viral anxiety and coronavirus reassurance-seeking behavior mediated the influence of pandemic grief reaction or intolerance of uncertainty on the preoccupation with coronavirus.
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Affiliation(s)
- Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han-Sung Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soomin Jang
- Department of Psychiatry, SMG-SNU (Seoul National University) Boramae Medical Center, Seoul, Republic of Korea
| | - Yong-Wook Shin
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jin Yong Jun
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Afifi RA, Calderon JL, Pham H, Teahen P, Zarate-Sada S, Sewell DK, Vander Weg MW. Ignored and distressed: a cross-sectional study of the impact of COVID-19 on last responders. BMC Public Health 2023; 23:1637. [PMID: 37633898 PMCID: PMC10463888 DOI: 10.1186/s12889-023-16565-z] [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: 09/18/2022] [Accepted: 08/20/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Last responders constitute an occupational category that includes all those that are involved in the postmortem care of deceased persons and their families. Last responders are exposed to several categories of work-related stressors that affect their health and well-being. COVID-19 exacerbated these stressors. Research to understand the consequences of COVID-19 on the health and wellbeing of last responders is nascent. This study aimed to assess COVID-19 related stress, coping and wellbeing among last responders in the United States. METHODS We conducted a national cross-sectional survey of last responders in July through September of 2020. The survey measured wellbeing, stress, coping, and stigma; COVID-19 experiences, and socio-demographics. A ridge regression model was fit for the outcome variables. RESULTS Analysis was conducted on 366 respondents from 43 states. Respondents were male (55.4%), age 50 + (57.4%), and White non-Hispanic (90.3%); 54% reported moderate-high stress and 41% endorsed mild-severe anxiety. Seventy-seven percent had experienced at least one form of stigma related to their occupation. Variables associated with higher perceived stress and anxiety included gender (female), shorter length of employment, perceiving a higher impact from COVID-19 on everyday life, and increased perceived stigma. CONCLUSIONS Last responders are a critical part of the health care system. Throughout this pandemic, last responders have been frequently ignored and not prioritized for protection and support. Interventions to support last responders cope with stress, and to decrease anxiety are urgently needed. There is also a critical need to challenge community stigma towards last responders.
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Affiliation(s)
- Rima A Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, Iowa, N416, USA.
| | - Jorge Luis Calderon
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, Iowa, N416, USA
| | - Hanh Pham
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Peter Teahen
- Teahen Funeral Home, Cedar Rapids, Iowa, USA
- Clinical Mental Health Counseling, College of Education, University of Iowa, Iowa City, Iowa, USA
| | - Sydney Zarate-Sada
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, Iowa, N416, USA
| | - Daniel K Sewell
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Mark W Vander Weg
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, Iowa, N416, USA
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Mendoza NS, Holmes T. First responder perceptions of the system of care and people who use drugs: Spanning boundaries. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2202-2212. [PMID: 36840907 DOI: 10.1002/jcop.23021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/26/2022] [Accepted: 02/16/2023] [Indexed: 06/14/2023]
Abstract
Addressing the beliefs of first responders about people who use drugs and the system of care with which they interact must be part and parcel to addressing the opioid crisis. Using a boundary spanning framework, we examine how first responders perceive community behavioral health. With qualitative methods, we asked: What are first responders' lived experiences on the frontlines of the opioid crisis? In sum, it is important to consider that there is a critical role that first responders could play in brokering services when they are not themselves behavioral health practitioners but are, importantly, boundary spanners.
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Affiliation(s)
- Natasha S Mendoza
- School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Tasha Holmes
- School of Community Resources and Development, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, Arizona, USA
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Słysz A, Urbańska J. Psychological consequences of experiencing the COVID-19 coronavirus pandemic: early maladaptive schemas and mental health and quality of life. PSYCHOL HEALTH MED 2023; 28:2660-2671. [PMID: 36799473 DOI: 10.1080/13548506.2023.2179645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 02/07/2023] [Indexed: 02/18/2023]
Abstract
The research presented here aimed to determine the psychological consequences of experiencing Poland's coronavirus disease 2019 (COVID-19) pandemic. We focused on changes in mental health (anxiety and depression symptoms, morbid thoughts, and suicidal ideation) and quality of life. Our retrospective study included 499 adults comprising 316 women and 173 men (aged 18-72, Me = 27, SD = 12.48). We employed the following research tools: the General Health Questionnaire (GHQ-30), the shortened version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the abridged version of the Harkavy Asnis Suicide Survey (HASS-BREF) scale to assess the severity of suicidal ideations and behaviors, as well as the Young Schema Questionnaire (YSQ-S3-PL). The questionnaires' instructions for the subjects were modified to obtain information for three specific periods: before the pandemic, at the most difficult time of the pandemic for individuals, and in the last two weeks (the time period preceding data collection; January/February 2021). It emerged that both mental health and quality of life had deteriorated significantly in the studied population. In addition, early maladaptive schemas (Abandonment, Vulnerability to Harm, and Insufficient Self-Control) were likely predictors of mental health deterioration at the most difficult time of the COVID-19 pandemic. The schema of Defectiveness was likely predictor of a lower severity of symptoms of mental health disturbances. If psychological diagnosis covered the identification of thinking patterns typical of maladaptive schemas, which may be a risk factor for mental health deterioration, psychologists could better adapt forms and ways of psychological assistance to the patient's needs.
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Affiliation(s)
- Anna Słysz
- Department of Psychology and Cognitive Sciences, Adam Mickiewicz University, Poznań, Poland
| | - Joanna Urbańska
- Department of Psychology and Cognitive Sciences, Adam Mickiewicz University, Poznań, Poland
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What alleviates depression among medical workers in emergency risk events? The function of subjective social status. Heliyon 2023; 9:e13762. [PMID: 36873523 PMCID: PMC9981910 DOI: 10.1016/j.heliyon.2023.e13762] [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: 09/11/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
Medical workers often face serious family-work conflicts and are prone to depressive symptoms. The present study aimed at investigating associations between family-work conflict and depression in emergencies, and at exploring psychological processes involved in this association. A total of 1347 participants were recruited to complete questionnaires. Results showed that the positive effect of family-work conflict on depression was mediated by the basic psychological needs satisfaction, and subjective social status moderated this relationship as a buffer. For individuals with high levels of subjective social status, the direct and indirect effects of family-work conflict on depression were weaker. This study identified the mediating and moderating mechanisms of family-work conflict and depression. The implications of these findings in both theoretical and practical terms will be discussed.
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Mental Health Risk Factors Related to COVID-19 among Canadian Public Safety Professionals. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint4010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Public safety personnel (PSP) are known to experience difficult and demanding occupational environments, an environment that has been complicated by the COVID-19 pandemic. Firefighters, paramedics, and public safety communicators were among the front-line workers that continued to serve the public throughout the course of the pandemic. The present study considered the potential impacts of the COVID-19 pandemic on self-reported symptoms of mental health challenges in Canadian firefighters, paramedics, and public safety communicators. Participants were firefighters (n = 123), paramedics (n = 246), and public safety communicators (n = 48), who completed an online survey, including demographics, questions related to COVID-19 exposure and worry, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Social Interaction Phobia Scale, and the Posttraumatic Stress Disorder Checklist-5. Results revealed that risk factors for increased mental health symptom reporting were paramedic occupation, self-identified female, younger in age, COVID-19 personal contact, requirement to self-isolate, and self-perception of COVID-19 contraction (without confirmation through testing). The COVID-19 pandemic should be considered a risk factor for increased mental health symptom reporting in PSP.
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Cheng CY, Sun JT, Chang HP, Chen YL, Pei D, Liang YJ. Investigation of Psychological Stress and Sleep Quality of Emergency Medical Technicians in Taiwan Fire Department during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:137. [PMID: 36612456 PMCID: PMC9819878 DOI: 10.3390/ijerph20010137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
When the coronavirus disease 2019 (COVID-19) began to ravage the world in 2019, the World Health Organization became concerned. The epidemic has a high mortality and contagion rate, with severe health and psychological impacts on frontline emergency medical service system practitioners. There are many hospital staff surveys, but few have covered the stress among emergency medical technicians. DASS-21, PSQI, and AUDIT questionnaires were used to evaluate the sources of psychological stress factors of firefighters in Taiwan. Multiple logistic regression was used to analyze the questionnaire content. We conducted questionnaire surveys from May 2022 to July 2022. Our sample comprised 688 participants. The odds ratios of increased depression, anxiety, and stress levels due to reduced family or peer understanding and support were 2.72 (95% CI: 1.50−4.92), p = 0.001; 2.03 (95% CI: 1.11−3.68), p = 0.021; and 3.27 (95% CI: 1.83−5.86), p < 0.001, respectively. The odds ratios of poor sleep quality due to depression, anxiety, and increased stress levels were 5.04 (3.18−7.99), p < 0.001; 2.44 (95% CI: 1.57−3.81), p < 0.001; and 4.34 (95% CI: 2.76−6.82), p-value < 0.001, respectively. During the COVID-19 pandemic, poor sleep quality and a lack of understanding and support from the Taiwan firefighting agency staff, family, or peers resulted in increased depression, anxiety, and stress levels.
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Affiliation(s)
- Chiao-Yin Cheng
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei 220, Taiwan
- Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University, New Taipei 242, Taiwan
| | - Jen-Tang Sun
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei 220, Taiwan
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan 266, Taiwan
| | - Hung-Pin Chang
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei 220, Taiwan
| | - Yen-Lin Chen
- Department of Pathology, Tri-Service General Hospital, Medical Defense Medical Center, Taipei 114, Taiwan
| | - Dee Pei
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 242, Taiwan
| | - Yao-Jen Liang
- Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University, New Taipei 242, Taiwan
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Du BB, Rezvani S, Bigelow P, Nowrouzi-Kia B, Boscart VM, Yung M, Yazdani A. Synthesis of Evidence to Support EMS Personnel's Mental Health During Disease Outbreaks: A Scoping Review. Saf Health Work 2022; 13:379-386. [PMID: 36579015 PMCID: PMC9772480 DOI: 10.1016/j.shaw.2022.08.006] [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: 04/12/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 12/31/2022] Open
Abstract
Emergency medical services (EMS) personnel are at high risk for adverse mental health outcomes during disease outbreaks. To support the development of evidence-informed mitigation strategies, we conducted a scoping review to identify the extent of research pertaining to EMS personnel's mental health during disease outbreaks and summarized key factors associated with mental health outcomes. We systematically searched three databases for articles containing keywords within three concepts: EMS personnel, disease outbreaks, and mental health. We screened and retained original peer-reviewed articles that discussed, in English, EMS personnel's mental health during disease outbreaks. Where inferential statistics were reported, the associations between individual and work-related factors and mental health outcomes were synthesized. Twenty-five articles were eligible for data extraction. Our findings suggest that many of the contributing factors for adverse mental health outcomes are related to inadequacies in fulfilling EMS personnel's basic safety and informational needs. In preparation for future disease outbreaks, resources should be prioritized toward ensuring adequate provisions of personal protective equipment and infection prevention and control training. This scoping review serves as a launching pad for further research and intervention development.
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Affiliation(s)
- Bronson B. Du
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada,Corresponding author. Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON N2G 4M4, Canada.
| | - Sara Rezvani
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Philip Bigelow
- Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada,Institute for Work & Health, Toronto, ON, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Veronique M. Boscart
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada,Canadian Institute for Seniors Care, School of Health and Life Sciences, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Marcus Yung
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Amin Yazdani
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada,Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada,School of Geography and Earth Sciences, McMaster University, Hamilton, ON, Canada
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13
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Bahji A, Di Nota PM, Groll D, Carleton RN, Anderson GS. Psychological interventions for post-traumatic stress injuries among public safety personnel: a systematic review and meta-analysis. Syst Rev 2022; 11:255. [PMID: 36434683 PMCID: PMC9701019 DOI: 10.1186/s13643-022-02112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Public safety personnel (PSP) are exposed to potentially psychologically traumatic events (PPTE) far more often than the general public, which increases the risk for various post-traumatic stress injuries (PTSIs). While there are many evidence-based psychological interventions for PTSI, the effectiveness of each intervention for PSP remains unclear. OBJECTIVES The current study assessed the effectiveness and acceptability of psychological interventions for PTSI among PSPs. METHODS A systematic review and random-effects meta-analysis were performed on the effectiveness and acceptability of psychotherapies for PTSIs (i.e., symptoms of depression, anxiety, post-traumatic stress disorder) among PSP. The review adhered to the PRISMA reporting guidelines and used standardized mean differences (Cohen's d), rate ratios (RR), and their 95% confidence intervals (95% CI) to measure pooled effect sizes across studies; negative d values and RR values less than one indicated a reduction in symptoms compared to baseline or control groups. In addition, heterogeneity was quantified using I2, and publication bias was evaluated using Egger's test. RESULTS The analyses included data from eight randomized controlled trials representing 402 PSP (79.4% male, 35.3 years). Psychological interventions included narrative exposure therapy (n = 1), cognitive behavioral therapy (n = 2), eclectic psychotherapy (n = 2), eye-movement desensitization and reprocessing (n = 1), supportive counseling (n = 2), and group critical incident stress debriefing (n = 1). The interventions were associated with statistically significant reductions in symptoms associated with PTSD (d = - 1.23; 95% CI - 1.81, - 0.65; 7 studies; I2 = 81%), anxiety (- 0.76; 95% CI - 1.28, - 0.24; 3 studies; I2 = 47%), and depression (d = - 1.10; 95% CI - 1.62, - 0.58; 5 studies; I2 = 64%). There were smaller but statistically significant improvements at follow-up for symptoms of PTSD (d = - 1.29 [- 2.31, - 0.27]), anxiety (d = - 0.82 [- 1.20, - 0.44]), and depression (d = - 0.46 [- 0.77, - 0.14]). There were no statistically significant differences in dropout rates (RR = 1.00 [0.96, 1.05]), suggesting high acceptability across interventions. CONCLUSIONS There is preliminary evidence that psychotherapies help treat PTSIs in PSP; however, the shortage of high-quality studies on PSP indicates a need for additional research into treating PTSI among PSP. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42019133534.
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Affiliation(s)
- Anees Bahji
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Paula M Di Nota
- Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, Vancouver, BC, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
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14
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Mengin AC, Rolling J, Porche C, Durpoix A, Lalanne L. The Intertwining of Posttraumatic Stress Symptoms, Alcohol, Tobacco or Nicotine Use, and the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14546. [PMID: 36361425 PMCID: PMC9658659 DOI: 10.3390/ijerph192114546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Posttraumatic stress symptoms (PTSSs) and alcohol, tobacco, or nicotine use are frequently associated conditions. The COVID-19 pandemic has been a stressful situation globally and has worsened mental health conditions and addictions in the population. Our systematic review explores the links between PTSSs and (1) alcohol use and (2) tobacco or nicotine use during the COVID-19 pandemic. METHODS We searched the PubMed, PsycINFO, and Web of Science databases for studies published between January 2020 and 16 December 2021. We included studies published in English concerning adults or adolescents. Included articles dealt simultaneously with the COVID-19 pandemic, PTSSs, and alcohol, tobacco, or nicotine use. The reports included were cross-sectional, longitudinal, or cohort studies. We categorized the reports according to the population explored. Our main outcomes are the impacts of PTSSs on (1) alcohol use and (2) tobacco and nicotine use and their relation to COVID-19-related stressors (worries, exposure, lockdown, and infection, either of self or relatives). RESULTS Of the 503 reports identified, 44 were assessed for eligibility, and 16 were included in our review, encompassing 34,408 participants. The populations explored were the general population, healthcare workers, war veterans, patients with substance use disorders, and other vulnerable populations. Most studies were online surveys (14) with cross-sectional designs (11). Every study explored alcohol use, while only two assessed tobacco use. In most populations explored, a high level of PTSSs was associated with alcohol use increase. COVID-19-related stress was frequently correlated with either high PTSSs or alcohol use. In healthcare workers, PTSSs and alcohol use were not associated, while COVID-19 worries were related to both PTSSs and alcohol use. DISCUSSION 1. PTSSs and increased alcohol use are frequently associated, while COVID-19 worries might trigger both conditions and worsen their association. Alcohol use increase may represent either an inadequate way of coping with PTSSs or a vulnerability amid the COVID-19 pandemic, leading to PTSSs. As most studies were cross-sectional online surveys, longitudinal prospective studies are needed to ascertain the direction of the associations between these conditions. These studies need to be sufficiently powered and control for potential bias and confounders. 2. Our review highlighted that research about PTSSs and tobacco or nicotine use is scarce.
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Affiliation(s)
- Amaury C. Mengin
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Regional Center for Psychotrauma Great East, 67000 Strasbourg, France
- Institut National de la Santé et de la Recherche Médiale, Unité de Recherche 1114 (INSERM U1114), Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, 67000 Strasbourg, France
| | - Julie Rolling
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Regional Center for Psychotrauma Great East, 67000 Strasbourg, France
- Centre National de la Recherche Scientifique Unité Propre de Recherche 3212 (CNRS UPR 3212), Institute for Cellular and Integrative Neurosciences (INCI), 67000 Strasbourg, France
| | - Christelle Porche
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Institut National de la Santé et de la Recherche Médiale, Unité de Recherche 1114 (INSERM U1114), Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, 67000 Strasbourg, France
| | - Amaury Durpoix
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Faculty of Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Laurence Lalanne
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Institut National de la Santé et de la Recherche Médiale, Unité de Recherche 1114 (INSERM U1114), Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, 67000 Strasbourg, France
- Faculty of Medicine, Strasbourg University, 67000 Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, 67000 Strasbourg, France
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15
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Corbett B, Feeney A, McCormack T. Prosocial risk taking and interpersonal regret in children: An individual differences study. SOCIAL DEVELOPMENT 2022. [DOI: 10.1111/sode.12638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Aidan Feeney
- School of Psychology Queen's University Belfast Belfast UK
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16
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Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity. Behav Res Ther 2022; 156:104141. [PMID: 35752013 PMCID: PMC9212258 DOI: 10.1016/j.brat.2022.104141] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/18/2022] [Accepted: 06/03/2022] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic is associated with an increased prevalence of mental health problems and addictive behaviors. There is a growing theoretical and empirical evidence that individual differences in interoceptive anxiety-related processes are a one set of vulnerability factors that are important in understanding the impact of pandemic-related mental health problems and addictive behavior. However, there has not been a comprehensive effort to explore this rapidly growing body of research and its implications for public health. In this paper, we discuss why interoceptive anxiety-related processes are relevant to understanding mental health and addictive behaviors during the COVID-19 pandemic. We then provide a narrative review of the available COVID-19 literature linking interoceptive fear and anxiety-related processes (e.g., anxiety sensitivity, health anxiety, and COVID-19 anxiety, fear, and worry) to mental health and addictive behaviors. We then propose a novel transdiagnostic theoretical model that highlights the role of interoceptive anxiety-related processes in mental health and addictive behavior in the context of the present and future pandemics. In the final section, we utilize this conceptualization to underscore clinical implications and provide guidance for future research initiatives in the management of COVID-19 mental health and addictive behaviors and inform the public health field for future pandemics.
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17
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Voth J, Jaber L, MacDougall L, Ward L, Cordeiro J, Miklas EP. The presence of psychological distress in healthcare workers across different care settings in Windsor, Ontario, during the COVID-19 pandemic: A cross-sectional study. Front Psychol 2022; 13:960900. [PMID: 36110267 PMCID: PMC9469090 DOI: 10.3389/fpsyg.2022.960900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/12/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Few studies have examined psychological distress in healthcare workers (HCWs) across the care continuum. This study describes distress levels reported by HCWs across care settings and factors associated with distress. Methods A cross-sectional survey of HCWs from Windsor, Ontario, was conducted between May 30th, 2020, and June 30th, 2020. The survey included the Kessler Psychological Distress Scale (K10), sociodemographic, frontline status, perceptions of training, protection, support, respect among teams, and professional and personal stressors. Univariate analyses were used to compare across settings and multivariate logistic regression assessed factors associated with distress. Results Four hundred and three HCWs from the hospital (49.4%), community health and social service (18.4%), first responder (14.7%), primary care (7.9%), home (6.0%), and long-term care (LTC; 4.0%) participated in the survey. Common concerns included fear of transmitting COVID-19 to family, safety on the job, and balancing personal care with work demands. LTC and home-care HCWs reported greater concern about workload and staffing levels, whereas community health workers were more anxious about their financial security. Overall, 228 (74.2%) HCWs who completed the K10 reported high distress, with greater rates among hospital and LTC HCWs. Distress was more likely in HCWs who identified as female, younger than 55, perceived lower respect among team, and experienced greater worry about physical and mental health and managing high workloads. Conclusion Results showed a high degree of distress experienced by HCWs across care settings and the impact of the COVID-19 pandemic on personal and work-related stress. Promoting self-care and supportive and collaborative healthcare teams are promising avenues for mitigating symptoms of distress.
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Affiliation(s)
- Jennifer Voth
- Hôtel-Dieu Grace Healthcare, Windsor, ON, Canada
- Faculty of Human Kinetics, University of Windsor, Windsor, ON, Canada
- *Correspondence: Jennifer Voth,
| | - Lindsey Jaber
- Faculty of Education, University of Windsor, Windsor, ON, Canada
| | | | - Leslee Ward
- Hôtel-Dieu Grace Healthcare, Windsor, ON, Canada
| | | | - Erica P. Miklas
- Faculty of Education, University of Windsor, Windsor, ON, Canada
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18
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Huang G, Chu H, Chen R, Liu D, Banda KJ, O’Brien AP, Jen HJ, Chiang KJ, Chiou JF, Chou KR. Prevalence of depression, anxiety, and stress among first responders for medical emergencies during COVID-19 pandemic: A meta-analysis. J Glob Health 2022; 12:05028. [PMID: 35871411 PMCID: PMC9309001 DOI: 10.7189/jogh.12.05028] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Garry Huang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
- Australasian College of Paramedicine, Australia
- Australian Institute of Project Management, Australia
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ruey Chen
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Doresses Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Wan Fang Hospital, Taipei Medical University
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kondwani Joseph Banda
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Anthony Paul O’Brien
- Clinical Nursing, Centre for Practice Opportunity and Development, Australia
- School of Nursing and Midwifery, Peninsula campus, Monash University, Frankston, Victoria, Australia
| | - Hsiu-Ju Jen
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Kai-Jo Chiang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Tri-Service General Hospital Taipei, Taiwan
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Jeng-Fong Chiou
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Kuei-Ru Chou
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
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19
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Qian J, Tong J, Xu R. Can Physical Exercise Help Deal With the COVID-19 Stressors? Comparing Somatic and Psychological Responses. Front Psychol 2022; 13:883801. [PMID: 35911012 PMCID: PMC9326507 DOI: 10.3389/fpsyg.2022.883801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/23/2022] [Indexed: 01/09/2023] Open
Abstract
This research aims to explore whether physical exercise can buffer the impact of the COVID-19 stressors. Based on the cross-stressor adaptation hypothesis, we proposed a moderated mediation model relating the COVID-19 stressors to sleep disorder via somatic and worry complaints, depending on the amount of physical exercise. A sample of working adults in Beijing (N = 207) filled surveys in two waves during the COVID-19 pandemic. Structural regression analysis showed that physical exercise moderates the impact of the COVID-19 stressors on sleep disorder via somatic complaints (index = -0.11, 95% CI [-0.22, -0.01]), rather than psychological worry complaints (index = -0.01, 95% CI [-0.07, 0.04]). Specifically, the COVID-19 stressors increase somatic complaints for people with a low amount of physical exercise (b = 0.17, p = 0.01]), while the COVID-19 stressors are not significantly related to somatic complaints for people with a high amount of physical exercise (b = -0.06, p = 0.33). This research extends the cross-stressor adaptation hypothesis and provides evidence on an individual intervention of physical exercise to deal with the COVID-19 pandemic.
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Affiliation(s)
- Junwei Qian
- Department of Physical Education and Research, Peking University, Beijing, China
| | - Jiajin Tong
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China,*Correspondence: Jiajin Tong,
| | - Ruiheng Xu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
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20
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Sabbaghi M, Miri K, Kahi R, Nia MN. Investigation of stress, anxiety, and depression levels of Pre-Hospital Emergency Medicine personnel in eastern Iran during the Covid-19 pandemic. BMC Emerg Med 2022; 22:97. [PMID: 35659184 PMCID: PMC9164470 DOI: 10.1186/s12873-022-00647-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pre-hospital emergency medicine (PHEM) personnel are at risk of developing psychological disorders during the Covid-19 pandemic. This study aimed to investigate depression, anxiety, and stress levels of the Iranian PHEM personnel during the Covid-19 pandemic. Methods This descriptive cross-sectional study was performed on 544 PHEM personnel chosen by purposive sampling in North Khorasan, Khorasan-Razavi, South Khorasan, Sistan-Baluchestan, and Kerman provinces in eastern Iran from August to September 2021. Data collection tools included a demographic information questionnaire and the standardized 21-item Depression, Anxiety, and Stress Scale (DASS-21). Data were analyzed in SPSS 16 using one-way analysis of variance and linear regression. Results The mean scores of depression, anxiety, and stress were 8.7 ± 9.2, 7.0 ± 7.8, and 11.6 ± 9.2, respectively. Depression, stress, and anxiety were more prevalent in the age group of 41-55 years, people with master’s and higher degrees, people with a history of underlying diseases, and people with over 10 years of work experience(p < 0.05). Depression and stress also showed a significant relationship with the type of employment. Stress alone was also significantly associated with working less than 35 hours a week and living separately from family(p < 0.05). Conclusions PHEM personnel suffer from significant levels of depression, anxiety, and stress during the Covid-19 pandemic. Therefore, in order to improve the mental condition, it is recommended that the work schedule and services provided to these people be designed in such a way that they have more time for rest and communication with their family members. The personnel should also have easier access to the expert team in the fields of counseling and psychiatry.
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21
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Isakov A, Carr M, Munjal KG, Kumar L, Gausche-Hill M. EMS Agenda 2050 Meets the COVID-19 Pandemic. Health Secur 2022; 20:S97-S106. [PMID: 35475661 DOI: 10.1089/hs.2021.0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alexander Isakov
- Alexander Isakov, MD, MPH, FACEP, FAEMS, is a Professor of Emergency Medicine, Section of Prehospital and Disaster Medicine, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA
| | - Michael Carr
- Michael Carr, MD, FACEP, is an Assistant Professor of Emergency Medicine, Section of Prehospital and Disaster Medicine, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA
| | - Kevin G Munjal
- Kevin G. Munjal, MD, MPH, MSCR, is an Associate Professor of Emergency Medicine and Population Health Science and Policy, Departments of Emergency Medicine, Population Health Science and Policy, and Prehospital Care, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lekshmi Kumar
- Lekshmi Kumar, MD, MPH, FACEP, FAEMS, is an Associate Professor of Emergency Medicine, Section of Prehospital and Disaster Medicine, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA
| | - Marianne Gausche-Hill
- Marianne Gausche-Hill MD, FACEP, FAAP, FAEMS, is a Professor of Clinical Emergency Medicine and Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA
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22
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Xue Y, Lopes J, Ritchie K, D'Alessandro AM, Banfield L, McCabe RE, Heber A, Lanius RA, McKinnon MC. Potential Circumstances Associated With Moral Injury and Moral Distress in Healthcare Workers and Public Safety Personnel Across the Globe During COVID-19: A Scoping Review. Front Psychiatry 2022; 13:863232. [PMID: 35770054 PMCID: PMC9234401 DOI: 10.3389/fpsyt.2022.863232] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Healthcare workers (HCWs) and public safety personnel (PSP) across the globe have continued to face ethically and morally challenging situations during the COVID-19 pandemic that increase their risk for the development of moral distress (MD) and moral injury (MI). To date, however, the global circumstances that confer risk for MD and MI in these cohorts have not been systematically explored, nor have the unique circumstances that may exist across countries been explored. Here, we sought to identify and compare, across the globe, potentially morally injurious or distressful events (PMIDEs) in HCWs and PSP during the COVID-19 pandemic. A scoping review was conducted to identify and synthesize global knowledge on PMIDEs in HCWs and select PSP. Six databases were searched, including MEDLINE, EMBASE, Web of Science, PsychInfo, CINAHL, and Global Health. A total of 1,412 articles were retrieved, of which 57 articles were included in this review. These articles collectively described the experiences of samples from 19 different countries, which were comprised almost exclusively of HCWs. Given the lack of PSP data, the following results should not be generalized to PSP populations without further research. Using qualitative content analysis, six themes describing circumstances associated with PMIDEs were identified: (1) Risk of contracting or transmitting COVID-19; (2) Inability to work on the frontlines; (3) Provision of suboptimal care; (4) Care prioritization and resource allocation; (5) Perceived lack of support and unfair treatment by their organization; and (6) Stigma, discrimination, and abuse. HCWs described a range of emotions related to these PMIDEs, including anxiety, fear, guilt, shame, burnout, anger, and helplessness. Most PMIDE themes appeared to be shared globally, particularly the 'Risk of contracting or transmitting COVID-19' and the 'Perceived lack of support and unfair treatment by their organization.' Articles included within the theme of 'Stigma, discrimination, and abuse' represented the smallest global distribution of all PMIDE themes. Overall, the present review provides insight into PMIDEs encountered by HCWs across the globe during COVID-19. Further research is required to differentiate the experience of PSP from HCWs, and to explore the impact of social and cultural factors on the experience of MD and MI.
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Affiliation(s)
- Yuanxin Xue
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Faculty of Health Science, McMaster University, Hamilton, ON, Canada
| | - Jillian Lopes
- Psychology, Neuroscience and Behaviour Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Kimberly Ritchie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada
| | | | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, ON, Canada
| | - Randi E McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Alexandra Heber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Veterans Affairs Canada, Ottawa, ON, Canada.,Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Ruth A Lanius
- Homewood Research Institute, Guelph, ON, Canada.,Department of Psychiatry, Western University of Canada, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada.,St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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23
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Croghan IT, Hurt RT, Aakre CA, Fokken SC, Fischer KM, Lindeen SA, Schroeder DR, Ganesh R, Ghosh K, Bauer BA. Virtual Reality for Health Care Professionals During a Pandemic: A Pilot Program. J Prim Care Community Health 2022; 13:21501319221086716. [PMID: 35352605 PMCID: PMC8972930 DOI: 10.1177/21501319221086716] [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] [Indexed: 12/04/2022] Open
Abstract
Objective: The purpose of this pilot study was to evaluate the safety and use of a nature-based virtual reality (VR) experience among health care providers (HCP) during a pandemic. Methods: Twenty-four frontline HCP participated in this crossover pilot where the viewing order of the experiences were randomized. All participants attended in-person consent, baseline, and end-of-study visits. The intervention consisted of viewing 2 nature-based scenes (“walk in the woods” and “forest of focus”) through 3-D VR and with computer 4K graphic imagery. Randomization took place with regards to the viewing order (VR vs 4K computer video, scene 1 and 2). Outcomes measured were safety, acceptability and changes in intensity of anxiety feelings, resilience, emotional distress, cognitive function, and self-efficacy. Results: Among the 26 HCP expressing interest in the study, 24 enrolled in this study. The majority were male (58.3%), white (66.7%) and of an average age of 46.3 ± 10.5 years (standard deviation (SD)). End of the study survey showed that almost all participants (96%) would participate in the study again and recommend it to others. Twenty-three of the 24 participants also felt relaxed after seeing the imagery. With respect to anxiety (as measured by the STAI Y1), the VR “walk in the woods” had the greatest reduction from pre to post (6.4 points, SD = 5.98) followed by VR “forest of focus” (5.8 points, SD = 9.29), computer screen “forest of focus” (5.0 points, SD = 8.89), and computer screen “walk in the woods” (4.1 points, SD = 6.22). All 4 sessions had a significant decrease in score from pre to post (P-values ≤.005), but there was no significant difference in the change from pre- to post-session between the 4 groups (P-value = .5835). Conclusion: The use of the VR among HCP has promise for reducing stress among health care providers during a high stress period, such as a pandemic but much larger studies are needed.
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24
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Aslaner H, Özen B, Erten ZK, Gökçek MB. Death and COVID-19 Anxiety in Home-Quarantined Individuals Aged 65 and Over During the Pandemic. OMEGA-JOURNAL OF DEATH AND DYING 2021; 85:246-258. [PMID: 34873982 PMCID: PMC9039587 DOI: 10.1177/00302228211059894] [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] [Indexed: 11/15/2022]
Abstract
Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.
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Affiliation(s)
- Hümeyra Aslaner
- Family Medicine, 147026Kayseri City Hospital, Kayseri, Turkey
| | - Betül Özen
- Faculty of Health, Department of Community Health Nursing, 52958Erciyes University, Kayseri, Turkey
| | - Zeliha K Erten
- Department of Nursing, Health Sciences Faculty, 218509Nuh Naci Yazgan University, Kayseri, Turkey
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Soto-Cámara R, García-Santa-Basilia N, Onrubia-Baticón H, Cárdaba-García RM, Jiménez-Alegre JJ, Reques-Marugán AM, Molina-Oliva M, Fernández-Domínguez JJ, Matellán-Hernández MP, Morales-Sanchez A, Navalpotro-Pascual S. Psychological Impact of the COVID-19 Pandemic on Out-of-Hospital Health Professionals: A Living Systematic Review. J Clin Med 2021; 10:jcm10235578. [PMID: 34884280 PMCID: PMC8658089 DOI: 10.3390/jcm10235578] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/23/2022] Open
Abstract
Health professionals (HPs), especially those working in the front line, have been one of the groups most affected by the COVID-19 pandemic. The objective of this study is to identify the best available scientific evidence on the impact of the COVID-19 pandemic on the mental health of out-of-hospital HPs in terms of stress, anxiety, depression, and self-efficacy. A living systematic review of the literature was designed, consulting the electronic online versions of the CINHAL, Cochrane Library, Cuiden, IBECS, JBI, LILACS, Medline PyscoDoc, PsycoINFO, Scopus, and Web of Science databases in November 2021. Original research was selected, published in either English, Spanish, French, Italian, or Portuguese. In total, 2082 publications were identified, of which 16 were included in this review. The mental health of out-of-hospital HPs was affected. Being a woman or having direct contact with patients showing suspicious signs of COVID-19 or confirmed cases were the factors related to a greater risk of developing high levels of stress and anxiety; in the case of depressive symptoms, it was having a clinical history of illnesses that could weaken their defenses against infection. Stopping unpleasant emotions and thoughts was the coping strategy most frequently used by these HPs.
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Affiliation(s)
- Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain;
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Noemí García-Santa-Basilia
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
- Correspondence: (N.G.-S.-B.); (R.M.C.-G.)
| | - Henar Onrubia-Baticón
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Rosa M. Cárdaba-García
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
- Nursing Department, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
- Correspondence: (N.G.-S.-B.); (R.M.C.-G.)
| | - José Julio Jiménez-Alegre
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain; (J.J.J.-A.); (J.J.F.-D.); (S.N.-P.)
| | - Ana María Reques-Marugán
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - María Molina-Oliva
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | | | - María Paz Matellán-Hernández
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Almudena Morales-Sanchez
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Susana Navalpotro-Pascual
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain; (J.J.J.-A.); (J.J.F.-D.); (S.N.-P.)
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Roncone R, Giusti L, Mammarella S, Salza A, Bianchini V, Lombardi A, Prosperocco M, Ursini E, Scaletta V, Casacchia M. "Hang in There!": Mental Health in a Sample of the Italian Civil Protection Volunteers during the COVID-19 Health Emergency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8587. [PMID: 34444336 PMCID: PMC8394470 DOI: 10.3390/ijerph18168587] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 01/23/2023]
Abstract
Few studies have been conducted on civil volunteers and their emotional conditions concerning the current COVID-19 pandemic. The present study aimed to evaluate the impact of the COVID-19 emergency on the mental health (general well-being, depression level, and post-traumatic distress), coping strategies, and training needs in an Italian sample of 331 Civil Protection volunteers of the L'Aquila province, during the first nationwide "lockdown" (8 March-3 June 2020). The rate of respondents to the online survey was limited (11.5%), presumably because displaying distress would be considered a sign of "weakness", making volunteers unable to do their jobs. More than 90% of the volunteers showed good mental health conditions and a wide utilization of positive coping strategies, with the less experienced displaying better emotional conditions compared to colleagues with 10 or more years of experience. The type of emergency, the relatively few cases of contagion and mortality in the territory compared to the rest of Italy, and the sense of helping the community, together with the awareness of their group identity, could have contributed to the reported well-being. These results may help to identify the needs of volunteers related to this new "urban" emergency to improve both their technical and emotional skills.
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Affiliation(s)
- Rita Roncone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
- University Unit Rehabilitation Treatment, Early Interventions in Mental Health, Hospital S. Salvatore, 67100 L’Aquila, Italy
| | - Laura Giusti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
| | - Silvia Mammarella
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
| | - Anna Salza
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
| | - Valeria Bianchini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
| | - Annalina Lombardi
- LARES Italia—Unione Nazionale Laureati Esperti in Protezione Civile, 67100 L’Aquila, Italy; (A.L.); (M.P.); (E.U.); (V.S.)
| | - Massimo Prosperocco
- LARES Italia—Unione Nazionale Laureati Esperti in Protezione Civile, 67100 L’Aquila, Italy; (A.L.); (M.P.); (E.U.); (V.S.)
| | - Elio Ursini
- LARES Italia—Unione Nazionale Laureati Esperti in Protezione Civile, 67100 L’Aquila, Italy; (A.L.); (M.P.); (E.U.); (V.S.)
| | - Valentina Scaletta
- LARES Italia—Unione Nazionale Laureati Esperti in Protezione Civile, 67100 L’Aquila, Italy; (A.L.); (M.P.); (E.U.); (V.S.)
| | - Massimo Casacchia
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
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Rogers AH, Zvolensky MJ. Transdiagnostic vulnerability factors for behavioral health problems during COVID-19. Cogn Behav Ther 2021; 50:179-184. [PMID: 34018469 DOI: 10.1080/16506073.2021.1897667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The novel 2019 SARS-2-CoV causing COVID-19 has had a devastating impact on the entire world. COVID-19 is a broad-based stressor, and research to date has documented increases in mental health problems, including anxiety, depression, and substance use, since the onset of COVID-19. By taking a transdiagnostic approach, scholars can help elucidate mechanisms and vulnerability as well as resiliency related to behavioral health problems in the context of COVID-19. The aim of the current special issue of Cognitive Behaviour Therapy was to showcase ongoing research focused on transdiagnostic factors in the context of COVID-19. The purpose of this issue is to highlight the significance of this work in the pandemic for research and practice; illustrate some of the many domains currently being explored via innovative approaches; and explicate fruitful areas for programmatic study. We hope that readers will recognize the important role of transdiagnostic models and their potential to offset the mental, addictive, and physical health disease burden of COVID-19.
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Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,HEALTH Institute, University of Houston, Houston, TX, USA,
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Clemente-Suárez VJ, Navarro-Jiménez E, Ruisoto P, Dalamitros AA, Beltran-Velasco AI, Hormeño-Holgado A, Laborde-Cárdenas CC, Tornero-Aguilera JF. Performance of Fuzzy Multi-Criteria Decision Analysis of Emergency System in COVID-19 Pandemic. An Extensive Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105208. [PMID: 34068866 PMCID: PMC8153618 DOI: 10.3390/ijerph18105208] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 12/20/2022]
Abstract
The actual coronavirus disease 2019 (COVID-19) pandemic has led to the limit of emergency systems worldwide, leading to the collapse of health systems, police, first responders, as well as other areas. Various ways of dealing with this world crisis have been proposed from many aspects, with fuzzy multi-criteria decision analysis being a method that can be applied to a wide range of emergency systems and professional groups, aiming to confront several associated issues and challenges. The purpose of this critical review was to discuss the basic principles, present current applications during the first pandemic wave, and propose future implications of this methodology. For this purpose, both primary sources, such as scientific articles, and secondary ones, such as bibliographic indexes, web pages, and databases, were used. The main search engines were PubMed, SciELO, and Google Scholar. The method was a systematic literature review of the available literature regarding the performance of the fuzzy multi-criteria decision analysis of emergency systems in the COVID-19 pandemic. The results of this study highlight the importance of the fuzzy multi-criteria decision analysis method as a beneficial tool for healthcare workers and first responders’ emergency professionals to face this pandemic as well as to manage the created uncertainty and its related risks.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain;
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain;
- Correspondence: ; Fax: +34-911-413-585
| | - Eduardo Navarro-Jiménez
- Grupo de investigacion en Microbiologia y Biotecnologia (IMB), Universidad Libre, Barranquilla 08002, Colombia;
| | - Pablo Ruisoto
- Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Spain;
| | - Athanasios A. Dalamitros
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece;
| | | | | | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain;
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain;
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Di Nota PM, Bahji A, Groll D, Carleton RN, Anderson GS. Proactive psychological programs designed to mitigate posttraumatic stress injuries among at-risk workers: a systematic review and meta-analysis. Syst Rev 2021; 10:126. [PMID: 33910641 PMCID: PMC8079856 DOI: 10.1186/s13643-021-01677-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/15/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Public safety personnel and frontline healthcare professionals are at increased risk of exposure to potentially psychologically traumatic events (PPTE) and developing posttraumatic stress injuries (PTSI, e.g., depression, anxiety) by the nature of their work. PTSI are also linked to increased absenteeism, suicidality, and performance decrements, which compromise occupational and public health and safety in trauma-exposed workers. Evidence is lacking regarding the effectiveness of "prevention" programs designed to mitigate PTSI proactively. The purpose of this review is to measure the effectiveness of proactive PTSI mitigation programs among occupational groups exposed to PPTE on measures of PTSI symptoms, absenteeism, and psychological wellness. METHODS Five electronic databases were searched per PRISMA guidelines for English or French peer-reviewed studies from 2008 to 2019 evaluating PTSI and psychological wellness in adults exposed to occupational PPTE. The risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS We identified 42 studies evaluating 3182 public safety and frontline healthcare professionals, PPTE-exposed educational staff, and miners. Significant overlap was found across program themes that included mindfulness, psychoeducation, resilience promotion, and stress management strategies. Post-program effect sizes were small (SMD < 0.5) to moderate (SMD < 0.8) for reductions in PTSI symptoms and for promoting measures of well-being as indicated by a meta-analysis on 36 studies. There was no evidence for significant reductions in substance use, absenteeism, or biomarkers of distress except for heart rate. Subgroup analyses indicated that multimodal programs effectively improved general psychological health, while resilience programs improved measures of depression, burnout, coping, and resilience. Effect sizes for resilience, depression, and general psychological health improvements were greatest immediately or 1-month post-training, while improvements in PTSD symptoms and coping were larger at longer follow-up. Studies were of moderate quality and risk of bias. CONCLUSIONS The current results showcase modest evidence for time-limited reductions in PTSI following participation in holistic programs that promote resilience, stress, and emotion regulation among at-risk workers. Implications for organizational implementation of proactive PTSI mitigation programs and areas of future research are discussed. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42019133534).
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Affiliation(s)
- Paula M Di Nota
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Anees Bahji
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, Canada
| | | | - Gregory S Anderson
- Faculty of Science, Thompson Rivers University, TRU Way, Kamloops, BC, V2C 0C8, Canada.
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Abeldaño Zuñiga RA, Juanillo-Maluenda H, Sánchez-Bandala MA, Burgos GV, Müller SA, Rodríguez López JR. Mental Health Burden of the COVID-19 Pandemic in Healthcare Workers in Four Latin American Countries. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211061059. [PMID: 34865558 PMCID: PMC8655476 DOI: 10.1177/00469580211061059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of the study was to assess the mental health burden of the COVID-19 pandemic in healthcare workers in four Latin American countries in 2020.An online survey was carried out with 1721 participants from Argentina, Chile, Colombia and Mexico in 2020. A non-probabilistic convenience sampling method was used to recruit voluntary participants. Post-traumatic stress symptoms were assessed with the SPRINT-E scale, Perceived Discrimination was assessed with a Spanish version of the scale developed by Molero, and anxiety toward death was assessed with the Spanish version of the Templer scale. All instruments were assessed for internal consistency.The overall frequency of post-traumatic stress symptoms was 23.9%. The frequency by countries was 26.4% in Argentina, 29.8% in Chile, 19.9 in Colombia, and 23.8% in Mexico. Post-traumatic stress symptoms were associated with individual subtle discrimination, anxiety toward the death of the elderly, lack of Personal Protective Equipment, and exposition to the death.The COVID-19 pandemic has imposed a mental health burden on health workers in the countries included in the study, not only due to the implications of the disease in the face of exposure to death, but also due to institutional conditions and in which they carry out their work.
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Affiliation(s)
| | | | | | - Graciela Verónica Burgos
- Facultad de Ciencias Médicas, Universidad Nacional de Santiago Del Estero, Santiago Del Estero, Argentina
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