Prevalence and Correlates of Mental Health Status Among Pre-Hospital Healthcare Staff

Prevalence of Anxiety, Depression, and Insomnia Among Medical Workers in Emergency Medical Services in Eastern Kazakhstan

Introduction: Studying the prevalence of anxiety, depression, and insomnia among medical workers in emergency medical services is a relevant task that will improve our understanding of scope of the problem and develop effective strategies to support and prevent psychological problems among medical staff. Insomnia is closely linked to anxiety and depression, as sleep disturbances can exacerbate emotional distress, while persistent anxiety and depressive symptoms contribute to sleep disruptions. Individuals suffering from insomnia are at a higher risk of developing anxiety and depression, creating a bidirectional relationship that negatively impacts overall mental well-being. This raises a crucial question: "What specific measures and intervention strategies can be implemented to reduce the levels of anxiety, depression, and insomnia among EMS personnel?" Methods: A cross-sectional study was conducted with the participation of 592 medical workers employed in emergency medical services in the East Kazakhstan and Abay regions of the Republic of Kazakhstan. This study included questions regarding the socio-demographic data of the respondents, questions assessing the severity of insomnia using the Insomnia Severity Index (ISI), and questions from the Hospital Anxiety and Depression Scale (HADS) scale assessing the level of anxiety and depression among the participants. Results: Nearly a third of the EMS personnel reported symptoms of insomnia (28.2% subthreshold, 16.2% insomnia, and 3.0% severe), anxiety (22.1% subclinical, and 13.0% clinical), or depression (20.4% subclinical, and 9.8% clinical). Feldshers (nursing staff) and those with higher education had elevated levels of these conditions. The insomnia was strongly correlated with anxiety (r = 0.539, p < 0.001) and depression (r = 0.415, p < 0.001), emphasizing the need for targeted mental health interventions. Conclusions: This study found elevated levels of insomnia, anxiety, and depression among emergency medical service (EMS) personnel-especially nursing staff and those with higher education. We recommend comprehensive mental health support, routine screenings, stress management training, and integrating sleep hygiene into wellness programs.

'It overwhelms the system': examining EMS provision in a South Texas border community

OBJECTIVE

Examine how the characteristics of border communities along the US southern land border impact Emergency Medical Services (EMS) personnel in these border communities.

DESIGN

Using phenomenological approach, we conducted face-to-face, one-on-one interviews using a semistructured interview methodology.

SETTING

All participants worked as EMS providers in a city fire department along the Texas-Mexico border.

PARTICIPANTS

28 EMS providers participated in the study. 93% of participants were male and 7% were female. 50% of participants had more than 10 years of experience working as an EMS provider.

FINDINGS

We found that local EMS personnel frequently provide medical support for Border Patrol due to the lack of medical capability within the agency. This care provision creates negative impacts for both the community and EMS personnel. These findings were shown through the overarching theme that the presence of federal law enforcement in the community is the primary characteristic that impacts the experiences and perspectives of EMS personnel. Additional primary themes include: (1) Customs and Border Protection (CBP) utilisation of local EMS strains the system, (2) CBP utilisation of local EMS is the result of a lack of medical training and (3) the presence of the international boundary creates a unique work environment.

CONCLUSION

The lack of medical support within Border Patrol and relevant federal agencies creates a burden on local EMS resources and causes stress among EMS personnel.

Associations between paramedics' salutogenic health experience and the intention to stay in the profession: A cross-sectional survey

AIM

To investigate the association between paramedics' salutogenic health and their intentions to stay in their profession.

DESIGN

A cross-sectional survey.

METHODS

Paramedics from eight purposively selected organizations participated in this study (n = 433). The data were collected in 2022 with the Salutogenic Health Indicator Scale and validated single questions that assessed work ability, recovery and self-rated stress. Intention to stay was measured using two questions about the intention to leave prehospital emergency medical service work and leave the nursing sector completely during the next 2 years. Data were analysed using logistic regression and statistical significance tests.

RESULTS

Men had higher mean salutogenic health scores than women. No significant differences in salutogenic health were observed across work experience or occupational groups. Paramedics intending to stay in their profession exhibited higher salutogenic health scores than those intending to leave. In the logistic regression models, increasing levels of salutogenic health and work ability were associated with intention to stay in the profession.

The effectiveness of acceptance and commitment therapy on clinical symptoms and treatment adherence in dialysis patients

BACKGROUND

Clinical symptoms and treatment adherence are one of the most important problems in dialysis patients. Psychological treatments can be effective in reducing the problems of these patients. Therefore, this study aimed at investigating the effectiveness of acceptance and commitment therapy (ACT) on clinical symptoms and treatment adherence in these patients.

MATERIALS AND METHOD

This study was a quasi-experimental study with the experimental and control groups in the dialysis clinic of Torbat-e Heydarieh City in 2012. The sample consisted of 40 people who were referred to the dialysis clinic, and the available sampling method was used to randomly assign participants to the experimental and control groups. In the experimental group, ACT was performed in eight sessions of 90 minutes. Questionnaires of Depression, Anxiety, and Stress Scale (DASS-21) and general adherence scale were used. Data were analyzed using Statistical Package for the Social Sciences (SPSS 21) software and multivariate analysis of covariance (MANCOVA) test.

RESULTS

There was a significant difference between the mean scores of clinical symptoms and treatment adherence variables in the experimental and control groups (P < 0.05). The effect of this treatment on reducing the clinical symptoms score was 48%, and on increasing the treatment, the adherence score was 44%.

CONCLUSION

ACT can reduce clinical symptoms and increase treatment adherence in dialysis patients, so it is suggested to use this intervention in the design of treatment plans for dialysis patients.

Thought Believability and Anxious Feelings about COVID-19: A Case-Control Study in Northeastern Iran

Background

Believability and thoughts are considered as the pillars of behaviors over time, and anxious feelings are a risk factor for mental disorders, especially during the coronavirus disease (COVID-19) pandemic. This study aimed to explore the thought believability and anxious feelings of COVID-19 among infected and healthy families.

Methods

In this hospital-based matched case-control study, health surveillance files of COVID-19 patients were collected from January to June 2021 and were analyzed statistically. In this study, two questionnaires of demographic characteristics and the Believability of Anxious Feelings and Thoughts (BAFT) were used. Data were analyzed using the One-way ANOVA.

Results

Of 600 participants, 300 (50%) were PCR-confirmed and 300 (50%) were non-infected. Overall, 163 (54.33%) of infected people were male, 146 (48.67%) single, and 156 (52.00%) government employees. The results showed that the mean scores of physical anxiety (PA) and negative evaluation (NE) in the case group is significantly higher than the control group (P = 0.001); while emotional regulation (ER) in the control group was significantly higher than the case group (P = 0.001).

Conclusion

Having high believability to the risks of COVID-19 may be a predictor of preventive behaviors in individuals. Worrying about COVID-19 can increase the perceived risk of a pandemic in societies and consequence, increase the general public health.

Effectiveness of educational intervention-based compassion therapy on emotional regulation and self-control after discharge of patients With COVID-19

BACKGROUND

One of the important causes of anxiety in COVID-19 disease is the inability to regulate emotion and lack of self-control during threatening conditions. The psychotherapy technique has been effective in reducing these symptoms. Therefore, this study attempted to evaluate the effectiveness of compassion-based therapy on emotion regulation and self-control in patients with COVID-19 after discharge.

MATERIALS AND METHOD

It was a quasi-experimental pretest-posttest study with a control group. The statistical population consisted of 30 men (15 in each group) who were in the quarantine period of COVID-19 disease. Available sampling was used and the participants were randomly assigned to experimental and control groups. In the experimental group, compassion-based treatment was performed in 10 sessions of 90 min. Tanji's self-control questionnaire and Garnofsky's Emotion Regulation questionnaires were used. Data analysis were performed using SPSS 21 software and multivariate analysis of covariance.

RESULTS

There was a significant difference between the mean scores of emotion regulation and self-control variables in the experimental and control groups (P < 0.001). The effect of this treatment on increasing the emotion regulation score was 49% and on increasing the self-control score was 37%.

CONCLUSION

Compassion-based therapy can increase cognitive regulation and improve self-control in patients with COVID-19 disease. It is suggested that this intervention can be used in psychological treatment programs.

Prehospital Emergency Nurses' coping strategies associated to traumatic experiences

BACKGROUND

Prehospital care constitutes a work environment in which Prehospital Emergency Nurses (PENs) are exposed to traumatic situations that can lead to stress and increase their vulnerability to stress reactions. PENs' coping strategies after traumatic experiences have been little explored, which suggests that an investigation leading to a deeper understanding of their coping strategies is needed.

AIM

To investigate and describe PENs' coping strategies after traumatic experiences.

METHOD

A descriptive, inductive design with a qualitative research approach was used. Semi-structured interviews were analysed using Graneheim and Lundman's method of content analysis. Twelve PENs were interviewed.

RESULTS

The main theme that emerged was: "a professional approach supports coping strategies for traumatic experiences". Being unprepared increases the feeling of vulnerability when facing a traumatic event, even though PENs acknowledge that traumatic events are unavoidable in their profession. Previous experiences and mental preparation help PENs to keep focused. To be able to act professionally, PENs distance themselves, thus acquiring a sense of control. Inter-professional teamwork can reduce the sense of aloneness.

CONCLUSION

PENs' coping involves several strategies. Their own processing and understanding of an experience are crucial for the management of their own feelings, also affecting the care that PENs can offer the next patient. This study emphasises that a professional approach is the strongest coping strategy after traumatic events.

Relationship Between Work Engagement, Psychosocial Risks, and Mental Health Among Spanish Nurses: A Cross-Sectional Study

Background: Exposure to risk factors may lead to health problems of varied nature and to an increased risk of suffering accidents at work. Objectives: The aim of this study was to evaluate the work engagement, psychosocial risks, and psychological well-being of Spanish nurses, analyzing existing relationships, and their associations with self-reported mental health problems of nurses. Methods: To this end, a cross-sectional observational study was carried out with a sample of 1,704 Spanish nurses between January 2019 and January 2020, using a self-administered questionnaire containing sociodemographic variables, the Spanish version of the Copenhagen Psychosocial Questionnaire (CoPsoQ-istas21), the Utrecht Work Engagement Scale (UWES-9), and the General Health Questionnaire (GHQ-12). Results: The Kruskal-Wallis test showed that nurses' perceptions for each of the tests significantly differed among different healthcare areas (p < 0.05). The results indicated that emergency nurses offered higher scores in all dimensions of the CoPsoQ-istas21 and GHQ-12 tests; and in primary care, nurses scored higher in all three dimensions of the UWES-9 test. In addition, self-perceived health and vigor at work were identified as predictive factors of mental health. Conclusions: A high percentage of Spanish nurses perceived a high level of psychosocial risk in the exercise of their duties and nearly 41% could suffer from some mental health-related problem. Primary Care nurses showed higher levels of work engagement and lower perception of psychosocial risks than Emergency nurses. Results may allow to identify a professional profile which is more likely to suffer from psychological distress, as both the working conditions and the work commitment expressed by nurses in their daily work are key elements in assessing the possible psychosocial risks to which they may be exposed.