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Georgousopoulou V, Pervanidou P, Perdikaris P, Vlachioti E, Zagana V, Kourtis G, Pavlopoulou I, Matziou V. Covid-19 pandemic? Mental health implications among nurses and Proposed interventions. AIMS Public Health 2024; 11:273-293. [PMID: 38617410 PMCID: PMC11007424 DOI: 10.3934/publichealth.2024014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 04/16/2024] Open
Abstract
Background With its abrupt and huge health and socio-economic consequences, the coronavirus disease (COVID-19) pandemic has led to a uniquely demanding, intensely stressful, and even traumatic period. Healthcare workers (HCW), especially nurses, were exposed to mental health challenges during those challenging times. Objectives Review the current literature on mental health problems among nurses caring for COVID-19 patients. Methods This is a narrative review and critical evaluation of relevant publications. Results Nurses experienced higher levels of stress, burnout, anxiety, depression, frustration, stigma, and depersonalization compared to other HCW. Factors that increased this symptomatology included concerns about infection or infection of family members, inadequate staff protective equipment, extended working hours, insufficient information, a reduced sense of security, and post-traumatic stress disorder. The factors that improved the psychopathology included a general positive attitude, job satisfaction, adequate information and education, harmonious group relationships, post-traumatic development, emotional intelligence, psychological counseling, mindfulness-based stress reduction, stable leadership, guidance, and moral and practical administrative support. Conclusions Recent studies clearly show that nurses, especially women, are the most vulnerable subgroup among HCW and are particularly prone to mental health impacts during the COVID-19 pandemic. The documented mental health vulnerability of frontline nursing staff during the COVID-19 pandemic requires preventive nursing management actions to increase resilience and to develop relevant defense mechanisms.
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Affiliation(s)
- Vasiliki Georgousopoulou
- Department of Research, Quality Control and Continuing Education, University General Hospital of Alexandroupolis
| | - Panagiota Pervanidou
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, “Agia Sophia” Children's Hospital
| | | | - Efrosyni Vlachioti
- Department of Nursing, ‘Aghia Sophia’ Children's Hospital, Athens, Greece
| | - Vaia Zagana
- Department of Nursing, “Sotiria” General Hospital, Athens, Greece
| | - Georgios Kourtis
- Department of Nursing, “Sotiria” General Hospital, Athens, Greece
| | | | - Vasiliki Matziou
- Department of Nursing, National and Kapodistrian University of Athens
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D’Alessandro-Lowe AM, Karram M, Ritchie K, Brown A, Millman H, Sullo E, Xue Y, Pichtikova M, Schielke H, Malain A, O’Connor C, Lanius R, McCabe RE, McKinnon MC. Coping, Supports and Moral Injury: Spiritual Well-Being and Organizational Support Are Associated with Reduced Moral Injury in Canadian Healthcare Providers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6812. [PMID: 37835082 PMCID: PMC10572244 DOI: 10.3390/ijerph20196812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/08/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023]
Abstract
Healthcare providers (HCPs) have described the onset of shame- and trust-violation-related moral injuries (MI) throughout the COVID-19 pandemic. Previous research suggests that HCPs may turn to various coping methods and supports, such as spirituality/religiosity, substance use, friends/family or organizational support, to manage workplace stress. It remains unknown, however, if similar coping methods and supports are associated with MI among this population. We explored associations between MI (including the shame and trust-violation presentations individually) and coping methods and supports. Canadian HCPs completed an online survey about their mental health and experiences during the COVID-19 pandemic, including demographic indices (e.g., sex, age, mental health history) and measures of MI, organizational support, social support, spiritual well-being, self-compassion, alcohol use, cannabis use and childhood adversity. Three hierarchical multiple linear regressions were conducted to assess the associations between coping methods/supports and (i) MI, (ii) shame-related MI and (iii) trust-violation-related MI, when controlling for age, mental health history and childhood adversity. One hundred and seventy-six (N = 176) HCPs were included in the data analysis. Spiritual well-being and organizational support were each significantly associated with reduced total MI (p's < 0.001), shame-related MI (p = 0.03 and p = 0.02, respectively) and trust-violation-related MI (p's < 0.001). Notably, comparison of the standardized beta coefficients suggests that the association between trust-violation-related MI and both spiritual well-being and organizational support was more than twice as great as the associations between these variables and shame-related MI, emphasizing the importance of these supports and the trust-violation outcomes particularly. Mental health history (p = 0.02) and self-compassion (p = 0.01) were additionally related to shame-related MI only. Our findings indicate that heightened levels of spiritual well-being and organizational support were associated with reduced MI among HCPs during the COVID-19 pandemic. Rather than placing sole responsibility for mental health outcomes on HCPs individually, organizations can instead play a significant role in mitigating MI among staff by implementing evidence-informed organizational policies and interventions and by considering how supports for spiritual well-being may be implemented into existing models of care where relevant for employees.
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Affiliation(s)
- Andrea M. D’Alessandro-Lowe
- Department of Psychology Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4L6, Canada;
- Homewood Research Institute, Guelph, ON N13 6K9, Canada
| | - Mauda Karram
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Kim Ritchie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Trent/Fleming School of Nursing, Trent University, Peterborough, ON K9L 0G2, Canada
| | - Andrea Brown
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Heather Millman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Emily Sullo
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Yuanxin Xue
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Temetry Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Mina Pichtikova
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S 1V6, Canada
| | | | - Ann Malain
- Homewood Health Centre, Guelph, ON NIE 6K9, Canada
| | | | - Ruth Lanius
- Homewood Research Institute, Guelph, ON N13 6K9, Canada
- Lawson Health Research Institute, University of Western Ontario, London, ON N6C 2R5, Canada
| | - Randi E. McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
| | - Margaret C. McKinnon
- Homewood Research Institute, Guelph, ON N13 6K9, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
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3
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Ritchie K, D’Alessandro-Lowe AM, Brown A, Millman H, Pichtikova M, Xue Y, Altman M, Beech I, Karram M, Hosseiny F, Rodrigues S, O’Connor C, Schielke H, Malain A, McCabe RE, Heber A, Lanius RA, McKinnon MC. The Hidden Crisis: Understanding Potentially Morally Injurious Events Experienced by Healthcare Providers during COVID-19 in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4813. [PMID: 36981725 PMCID: PMC10049639 DOI: 10.3390/ijerph20064813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/23/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Healthcare providers (HCPs) may be at elevated risk for moral injury due to increased exposure to potentially morally injurious events (PMIEs) throughout the COVID-19 pandemic. Identifying PMIEs experienced during the COVID-19 pandemic is a critical first step for understanding moral injury in HCPs. Accordingly, the purpose of the present study was to gain a deeper understanding of the work-related PMIEs experienced by HCPs in Canada during the pandemic. METHODS Canadian HCPs completed an online survey between February and December 2021 about mental health and functioning, including demographics and the Moral Injury Outcome Scale (MIOS). We conducted a qualitative thematic analysis of PMIEs described extemporaneously by HCPs in the open-text field of the MIOS. RESULTS One-hundred and twenty-four (N = 124) HCPs were included in analysis. Eight PMIE-related themes were identified, comprising patients dying alone; provision of futile care; professional opinion being ignored; witnessing patient harm; bullying, violence and divided opinions; resources and personal protective equipment; increased workload and decreased staffing; and conflicting values. CONCLUSIONS Understanding broad categories of PMIES experienced by Canadian HCPs during the COVID-19 pandemic provides an opportunity to enhance cultural competency surrounding their experiences which will aid the development of targeted prevention and intervention approaches.
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Affiliation(s)
- Kim Ritchie
- Trent/Fleming School of Nursing, Trent University, Peterborough, ON K9L 0G2, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | | | - Andrea Brown
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Heather Millman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Mina Pichtikova
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S 1V6, Canada
| | - Yuanxin Xue
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Maxwell Altman
- Department of Psychology Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Isaac Beech
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Homewood Research Institute, Guelph, ON N1E 6K9, Canada
| | - Mauda Karram
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Fardous Hosseiny
- Atlas Institute of Veterans and Families, Ottawa, ON K1Z 7K4, Canada
- Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON K1Z 7K4, Canada
| | - Sara Rodrigues
- Atlas Institute of Veterans and Families, Ottawa, ON K1Z 7K4, Canada
- Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON K1Z 7K4, Canada
| | | | | | - Ann Malain
- Homewood Health Centre, Guelph, ON N1E 6K9, Canada
| | - Randi E. McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
| | - Alexandra Heber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Veteran’s Affairs Canada, Ottawa, ON K1H 1A1, Canada
| | - Ruth A. Lanius
- Homewood Health Centre, Guelph, ON N1E 6K9, Canada
- Lawson Health Research Institute, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Margaret C. McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Homewood Research Institute, Guelph, ON N1E 6K9, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
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Carleton RN, McCarron M, Krätzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Camp RD, Shields RE, Jamshidi L, Nisbet J, Maguire KQ, MacPhee RS, Afifi TO, Jones NA, Martin RR, Sareen J, Brunet A, Beshai S, Anderson GS, Cramm H, MacDermid JC, Ricciardelli R, Rabbani R, Teckchandani TA, Asmundson GJG. Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel. BMC Psychol 2022; 10:295. [PMID: 36494748 PMCID: PMC9733219 DOI: 10.1186/s40359-022-00989-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/13/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder. METHODS The current protocol paper describes the PSP PTSI Study (i.e., design, measures, materials, hypotheses, planned analyses, expected implications, and limitations), which was originally designed to evaluate an evidence-informed, proactive system of mental health assessment and training among Royal Canadian Mounted Police for delivery among diverse PSP (i.e., firefighters, municipal police, paramedics, public safety communicators). Specifically, the PSP PTSI Study will: (1) adapt, implement, and assess the impact of a system for ongoing (i.e., annual, monthly, daily) evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; and, (4) assess the impact of providing diverse PSP with a tailored version of the Emotional Resilience Skills Training originally developed for the Royal Canadian Mounted Police in mitigating PTSIs based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. Participants are assessed pre- and post-training, and then at a follow-up 1-year after training. The assessments include clinical interviews, self-report surveys including brief daily and monthly assessments, and daily biometric data. The current protocol paper also describes participant recruitment and developments to date. DISCUSSION The PSP PTSI Study is an opportunity to implement, test, and improve a set of evidence-based tools and training as part of an evidence-informed solution to protect PSP mental health. The current protocol paper provides details to inform and support translation of the PSP PTSI Study results as well as informing and supporting replication efforts by other researchers. TRIAL REGISTRATION Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022-Prospectively registered. TRIAL REGISTRATION ClinicalTrials.gov, NCT05530642. Registered 1 September 2022-Retrospectively registered. The subsequent PSP PTSI Study results are expected to benefit the mental health of all participants and, ultimately, all PSP.
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Affiliation(s)
- R. Nicholas Carleton
- grid.57926.3f0000 0004 1936 9131Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Michelle McCarron
- grid.412733.00000 0004 0480 4970Research Department, Saskatchewan Health Authority, Regina, SK S4S 0A5 Canada
| | - Gregory P. Krätzig
- grid.57926.3f0000 0004 1936 9131Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Shannon Sauer-Zavala
- grid.266539.d0000 0004 1936 8438Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY 40506 USA
| | - J. Patrick Neary
- grid.57926.3f0000 0004 1936 9131Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Lisa M. Lix
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3 Canada
| | - Amber J. Fletcher
- grid.57926.3f0000 0004 1936 9131Department of Sociology and Social Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Ronald D. Camp
- grid.266876.b0000 0001 2156 9982Faculty of Business and Economics, University of Northern British Columbia, Prince George, BC V2N 4Z9 Canada
| | - Robyn E. Shields
- grid.57926.3f0000 0004 1936 9131University of Regina, Regina, SK S4S 0A2 Canada
| | - Laleh Jamshidi
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Jolan Nisbet
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Kirby Q. Maguire
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Renée S. MacPhee
- grid.268252.90000 0001 1958 9263Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5 Canada
| | - Tracie O. Afifi
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W5 Canada
| | - Nicholas A. Jones
- grid.57926.3f0000 0004 1936 9131Department of Justice Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Ronald R. Martin
- grid.57926.3f0000 0004 1936 9131Faculty of Education, University of Regina, Regina, SK S4S 0A2 Canada
| | - Jitender Sareen
- grid.21613.370000 0004 1936 9609Department of Psychiatry, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W5 Canada
| | - Alain Brunet
- grid.459278.50000 0004 4910 4652McGill’s Psychiatry Department and Douglas Institute Research Center, 6875 Lasalle Boulevard, Verdun, QC H4H 1R3 Canada
| | - Shadi Beshai
- grid.57926.3f0000 0004 1936 9131Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Gregory S. Anderson
- grid.265014.40000 0000 9945 2031Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8 Canada
| | - Heidi Cramm
- grid.410356.50000 0004 1936 8331School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Joy C. MacDermid
- grid.39381.300000 0004 1936 8884School of Physiotherapy, Western University, London, ON N6A 3K7 Canada
| | - Rosemary Ricciardelli
- grid.25055.370000 0000 9130 6822School of Maritime Studies, Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3 Canada
| | - Rasheda Rabbani
- grid.21613.370000 0004 1936 9609George & Fay Yee Centre for Healthcare Innovation, Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Taylor A. Teckchandani
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Gordon J. G. Asmundson
- grid.57926.3f0000 0004 1936 9131Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
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Andrews KL, Jamshidi L, Nisbet J, Teckchandani TA, Price JAB, Ricciardelli R, Anderson GS, Carleton RN. Assessing the Relative Impact of Diverse Stressors among Canadian Coast Guard and Conservation and Protection Officers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16396. [PMID: 36554280 PMCID: PMC9778725 DOI: 10.3390/ijerph192416396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
Public Safety Personnel (PSP), including members of the Canadian Coast Guard (CCG) and Conservation and Protection (C&P) officers, are regularly exposed to potentially psychologically traumatic events (PPTEs) and other occupational stressors (organizational and operational stressors). The current study quantified occupational stressors among CCG and C&P and assessed relationships with PPTEs and mental health disorders. Participants (n = 341; 58.4% male) completed an online survey assessing self-reported occupational stressors, PPTEs, and mental health disorder symptoms. CCG and C&P Officers reported significantly lower mean overall and item-level organizational and operational stress scores compared to other Canadian PSP. Mean operational stress scores were statistically significantly associated with increased odds of screening positive for all mental disorders and organizational stress scores were statistically significantly associated with increased odds of screening positive for all mental disorders except social anxiety disorder. Participants reported several item-level occupational stressors associated with screening positive for posttraumatic stress disorder, general anxiety disorder, major depressive disorder, social anxiety disorder, panic disorder, and alcohol use disorder, even after accounting for diverse PPTE exposures. Exposure to PPTEs may be a regular part of employment for CCG and C&P PSP; however, bureaucratic red tape, staff shortages, excessive administrative duties, physical conditioning, healthy eating, and fatigue are occupational stressors that appear significantly related to mental health. Ongoing mental health efforts are needed to mitigate and manage the impact of occupational stressors among CCG and C&P.
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Affiliation(s)
- Katie L. Andrews
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Laleh Jamshidi
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jolan Nisbet
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Taylor A. Teckchandani
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jill A. B. Price
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3, Canada
| | - Gregory S. Anderson
- Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - R. Nicholas Carleton
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
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6
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Andrews KL, Jamshidi L, Nisbet J, Teckchandani TA, Price JAB, Ricciardelli R, Anderson GS, Carleton RN. Exposures to Potentially Psychologically Traumatic Events among Canadian Coast Guard and Conservation and Protection Officers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215116. [PMID: 36429829 PMCID: PMC9690280 DOI: 10.3390/ijerph192215116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 05/28/2023]
Abstract
Canadian Public Safety Personnel (PSP) (i.e., municipal/provincial police, firefighters, paramedics, Royal Canadian Mounted Police, correctional workers, dispatchers) report frequent and varied exposures to potentially psychologically traumatic events (PPTEs). Exposure to PPTEs may be one explanation for the symptoms of mental health disorders prevalent among PSP. The objective of the current study was to provide estimates of lifetime PPTE exposures among Canadian Coast Guard (CCG) and Conservation and Protection (C&P) Officers and to assess for associations between PPTEs, mental health disorders, and sociodemographic variables. Participants (n = 412; 55.3% male, 37.4% female) completed an online survey assessing self-reported PPTE exposures and self-reported symptoms of mental health disorders. Participants reported higher frequencies of lifetime exposures to PPTEs than the general population (all ps < 0.001) but lower frequencies than other Canadian PSP (p < 0.5). Several PPTE types were associated with increased odds of positive screens for posttraumatic stress disorder, major depressive disorder, general anxiety disorder, social anxiety disorder, panic disorder, and alcohol use disorder (all ps < 0.05). Experiencing a serious transportation accident (77.4%), a serious accident at work, home, or during recreational activity (69.7%), and physical assault (69.4%) were among the PPTEs most frequently reported by participants. The current results provide the first known information describing PPTE exposures of CCG and C&P members, supporting the growing evidence that PPTEs are more frequent and varied among PSP and can be associated with diverse mental health disorders.
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Affiliation(s)
- Katie L. Andrews
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Laleh Jamshidi
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jolan Nisbet
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Taylor A. Teckchandani
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jill A. B. Price
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3, Canada
| | - Gregory S. Anderson
- Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - R. Nicholas Carleton
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
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7
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"It Is Difficult to Always Be an Antagonist": Ethical, Professional, and Moral Dilemmas as Potentially Psychologically Traumatic Events among Nurses in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031454. [PMID: 35162485 PMCID: PMC8834915 DOI: 10.3390/ijerph19031454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/05/2023]
Abstract
AIMS We explore social and relational dynamics tied to an unexplored potentially psychologically traumatic event (PPTE) that can impact nurses' well-being and sense of their occupational responsibilities: namely, the moral, ethical, or professional dilemmas encountered in their occupational work. DESIGN We used a semi-constructed grounded theory approach to reveal prevalent emergent themes from the qualitative, open-ended component of our survey response data as part of a larger mixed-methods study. METHODS We administered a national Canadian survey on nurses' experiences of occupational stressors and their health and well-being between May and September 2019. In the current study, we analyzed data from four open text fields in the PPTE section of the survey. RESULTS In total, at least 109 participants noted that their most impactful PPTE exposure was a moral, professional, and/or ethical dilemma. These participants volunteered the theme as a spontaneous addition to the list of possible PPTE exposures. CONCLUSIONS Emergent theme analytic results suggest that physicians, other nurses, staff, and/or the decision-making power of patients' families can reduce or eliminate a nurse's perception of their agency, which directly and negatively impacts their well-being and may cause them to experience moral injury. Nurses also report struggling when left to operationalize patient care instructions with which they disagree. IMPACT Nurses are exposed to PPTEs at work, but little is known about factors that can aggravate PPTE exposure in the field, impact the mental wellness of nurses, and even shape patient care. We discuss the implications of PPTE involving moral, professional, and ethical dilemmas (i.e., potentially morally injurious events), and provide recommendations for nursing policy and practice.
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Tomblin Murphy G, Sampalli T, Bourque Bearskin L, Cashen N, Cummings G, Elliott Rose A, Etowa J, Grinspun D, Jones EW, Lavoie-Tremblay M, MacMillan K, MacQuarrie C, Martin-Misener R, Oulton J, Ricciardelli R, Silas L, Thorne S, Villeneuve M. Investing in Canada’s nursing workforce post-pandemic: A call to action. Facets (Ott) 2022. [DOI: 10.1139/facets-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Nurses represent the highest proportion of healthcare workers globally and have played a vital role during the COVID-19 pandemic. The pandemic has shed light on multiple vulnerabilities that have impacted the nursing workforce including critical levels of staffing shortages in Canada. A review sponsored by the Royal Society of Canada investigated the impact of the pandemic on the nursing workforce in Canada to inform planning and implementation of sustainable nursing workforce strategies. The review methods included a trend analysis of peer-reviewed articles, a jurisdictional scan of policies and strategies, analyses of published surveys and interviews of nurses in Canada, and a targeted case study from Nova Scotia and Saskatchewan. Findings from the review have identified longstanding and COVID-specific impacts, gaps, and opportunities to strengthen the nursing workforce. These findings were integrated with expert perspectives from national nursing leaders involved in guiding the review to arrive at recommendations and actions that are presented in this policy brief. The findings and recommendations from this policy brief are meant to inform a national and sustained focus on retention and recruitment efforts in Canada.
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Affiliation(s)
- Gail Tomblin Murphy
- VP Research, Innovation and Discovery and Chief Nurse Executive, Nova Scotia Health, Halifax, NS B3H 1V7, Canada
| | - Tara Sampalli
- Senior Scientific Director, Research, Innovation and Discovery, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Lisa Bourque Bearskin
- Associate Professor, and Researcher, Thompson Rivers University, School of Nursing, Kamloops, BC V2C 0C8, Canada
| | - Nancy Cashen
- Interim Director, Nursing and Professional Practice, IWK Health, Halifax, NS B3K 6R8, Canada
| | - Greta Cummings
- College of Health Sciences, and Professor, Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Annette Elliott Rose
- VP Clinical Care and Chief Nurse Executive, IWK Health, Halifax, NS B3K 6R8, Canada
| | - Josephine Etowa
- Professor at the University of Ottawa’s Faculty of Health Sciences, School of Nursing, Ottawa, ON K1H 8M5, Canada
| | - Doris Grinspun
- Chief Executive Officer of the Registered Nurses’ Association of Ontario, Toronto, ON M2P 2A9, Canada
| | - Esyllt W. Jones
- Professor of History, University of Manitoba, Winnipeg, MB R3T 2M5, Canada
| | - Mélanie Lavoie-Tremblay
- Associate Professor and Vice-Dean research, innovation and entrepreneuriat, Faculty of Nursing, University of Montréal, Montréal, QC H3T 1A8, Canada
| | - Kathleen MacMillan
- Adjunct (retired) Dalhousie University, School of Nursing; Adjunct, University of Prince Edward Island, Faculty of Nursing, Charlottetown, PE C1A 4P3, Canada
| | - Cindy MacQuarrie
- Senior Director, Interprofessional Practice and Learning, IWK Health, Halifax, NS B3H 2Y9, Canada
| | - Ruth Martin-Misener
- Professor and the Director of the School of Nursing and Assistant Dean, Research, at the Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Judith Oulton
- Former Executive Director, Canadian Nurses Association, Ottawa, ON K1Z 7M4, Canada
| | - Rosemary Ricciardelli
- Professor, Sociology, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Linda Silas
- President of Canadian Federation of Nurses Unions, Ottawa, ON K1V 8X7, Canada
| | - Sally Thorne
- Professor, School of Nursing and Associate Dean, Faculty of Applied Science, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Michael Villeneuve
- Chief Executive Officer, Canadian Nurses Association, Ottawa, ON K1Z 7M4, Canada
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Hilton NZ, Ricciardelli R, Shewmake J, Rodrigues NC, Seto MC, Ham E. Perceptions of Workplace Violence and Workplace Stress: A Mixed Methods Study of Trauma among Psychiatric Workers. Issues Ment Health Nurs 2021; 42:797-807. [PMID: 33835903 DOI: 10.1080/01612840.2021.1899350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Posttraumatic stress disorder (PTSD) among psychiatric workers is related to workplace violence and work-specific stress. We used quantitative and qualitative approaches to survey PTSD symptoms, critical events, chronic exposures, and occupational stress in 84 psychiatric workers. All but three had directly experienced critical events, over half experienced someone's life being in danger, and 14% screened positive for PTSD. Symptoms correlated with critical events and perceived threat to life. Respondents described emergency codes, direct involvement, and repeated exposure as most stressful. Symptoms also correlated with nonviolent stressors, replicating previous research and indicating need to reduce both violence and workplace stress.
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Affiliation(s)
- N Zoe Hilton
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | | | | | - Nicole C Rodrigues
- The Royal Ottawa Health Care Group, Brockville Mental Health Centre, Ottawa, Ontario, Canada
| | - Michael C Seto
- The Royal Ottawa Health Care Group, Brockville Mental Health Centre, Ottawa, Ontario, Canada
| | - Elke Ham
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
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Ham E, Ricciardelli R, Rodrigues NC, Hilton NZ, Seto MC. Beyond workplace violence: Direct and vicarious trauma among psychiatric hospital workers. A qualitative study. J Nurs Manag 2021; 30:1482-1489. [PMID: 34254403 DOI: 10.1111/jonm.13420] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/04/2021] [Accepted: 07/08/2021] [Indexed: 12/17/2022]
Abstract
AIM We aimed to explore psychiatric nurses' and other psychiatric workers' understanding of trauma in the context of their relationships with the people they care for and the effects on their mental health. BACKGROUND Workplace violence in psychiatric hospitals can lead to mental health problems, including posttraumatic stress disorder. Professional relationships with the people they care for may complicate psychiatric workers' experiences of trauma. METHODS We qualitatively analysed responses of 30 psychiatric workers who answered relevant open-ended questions in a survey of workplace violence and posttraumatic stress disorder symptoms. RESULTS We found that respondents were profoundly affected by violence and vicarious trauma through the current and previous suffering of people in their care. The effects of vicarious exposure and other potentially psychologically traumatic events were often made worse by lack of organizational support. CONCLUSION Not only direct exposure to violent events but also indirect exposure, vicarious traumatic stress and perceived lack of organizational support affect staff's well-being. IMPLICATIONS FOR NURSING MANAGEMENT Management should ensure that mental health supports are not limited to workers directly affected by workplace violence but should extend to those who witnessed the event and to those regularly exposed to vicarious trauma.
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Affiliation(s)
- Elke Ham
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | | | | | - N Zoe Hilton
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
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