ABSTRACT
Aims: The COVID-19 pandemic presented new difficulties for integrated healthcare worldwide. Our study aims to highlight developing needs for cooperation while describing structures and practices of consultation liaison (CL) services established during pandemic across Europe. Method(s): The cross-sectional survey used an ONLINE self-developed 25-item questionnaire in four language versions (English, French, Italian, German). Dissemination was via national professional societies cooperating in EAPM, and heads of CL services from June to October 2021 Results: 259 hospital CL services took part in the study (28.0% response rate). 222 (85.7%) of these services reported providing COVID-19-related mental health care (COVIDpsyCare). Among them, 192 services (86.5%) reported the development of specialized COVID-psyCare co-operation arrangements. 135 services (50.8%) provided specific COVID-psyCare for patients, 85 (38.2%) for relatives, and 171 (77.0%) for staff, with 56.3%, 14.6%, and 23.7% of time resources invested for these groups, respectively. Interventions for hospital staff, commonly related to the liaison function of CL services, were rated as being the most helpful. Regarding newly emerging demands, 129 (58.1%) CL services stated a need for communication and support among themselves concerning COVID-psyCare, and 142 (64.0%) suggested certain adjustments or enhancements that they thought were crucial for the future. Conclusion(s): Specific structure to provide COVID mental health care for patients, their relatives, or staff were implemented in over 80% of the participating CL services. Resources were primarily allocated for patient care, and staff assistance was mostly achieved through the implementation of specialized interventions. COVID psyCare's development calls for further intra- and interinstitutional cooperation.Copyright © 2023
ABSTRACT
Background: Many patients affected by COVID-19 suffer from persistent symptoms after infection. Compared to biomedical mechanisms, psychosocial mechanisms have been less investigated. This study examined the association between trust in sources of information on COVID-19 and the burden of incident persistent symptoms. Method(s): A prospective study using data from the SAPRIS and SAPRIS-Serologie surveys nested in the French CONSTANCES cohort. Trust in medical doctors, government, scientists, journalists, and social media was measured between April 2020 and May 2020. The number of incident persistent symptoms lasting for at least two months was recorded. Psychological burden was measured with the somatic symptom disorder B criteria scale. Associations between trust in information sources and outcomes were examined with zero-inflated negative binomial regression and general linear models, adjusting for gender, age, education, income, self-rated health, SARS-CoV-2 serology tests, and self-reported COVID-19 Results: Among 20,985 participants, those with higher trust in government/journalists at baseline had fewer incident persistent symptoms at follow-up (estimate (SE): -0.21 (0.03), p < 0.001). Among 3372 participants (16.07%) who reported at least one symptom, those with higher trust in government/journalists and medical doctors/scientists had lower SSD-12 scores (-0.39 (0.17), p = 0.0219 and - 0.85 (0.24), p < 0.001, respectively), whereas higher trust in social media sources predicted higher SSD-12 scores in those with lower trust in government/journalists (0.90 (0.34), p = 0.008). These associations did not depend upon surrogate markers of past infection with SARS-CoV-2 Conclusion(s): Trust in information sources on COVID-19 should be tested as a target in the prevention of incident persistent symptoms.Copyright © 2023
ABSTRACT
PURPOSE: The COVID-19 pandemic has put hospital workers around the world in an unprecedented and difficult situation, possibly leading to emotional difficulties and mental health problems. We aimed to analyze psychological symptoms of the hospital employees of the Paris Saint-Joseph Hospital Group a few months after the 1st wave of the pandemic. PARTICIPANTS AND METHODS: From July 15 to October 1, 2020, a cross-sectional survey was conducted among hospital workers in the two locations of our hospital group using the Hospital Anxiety and Depression Scale (HADS) and Post-Traumatic Stress Disorder (PTSD) Checklist (PCL) to measure anxiety, depression, and PTSD symptoms. Factors independently associated with these symptoms were identified. RESULTS: In total, 780 participants (47% caregivers, 18% health administrative workers, 16% physicians, and 19% other professionals) completed the survey. Significant symptoms of anxiety, depression, and PTSD were reported by 41%, 21%, and 14% of the participants, respectively. Hierarchical regression analysis showed a higher risk of having psychological symptoms among those (1) who were infected by SARS-CoV-2 or had colleagues or relatives infected by the virus, (2) who retrospectively reported to have had an anxious experience during the first wave, and (3) with a previous history of burnout or depression. In contrast, job satisfaction appeared to be a protective factor. Overall, hospital workers showed the statistically same levels of anxiety, depression, and PTSD symptoms, regardless of their profession and whether they had worked in units with COVID-19 patients or not. CONCLUSIONS: Our cross-sectional survey of 780 hospital workers shows that after the first wave, hospital employees had a significant burden of mental health symptoms. Specific preventive measures to promote mental well-being among hospital workers exposed to COVID-19 need to be implemented, first among particularly vulnerable staff, and then, for all hospital staff for whom anxiety is detected early, and not only those who were directly exposed to infected patients.
Subject(s)
COVID-19 , COVID-19/epidemiology , Cross-Sectional Studies , Hospitals , Humans , Pandemics , Personnel, Hospital , Retrospective Studies , SARS-CoV-2ABSTRACT
AIMS: To examine the association between benzodiazepine receptor agonist (BZRA) use and mortality in patients hospitalised for coronavirus disease 2019 (COVID-19). METHODS: A multicentre observational study was performed at Greater Paris University hospitals. The sample involved 14 381 patients hospitalised for COVID-19. A total of 686 (4.8%) inpatients received a BZRA at hospital admission at a mean daily diazepam-equivalent dose of 19.7 mg (standard deviation (s.d.) = 25.4). The study baseline was the date of admission, and the primary endpoint was death. We compared this endpoint between patients who received BZRAs and those who did not in time-to-event analyses adjusted for sociodemographic characteristics, medical comorbidities and other medications. The primary analysis was a Cox regression model with inverse probability weighting (IPW). RESULTS: Over a mean follow-up of 14.5 days (s.d. = 18.1), the primary endpoint occurred in 186 patients (27.1%) who received BZRAs and in 1134 patients (8.3%) who did not. There was a significant association between BZRA use and increased mortality both in the crude analysis (hazard ratio (HR) = 3.20; 95% confidence interval (CI) = 2.74-3.74; p < 0.01) and in the IPW analysis (HR = 1.61; 95% CI = 1.31-1.98, p < 0.01), with a significant dose-dependent relationship (HR = 1.55; 95% CI = 1.08-2.22; p = 0.02). This association remained significant in sensitivity analyses. Exploratory analyses indicate that most BZRAs may be associated with an increased mortality among patients hospitalised for COVID-19, except for diazepam, which may be associated with a reduced mortality compared with any other BZRA treatment. CONCLUSIONS: BZRA use may be associated with an increased mortality among patients hospitalised for COVID-19, suggesting the potential benefit of decreasing dose or tapering off gradually these medications when possible.
Subject(s)
COVID-19 , GABA-A Receptor Antagonists/adverse effects , COVID-19/mortality , Hospitalization , Humans , Proportional Hazards ModelsABSTRACT
OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has caused major sanitary crisis worldwide. Half of the world has been placed in quarantine. In France, this large-scale health crisis urgently triggered the restructuring and reorganization of health service delivery to support emergency services, medical intensive care units and continuing care units. Health professionals mobilized all their resources to provide emergency aid in a general climate of uncertainty. Concerns about the mental health, psychological adjustment, and recovery of health care workers treating and caring for patients with COVID-19 are now arising. The goal of the present article is to provide up-to-date information on potential mental health risks associated with exposure of health professionals to the COVID-19 pandemic. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature considering previous epidemics of 2003 (SARS-CoV-1) and 2009 (H1N1) with the more recent data about the COVID-19 pandemic. We highlighted most relevant data concerning the disease characteristics, the organizational factors and personal factors that may contribute to developing psychological distress and other mental health symptoms. RESULTS: The disease characteristics of the current COVID-19 pandemic provoked a generalized climate of wariness and uncertainty, particularly among health professionals, due to a range of causes such as the rapid spread of COVID-19, the severity of symptoms it can cause in a segment of infected individuals, the lack of knowledge of the disease, and deaths among health professionals. Stress may also be caused by organizational factors, such as depletion of personal protection equipment, concerns about not being able to provide competent care if deployed to new area, concerns about rapidly changing information, lack of access to up-to-date information and communication, lack of specific drugs, the shortage of ventilators and intensive care unit beds necessary to care for the surge of critically ill patients, and significant change in their daily social and family life. Further risk factors have been identified, including feelings of being inadequately supported, concerns about health of self, fear of taking home infection to family members or others, and not having rapid access to testing through occupational health if needed, being isolated, feelings of uncertainty and social stigmatization, overwhelming workload, or insecure attachment. Additionally, we discussed positive social and organizational factors that contribute to enhance resilience in the face of the pandemic. There is a consensus in all the relevant literature that health care professionals are at an increased risk of high levels of stress, anxiety, depression, burnout, addiction and post-traumatic stress disorder, which could have long-term psychological implications. CONCLUSIONS: In the long run, this tragic health crisis should significantly enhance our understanding of the mental health risk factors among the health care professionals facing the COVID-19 pandemic. Reporting information such as this is essential to plan future prevention strategies. Protecting health care professionals is indeed an important component of public health measures to address large-scale health crisis. Thus, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented, and to strengthen prevention and response strategies by training health care professionals on mental help and crisis management.