ABSTRACT
The COVID-19 pandemic has caused additional strain and disruption to an already strained mental health workforce. Life disruption, compassion fatigue, and traumatic stress are contributing to record levels of burnout. Efforts are needed to improve retention and the well-being of mental health providers, yet little is known about the personal traits that contribute to compassion satisfaction during difficult times. Professional grit is an emerging concept that has broad applicability and makes a potentially unique contribution to the experiences of professionals in the context of COVID-19. Our paper describes perceptions of professional grit and its association with compassion fatigue and traumatic stress. A small exploratory study was used to analyze results from an online survey of mental health workers (N = 31). Measures included compassion fatigue, secondary traumatic stress, and grit, along with open-ended questions to explore perceived contributors to grit. Results confirmed the added stress mental health professionals are working under and 29% met the cut-off for significant traumatic stress symptoms. Participants' responses were coded and a primary theme and contributor to professional grit is coping, inclusive of adaptation, self-care, perseverance, and professional and personal support. Further, participants identifying the coping skills of self-care, adaptation, and perseverance scored higher on a measure of professional grit. Our study also suggests that grit and suffering are not mutually exclusive, such that many of our participants reported components of professional grit and also reported posttraumatic stress and compassion fatigue symptoms. More extensive studies on the function of professional grit and services to improve coping skills are needed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
COVID-19-associated pulmonary aspergillosis (CAPA) was recently reported as a potential infective complication affecting critically ill patients with acute respiratory distress syndrome following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with incidence rates varying from 8 to 33% depending on the study. However, definitive diagnosis of CAPA is challenging. Standardized diagnostic algorithms and definitions are lacking, clinicians are reticent to perform aerosol-generating bronchoalveolar lavages for galactomannan testing and microscopic and cultural examination, and questions surround the diagnostic sensitivity of different serum biomarkers. Between 11 March and 14 July 2020, the UK National Mycology Reference Laboratory received 1,267 serum and respiratory samples from 719 critically ill UK patients with COVID-19 and suspected pulmonary aspergillosis. The laboratory also received 46 isolates of Aspergillus fumigatus from COVID-19 patients (including three that exhibited environmental triazole resistance). Diagnostic tests performed included 1,000 (1-3)-ß-d-glucan and 516 galactomannan tests on serum samples. The results of this extensive testing are presented here. For a subset of 61 patients, respiratory specimens (bronchoalveolar lavage specimens, tracheal aspirates, and sputum samples) in addition to serum samples were submitted and subjected to galactomannan testing, Aspergillus-specific PCR, and microscopy and culture. The incidence of probable/proven and possible CAPA in this subset of patients was approximately 5% and 15%, respectively. Overall, our results highlight the challenges in biomarker-driven diagnosis of CAPA, especially when only limited clinical samples are available for testing, and the importance of a multimodal diagnostic approach involving regular and repeat testing of both serum and respiratory samples.