The usefulness of pre-employment and pre-deployment psychological screening for disaster relief workers: a systematic review

Compassion satisfaction and compassion fatigue in humanitarian aid workers: the relationship with shared trauma and coping mechanisms

Introduction

Forced displacement constitutes a global crisis impacting millions of people especially in the Middle East, leaving them impacted by traumatic history. Humanitarian aid workers (HAWs) who support displaced individuals are exposed to high risk of burnout and secondary traumatic stress (STS).

Methods

This study aimed to identify the prevalence of compassion satisfaction (CS) and compassion fatigue (CF), referring to burnout and STS, respectively, using the Professional Quality of Life Scale (ProQOL). The study explored the relationships between these factors and personal variables that are related to shared trauma, as well as coping mechanisms assessed using the Brief-COPE questionnaire among Middle Eastern HAWs working with displaced individuals.

Results

The study involved 78 HAWs supporting displaced individuals in the Middle East. The mean age was 25.81 years (SD = ± 5.54); 55% were females, and the majority (88%) were Syrians. Approximately 90% of participants were engaged in Turkey and Syria. The most prevalent coping mechanisms were religion and planning. Being a graduate predicted burnout, whereas older age, previous mental diagnosis, and shared trauma predicted higher STS levels. Compassion satisfaction was predicted by active coping, and compassion fatigue was predicted by negative coping.

Conclusion

HAWs require education to recognize CF signs and psychological training to promote effective coping mechanisms, mitigate CF, and enhance higher levels of CS. More research is needed on the psychology of HAWs and the role of shared trauma and coping mechanisms.

Psychosocial model of burnout among humanitarian aid workers in Bangladesh: role of workplace stressors and emotion coping

BACKGROUND

While trauma exposure is an established predictor of poor mental health among humanitarian aid workers (HAWs), less is known about the role of psychosocial work-related factors. This study aims to establish a psychosocial model for burnout and psychological distress in HAWs that tests and compares the effects of adversity exposure and workplace stressors in combination, and explores the potential mediating role of individual coping styles.

METHODS

Path analysis and model comparison using cross-sectional online survey data were collected from full-time international and local HAWs in Bangladesh between December 2020 and February 2021. HAWs self-reported on exposure to adversities, workplace psychosocial stressors (Third Copenhagen Psychosocial Questionnaire), coping styles (Coping Inventory for Stressful Situations), burnout (Maslach Burnout Inventory-Human Services Survey), and psychological distress (Kessler-6).

RESULTS

Among N = 111 HAWs, 30.6%, 16.4%, 12.7%, and 8.2% screened positive for moderate psychological distress (8 ≤ Kessler-6 ≤ 12), emotional exhaustion (EE ≥ 27), depersonalization (DP ≥ 13), and severe psychological distress (K-6 ≥ 13), respectively. 28.8% reported a history of mental disorder. The preferred model showed distinct pathways from adversity exposure and workplace stressors to burnout, with negative emotion-focused coping and psychological distress as significant intervening variables. While greater exposure to both types of stressors were associated with higher levels of burnout and distress, workplace stressors had a stronger association with psychological outcomes than adversity exposure did (β = .52, p ≤ .001 vs. β = .20, p = .032). Workplace stressors, but not adversities, directly influenced psychological distress (β = .45, p ≤ .001 vs. β = -.01, p = .927). Demographic variables, task-focused and avoidance-focused coping were not significantly associated with psychological outcomes.

CONCLUSIONS

Compared to exposure to adversities, workplace stressors primarily influenced occupational stress syndromes. Reducing workplace stressors and enhancing adaptive coping may improve psychological outcomes in humanitarian staff.

How do international humanitarian aid workers stay healthy in the face of adversity?

BACKGROUND

International humanitarian aid workers (iHAWs) are motivated strongly to travel abroad to help communities affected by war, famine, disaster and disease. They expose themselves to dangers and hardships during their field assignments. Despite working under such challenging circumstances, most workers remain healthy. The objective of the present study was to unravel the mechanism that enables workers to remain healthy under the same circumstances that affect these communities. We hypothesised that the different components of the Sense of Coherence (SOC) health mechanism mediate the relationship between field stressors and post-assignment health.

METHODS AND FINDINGS

The stress-health model was tested among 465 international aid workers using a longitudinal pre-post assignment study design and structural equation modelling for path analyses. The (health) outcome variables were PTSD, anxiety, depression, emotional exhaustion, and work engagement. Our findings highlight the importance of being healthy before aid assignment and the negative health impact of field stressors that were not potentially traumatic. The SOC components mediated the relationship between field stress and post-assignment health, with males and females using different SOC components to alleviate stress. Males are more likely trying to understand the nature of the stressor, whereas females mobilise their resources to manage stressors. In both groups, a high level of meaningfulness of the work was an important component in maintaining health. Regarding using the SOC concept for understanding the process of maintaining health, our findings indicated that SOC is best considered context-specific and multidimensional.

CONCLUSION

In addition to good pre-mission health, the SOC components help prevent field assignment-related negative health effects in iHAWs. Our findings support the idea to compose gender-balanced teams of iHAWs to maintain and promote health. The findings can be used to develop or refine health conversation tools and SOC based health interventions to promote health and wellbeing and prevent ill-health among aid workers and other stress-exposed populations.

Mental health plan for workers of the London Nightingale Hospital: following the evidence to support staff

The COVID-19 pandemic has extracted an enormous physical health toll on many millions worldwide, and the wider societal impact from economic turmoil, unemployment, social isolation and so forth continue to be measured. A less explored aspect has been the psychological impact on treating healthcare staff, with emerging evidence of 'moral injury' and mental illness for some. This review explores the evidence base for implementing a tiered model of care to minimise this and foster 'post-traumatic growth', and describes the authors' implementation of this in the London Nightingale hospital, with lessons for the armed forces.