Psychological intervention for three COVID patients who suffered online violence.

Three patients diagnosed with COVID-19 were all young women in their thirties who have suffered from Internet violence in their personal life after hospitalization. They showed significant emotional distress such as, depression state, acute stress disorder, and dissociative disorder. The current study adopts short-term, individualized and comprehensive psychological interventions, including psychological support, encouragement, listening, safety confirmation, catharsis, psychological suggestion, and stimulation of internal potential to treat patients. The third case was provided with psychological interventions combined with antipsychotic treatment. After timely psychological interventions all three patients achieved sound results.Copyright © 2021 Chinese Medical Journals Publishing House Co.Ltd.

The Fruits of Labor: Home Food Procurement and Mental Health in the Time of COVID-19

We examine the relationship of home food procurement (HFP) during COVID-19 to emotional eating and stress using a statewide representative survey (n = 600) in Vermont. Women and people with a job change since COVID-19 were more likely to experience higher stress and emotional eating. Engaging in HFP, especially gardening, is associated with less emotional eating. However, people who fished, hunted, or canned more since the pandemic began were more likely to eat for emotional reasons and experience higher stress. These results suggest that gardening, even during a pandemic, may contribute to stress reduction, more so than other nature-based food production activities.Copyright © 2022 Taylor & Francis Group, LLC.

Burnout and Wellbeing during the Second Covid-19 Wave: Are There Differences between Medical Specialties?

Introduction: Burnout is common amongst clinical staff. Critical Care is widely accepted to have amongst the highest rates, with an incidence of >38%.1 The Covid-19 pandemic placed unprecedented pressures on staff, making them vulnerable to burnout.2 Although stressors were similar across medical teams, we suspected there were differences in burnout between medical specialties. Objective(s): This study aimed to examine burnout amongst the hospital MDT, focussing on three higher care clinical areas: Coronary Care (CCU), Respiratory (RSU) and Critical Care (ICU) and identify recurring positive and negative experiences. Method(s): Between March and April 2021 staff were invited to complete a two-part survey. Part one investigated demographic data and free text answers on feelings towards Covid-19. Part two questioned recipients on the 22 questions of the MBI -HSS (Maslach Burnout Index- Human Services Survey).3 This survey assesses burn-out in three domains: Emotional Exhaustion (EE), Depersonalisation (DP), and lack of Personal Accomplishment (PA). MBI-HSS results were analysed and a previously used 'high-risk' cut-off was used to calculate percentages per domain and overall. Free text analysis was conducted by two researchers to identify common themes, protective factors and negative factors which may increase burnout. Result(s): 148 staff members responded to the survey: 53% of respondents met the criteria for burnout in at least one domain. 58% of ICU staff, 42% of RSU staff and 44% of CCU staff were burnt out in one domain or more. ICU had the highest percentage of staff at high risk of EE and lack of PA. RSU had the highest percentage of staff scoring highly for DP. Free text analysis demonstrated some positive experiences from the Covid-19 pandemic: teamwork, communication, resilience, and opportunities to learn new skills were highlighted by staff across all areas. All areas found staffing and workload a negative factor. In ICU, workspace organisation and long shifts in PPE were key stressors which made communication and taking breaks safely difficult. Managing stress and uncertainty were highlighted by the ICU teams. In RSU, a significant proportion of staff found the lack of established treatments and poor outcomes difficult to manage, potentially highlighting the differences in Covid-19 management compared with ICU. As nursing staff work with higher ratios in RSU, some found managing patients' needs difficult: "Not having enough time to care for patients' basic needs . . . patients in side-rooms were left feeling isolated and scared". In CCU, there was a shift towards fear of catching the virus, PPE provision and poor infection control guidance, possibly arising from lower exposure to Covid-19: "It felt like the trust didn't give a s**t about their staff with regard to PPE and vaccinations." Conclusion(s): All clinical areas highlighted increased teamwork as a positive outcome of the Covid-19 pandemic, and good relationships have been built, a known protective factor against burnout. Many negative factors have impacted the rate of burnout, including high workload, staffing issues, redeployment and managing death and uncertainty. We hope to resurvey the same areas to assess wellbeing one year on, and address key factors to improve wellbeing.

Mental health parameters of adolescents during COVID-19 Pandemic, an era of compulsory online education in India

Background: COVID-19-Pandemic Lockdowns initiated online teaching-learning in India. We aimed to assess mental health (MH) of adolescents studying online for academic milestone of matriculation during these circumstances. Material(s) and Method(s): It was a cross sectional study carried out in Western Maharashtra, during 2021. MH of study subjects was assessed by presence and severity of symptoms of depression, anxiety, stress (DAS) and emotional intelligence (EI). They were measured by DAS Scale-42 (DASS-42) and Schutte's self-report EI test (SET) respectively with collection of socio-demographic information maintaining confidentiality. Data were analysed by SPSS-20 software. MH parameters were compared with pre-pandemic pilot and other studies to study effect of online education and overall COVID-19 Pandemic scenario on MH of study subjects. Result(s): Total 1162 adolescents participated, out of which 59 were omitted from the analysis due to incomplete data. Out of remaining 1103 participants, 43% boys & 57 % girls with the mean age of 14.69 (+0.78) years. Majority of them belonged to middle socio-economic-status. Mean DAS and EI scores denoted mild anxiety with no evidence of depression and stress. Mean EI score was in normal range. Mean DAS scores were significantly lower and mean EI score was significantly higher than reported in -pandemic pilot and other studies. Conclusion(s): MH derangement of matriculating adolescents during COVID-19- Pandemic with online education seemed to be less severe than that was in pre-pandemic times with in-class education. Recommendations: MH support at schools needs to be strengthened. During the post-COVID-19 period, online school education may be continued in LMIC like India on the basis of willingness of students and parents but with caution and understanding of socio-cultural background and support.Copyright © 2022 Pravara Institute of Medical Sciences. All rights reserved.

Specifically designed family communication booklet to help staff to communicate effectively with Intensive Care Unit patients' next of kin

Introduction: Families of patients admitted to the Intensive Care Unit (ICU) experience significant emotional distress.1 Visiting restrictions mandated during the COVID-19 pandemic presented new barriers to family communication, including a shift from regular bedside nursing updates and in-person family meetings to scheduled, clinician-led telephone calls and video calls.2 This resulted in loss of non-verbal clues and feedback during family discussions, difficulties establishing rapport with families and risked inconsistent messages and moral injury to staff.3 Objectives: We aimed to design a system where all ICU family discussions were documented in one place in a standardised format, thereby clarifying information given to families to date and helping staff give families a consistent message. In addition, we aimed to provide practical advice for the staff making family update telephone calls and strategies for managing difficult telephone conversations. Method(s): We designed and implemented an ICU family communication booklet: this was colour-coded blue;separate to other ICU documentation within the patient notes;and included communication aids and schematics to help staff optimise and structure a telephone update. Using Quality Improvement methodology, we completed four Plan-Do-Study-Act (PDSA) cycles and gathered qualitative and quantitative feedback: this occurred prior to the project and at one,12,18 and 21 months post introduction. We implemented suggested changes at each stage. We designed staff surveys with questions in a 5-point Likert scale format plus opportunity for free comments. Twenty-one months post implementation, we designed and delivered an MDT awareness campaign using the 'tea-trolley training' method,4 departmental induction sessions for new ICU doctors and nurses and a 'Message of the Week' initiative. An updated version of the booklet was introduced in February 2022 (Figure 1). Result(s): Staff survey results are shown in Table 1. Forty-six staff participated in tea trolley training, feedback form return rate 100%. Following feedback, the family communication booklet was updated to include the following: a prompt to set up a password;a new communication checklist at the front, including documentation of next of kin contact details, a prompt to confirm details for video calls, confirm primary contact and whether the next of kin would like updates during the night;consent (if the patient is awake) for video calls while sedated;information regarding patient property;prompt to give families our designated ICU email address to allow relatives to send in photographs to display next to patients' beds;prompts to encourage MDT documentation and patient diary entry. Conclusion(s): During unprecedented visiting restrictions in the COVID-19 pandemic, we implemented an ICU family communication booklet which has been so successful that we plan to use it indefinitely. We plan to further develop this tool by encouraging MDT involvement, seek further staff feedback in six months' time, incorporate this structure into our electronic patient information system when introduced and collect feedback from patients and their next of kin at our ICU follow up clinic. This communication booklet would potentially be reproducible and transferable to other ICUs and could be used as part of a national ICU family communication initiative.

Stress and resilience in the workers of three health authorities of Emilia-Romagna during the COVID-19 pandemic

Aims: The aim of the present study was to study the prevalence of depression, anxiety, stress, and post-traumatic symptoms in Health-Care Workers (HCWs) of three Health Authorities of Emilia-Romagna, Italy during the COVID pandemic. Material(s) and Method(s): An online questionnaire was spread to the staff of the University Hospital of Modena and the Local Health Agencies of Modena and Romagna, including the Depression Anxiety Stress Scale (DASS-21), the Impact of Event Scale - Revised (IES-R), and the Utrecht Work Engagement Scale - Short Version (UWES-9). The scores at DASS-21 and IES-R were used as dependent variables in multivariate logistic regression models. Result(s): A total of 5868 HCWs were reached (response rate of 22.4%), 76.1% of which were women, mostly aged between 45 and 54 years. Rates of positive scores were: 27.9% DASS-21 Depression;28.4% DASS-21 Anxiety;34.7% DASS-21 Stress;21.9% IES-R. At the multivariate logistic regression, the following were statistically significant risk factors for positive scores: female sex, young age, and working at the front line. An increase in alcohol and tobacco consumption and worsening of eating habits were also strongly associated with symptoms. At UWES-9, the three samples reported lower vigor than dedication and absorption, which are at a medium-high level. Conclusion(s): HCWs have experienced high levels of emotional distress related to the COVID-19 pandemic. Significant improvements are needed not only in terms of organization and distribution of resources, but also in provision of dedicated psycho-social interventions.Copyright © 2023

COVID-19 and tinnitus-a tertiary care Centre experience

Background: COVID-19 outbreak was declared a global pandemic in March 2020 by WHO. Due to person-to-person transmission of this infection, majority of countries of world introduced lockdown to ensure people stay at home. A complex bidirectional interaction exists between tinnitus and emotional distress, as they can exacerbate one another. Also, COVID-19 infection can cause damage to outer hair cells. The aim of this study is to find out relationship between COVID-19 and initiation or exacerbation of tinnitus. Method(s): The present retrospective study, after approval by Institutional Ethics Committee, was conducted in Department of ENT, GMC Jammu, from June 2020 to March 2021 on 90 patients with primary complaint of tinnitus. All 90 patients were asked to complete the Tinnitus Handicap Inventory. Also, all patients were asked COVID-19-related questions (history of contracting virus/history of grief/anxiety/depression/stress/nervousness/financial status/ physical exercise/sleep routine/ social interactions). Result(s): Out of 90 patients, 72 patients (80%) had chronic longstanding tinnitus and 18 patients (20%) experienced tinnitus during pandemic. Out of 72 patients who gave history of longstanding tinnitus, 41 patients (56.9%) reported tinnitus to be stable during COVID-19 pandemic, 26 patients (36.1%) reported it to become more bothersome and 5 patients (6.9%) reported that tinnitus was improved. Out of 90 patients, 21 patients (23.3%) were diagnosed as COVID-19 positive. Of these 21 patients experiencing COVID-19 symptoms, 16 patients (76.2%) gave history of exacerbation of tinnitus, 4 patients (19%) gave history of tinnitus remaining stable and 1 patient (4.7%) said that tinnitus was improved. Out of 90 patients, history of negative psychological impact due to COVID-19 restrictions was seen in 65 patients (72.2%). Conclusion(s): With our study, we concluded that ENT specialists should be fully aware that not only pre-existing tinnitus may be exaggerated due to COVID-19 infection, but also, there can be development of new-onset tinnitus due to COVID-19 infection and the negative psychological impact due to COVID-19 pandemic.Copyright © 2022, The Author(s).

Psychological impact of COVID-19 Pandemic on dentists

Background: The Covid-19 pandemic seems to have an incessant out-turn on the people in every field in some or the other way. It has been reported that maximum number of deaths in the countries during this pandemic are caused due to a term called death anxiety or phobia. There are certain parameters such as anxiety, apprehension, depression which if influence a person can alter one's well-being. Objective(s): The steadfast intent of this review article is to narrate the psychological impact of this pandemic on dentists. The eloquence and emergence of this topic will alarm all the medicos and paramedics to have a check on this scenario. Method(s): The article consists of detailed study from several articles from PubMed publications. Articles written only in English language were referred. Various keywords such as "Covid-19 pandemic" or "Psychological Impact" were used. Result(s): The Covid-19 Pandemic has adversely affected all of us physically as well as psychologically. This article signifies the psychological impact of this pandemic on dentists. Conclusion(s): The current studies that are carried out till date show an extensive impact on the psychology of the dental professionals. The following review article elaborates the importance of the same.Copyright © 2023 Patil B et al.

Senior Vs. Junior Urology Trainees: Factors Associated with Burnout

INTRODUCTION AND OBJECTIVE: Burnout is one of the many challenges physicians may face in their careers. While there are studies focusing on burnout among surgical specialties, there are limited studies focusing on burn out at different levels of training. The aim of this study is to measure and compare rates of burnout between junior and senior trainees in urological surgery as well as to identify changes in training that could be made to improve work-life balance. METHOD(S): To assess professional burnout, respondents completed the 22-item Maslach Burnout Inventory Human Services Survey as part of the 2019 AUA census. Respondents were categorized into junior trainees (PGY1, PGY2, PGY3) and senior trainees (PGY4, PGY5, and fellow). RESULT(S): A total of 512 respondents were included. Senior trainees represented 57% while junior trainees represented 43% of the total cohort. The prevalence of burnout (p=0.005) and high levels of depersonalization (p=0.018) were 50% in junior trainees and 38% in senior trainees. High levels of emotional exhaustion were 9% for junior and 5% for senior trainees (p=0.053) (Table 1). The top changes to improve work life balance for urology trainees were access to meal plans, on-call rooms, and time to attend health appointments (Figure 1). CONCLUSION(S): Juniors experience higher levels of burnout, depersonalization, and emotional exhaustion when compared to seniors. Providing meal plans, on-call quarters, and time to attend health appointments are the top changes to improve work-life balance among urology trainees. These changes may have a dramatic impact on the well-being of our trainees, especially in this post-COVID era. (Figure Presented).

Measuring caregiver stress and perceived self-efficacy during a worldwide pandemic

Background: Anxiety and depression levels are significant in caregivers of young people with cystic fibrosis (PwCF) [1]. Literature also shows that perceived self-efficacy (a person's beliefs about their capabilities) is lower in caregivers of children with chronic illness;particularly with increased stress, lack of resources, or ambiguity related to illness course [2,3]. There are few studies looking at the effects of the pandemic on self-efficacy in caregivers and children. Given the national distress, school closures, and uncertainty of the COVID-19 pandemic, our team aimed to investigate effects on caregivers of young PwCF (<=18) at our CF center, particularly their perceived stress, anxiety, and self-efficacy. Method(s): An anonymous survey using REDCap was developed to look at descriptive features of caregiver demographics, number of children in the home with CF, and perceptions related to COVID-19 and how it affected their lifestyle. Caregivers completing the survey rated their current stress, anxiety, and depression levels. The PROMIS self-efficacy tool, a validated measure of perceived self-efficacy, was incorporated into the survey. Most response options were on a Likert scale. The survey was available electronically through hyperlink and a QR scan code. Result(s): Of 17 caregivers who responded to our initial survey, 82% reported that COVID-19 had significantly affected their lives, 41% experienced financial hardship, 53% were feeling "more" or "much more" anxious, 76% were feeling angrier, and 94% reported "more" or "much more" stress than before the pandemic (Figure 1). Many respondents were worried about spreading illness to their children or being unable to care for their child. Perceived self-efficacy scores were average to high in most caregivers, indicating confidence in their abilities to manage difficult situations. Respondents were more likely to be female and well educated and have private insurance. (Figure Presented) Figure 1. Responses to difference in current perceived stress level before and durring the pandemic Conclusion(s): This is the first known descriptive study to look at effects of a worldwide pandemic on caregivers of young PwCF. It also is one of few studies examining caregiver perceived self-efficacy in CF. It was limited by the number of responses, skewed demographics of those who responded, and being administered at a single CF center. We found that caregivers of PwCF at our center are experiencing higher rates of stress, anxiety, and anger. This did not seem to affect their perceived self-efficacy, although therewas no pre-pandemic measurement.We learned thatwe need to find ways to reach a larger demographic and those who are underrepresented. This study shows the need to better understand caregiver emotional distress, especially during times of ambiguity. Understanding caregiver stress and perceived self-efficacy has the potential to provide insight for the medical team on supportive ways to abate negative outcomes in young PwCFCopyright © 2022, European Cystic Fibrosis Society. All rights reserved

Validity and reliability of the Thai version of the Zoom Exhaustion and Fatigue Scale (ZEF-T)

Objective: Overuse of video conferencing during the COVID-19 pandemic may contribute to the new mental health problem called 'Zoom fatigue'. This study examined convergent validity, factor validity, internal consistency and test-retest reliability of the Thai version of the Zoom Exhaustion & Fatigue Scale (ZEF-T). Method(s): The participants were 386 medical students from Thammasat University. Convergent validity was based on comparing ZEF-T scores with the Maslach Burnout Inventory-Student Survey (MBI-SS). Confirmatory factor analysis (CFA) was done to examine factor validity. Test-retest reliability was evaluated in 25 participants using intraclass correlation coefficient (ICC) and Bland-Altman plot. Result(s): The ZEF-T demonstrated a positive correlation with emotional exhaustion of MBI-SS. (r = 0.42, p < 0.001). The CFA showed a satisfactory fit and supported the five-factor model with acceptable fit statistics. All items had factor loading of more than 0.7. Internal consistency and test-retest reliability of the total ZEF-T scores was excellent with the alpha of 0.93 and ICC 0.94 (p < 0.001), respectively. Conclusion(s): The ZEF-T was shown to be a valid and reliable assessment for measuring zoom fatigue in Thai university students.Copyright © 2023 IACFS/ME.

Mental health of caregivers of children with neurodevelopmental disorders during the pandemic.

Caregivers are especially likely to be more psychologically affected during the social and health care system constraints generated by the COVID-19 pandemic. Caregivers of children with neurodevelopmental disorders (i.e., autism, intellectual disability, attention deficit, hyperactivity, motor disability) have a more essential role than caregivers of healthy children. A quantitative cross-sectional study was designed, using descriptive, comparative and correlational statistical techniques to analyze health-related quality of life, emotional distress and overload in four subgroups of caregivers, classified according to the child's diagnosis. A total of 132 caregivers (86.4% women) were included. In group 1 (cognitive disability), 28 caregivers participated;in group 2 (ADHD), 51 were included;in group 3 (autism spectrum disorder), 33 caregivers participated, and in group 4 (motor disability), 20 were included. The main findings of this study were: i) alterations in physical role, bodily pain, general health and vitality;ii) very low percentages of depression, anxiety, stress and overload symptomatology;iii) differences in social functioning between the motor disability and ADHD groups;and in stress and overload between the autism and motor disability groups;and iv) moderate correlations between the dimensions of bodily pain and emotional role and depression, anxiety, stress and overload. It was concluded that there is more impairment in variables associated with physical health than with mental health.Copyright © 2023

Aggressive behavior in Italian children with ADHD in the middle of COVID-19 pandemic: Preliminary data on MAOA gene polymorphisms involvement

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by oppositional, defiant, disobedient, disruptive and also aggressive behavior. Many genes are involved in its onset, particularly dopaminergic pathway genes. Moreover, genetic predisposition to aggression appears affected by the polymorphic genetic variants of the serotoninergic system, among which, functional polymorphisms in monoamine oxidase A (MAOA). The risk of contracting coronavirus infection may arouse in some people severe emotional distress characterized by symptoms of fatigue, guilt, and aggression. A survey on the psychological impact of COVID-19 pandemic in Italian families of children with neurodevelopmental disorders such as ADHD showed how children have been particularly affected by the emergency. The aim of this study was to determine whether polymorphisms at the MAOA gene are associated with increased or reduced susceptibility to develop ADHD. Therefore, the variants rs6323, rs587777457 and rs1137070 of the MAOA gene were evaluated by SBT in 35 children (mean age 10.257 range 6-16) with ADHD and 27 healthy individuals. Our analysis allowed us to identify the G/G genotype of the variant rs6323 (Arg297Arg) was significantly associated with an increased risk of ADHD (p = 0.015). Allele G indicates higher levels of the enzyme, while the T allele indicates lower levels of enzyme production. When compared in patients, the G allele was associated with higher anger (p-value = 0.01) and might cause aggressive behavior in males. Our study shows that defining a genetic profile of ADHD can provide important information on the etiopathogenesis of the disease and help identify the best therapeutic option for patients with this disorder.

Examining the burnout levels of healthcare employees and related factors during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: The high prevalence, severe contagious nature, and associated morbidity and mortality rates of COVID-19 increased the demand for healthcare and social care services worldwide. No doubt, the COVID-19 pandemic affected frontline healthcare employees the most. OBJECTIVE: The purpose of the present study was to examine the burnout levels of healthcare employees and related factors during the COVID-19 pandemic in Turkey. METHODS: The descriptive, cross-sectional study was completed with 478 healthcare professionals. The study the sampling included all healthcare professionals who were actively working in Turkey during the COVID-19 pandemic and agreed to participate in the study. The study data were collected through the internet (online) between 10.05.2021 and 10.08.2021. The Healthcare Staff Information Form and Maslach Burnout Inventory were used to collect the study data. RESULTS: Emotional burnout (p < 0.001) and desensitization (p = 0.007) scores were higher in those who lived separately from people they normally lived with. Emotional burnout and desensitization scores of the nurses were significantly higher than those of doctors and other healthcare professionals (p < 0.001). CONCLUSION: It was determined that healthcare professionals in Turkey experienced moderate levels of burnout in terms of emotional burnout and desensitization, and high levels of burnout in terms of personal achievement. It is recommended to improve working conditions, monitor employees in high-risk units more closely, and provide psychological support to prevent or reduce the burnout of healthcare employees during the pandemic period.

Burnout syndrome among Tunisian medical professionals during the COVID 19 pandemic

Introduction: Medical professionals are known to experience high levels of stress because of their work since the current pandemic but they are rarely recognized as vulnerable and little attention is paid to their mental health. Objective : To detect burn out syndrome (BOS) among health workers in COVID19 centers and to summarise its potential risc factors. Method(s): we conducted a prospective and descriptive study, referring to Maslash Burnout Inventory, among a sample of medical professionals in COVID departments in Sfax from January to March 2020 by emailing a survey to 114 eligible participants. Result(s): Public COVID hospitals were the most frequent workplaces. Sixty three percent of people had high level of emotional exhaustion (EE), 57% had high level of depersonnalisation(DP) and 73% had low personal accomplishement(AP). These three components of MBI were correlated to female gender (P=0.001), single status (P=0.001), and the fear of contaminating siblings (P=0.001). Daily direct exposure to positive patient was noted in 79% of cases, and 42% of them had night shifts. High level of (DP) and low (AP) were correlated with night shifts at hospital (P=0.001). BOS was related to the non payment of the shifts (P<0.001), and the lack of free time (P=0.004). High levels of pressure from superiors is also correlated to low (AP) (P<0.001), while high level of (DP) was correlated to lack of appreciation from superiors (P<0.001) Conclusion(s): This study shows a high self-reported burnout level among medical professionals. It highlights the need for effective interventions to reduce BOS since the pandemic is still going on to this day.

Pims-Ts: The Psychological Needs of Families Admitted to Intensive Care

Background Paediatric Inflammatory Multisystem Syndrome (PIMS-TS) is a rare inflammatory condition affecting children and young people (CYP) weeks after infection with the COVID-19 virus. The aim of this study was to understand the potential psychological needs of these families. Methods PIMS-TS patients and their parents admitted to the hospital between April 2020 and May 2021 were reviewed by a psychologist 6-8 weeks post discharge as part of their clinical care. Young people over the age of 7 were asked to complete 2 measures for psychological distress and PTSD symptoms (CRIES-13 and PIED) and their parent/carer completed a measure of PTSD symptoms (IES-R). Ethical approval was not required for this study. Results 118 CYP and parents/carers who were admitted to GOSH were screened 6-8 weeks post discharge. 85 of the 118 CYP were aged 8 or over. 76.8% (n=91) of parents/carers completed the IES-R 78% (n=66) of CYPs completed the PIED and CRIES. 15% (n=10) of CYPs scores on the PIED suggested they were at risk of anxiety and depression. 24% (n=16) of CYPs reported clinically significant difficulties for PTSD on the CRIES-13 placing them in high probability of for a diagnosis of PTSD. 35% of parents/carers met the threshold for clinical concern on IES-R with 23% (n=21) scoring in the range for a likely diagnosis of PTSD. Discussion The findings of both the self-report screening questionnaires, indicate that significant number for CYP and their parent/carers are at risk of developing symptoms of psychological distress and trauma in 6-8 week period post discharge after PIMS-TS admission. Conclusion The result of this study clearly show identification of high levels of trauma and emotional distress for the CYP and their parents and carers and a potential need for ongoing psychological support to be provided as part of ongoing care.

Psychological Impact of Coronavirus (COVID-19) Disease on Cancer Patients

In this letter, the psychological impact of COVID-19 on cancer infected patients is dis-cussed. Cancer is a serious health-related problem nowadays. The 2019 pandemic of coronavirus disease has developed into an unheard-of pandemic. Given the havoc wreaked by this pathogen worldwide, many countries have implemented a severe, legally enforced method of social distanc-ing, in the form of a lockdown. Unless adequate preventive measures are taken, the cost of the pandemic and subsequent lockdown can prove to be irreparable. The obvious consequences of this lockout, such as the escalating levels of unemployment, imminent economic crisis, and extreme food scarcity faced by the sudden unemployed migrant labour population, have been widely report-ed. Cancer patients are a highly vulnerable group even during non-pandemic periods, often present-ing late in the course of their illness, without the services required to avail recommended care. The incidence of psychological complications and emotional distress is considerably higher in cancer patients than in the general population, and the trauma of both the pandemic and subsequent lock-down contributes significantly to their mental trauma. This analysis is geared at solving the chal-lenges faced by cancer patients in the face of this pandemic and subsequent lockdown, with a look at potential solutions that can be enforced.Copyright © 2021 Bentham Science Publishers.

Palliative Care Movement Disorders Multidisciplinary Meeting

Introduction It is well recognised that patients with Parkinson's disease (PD) have significant symptom burden in advanced stages of their disease. Integration of movement disorder and palliative care services has been limited by concerns about resource and sustainability. We present our experience of establishing a movement disorders palliative care multidisciplinary meeting. Method In 2019 we established a multidisciplinary virtual bimonthly meeting between movement disorders and palliative care specialists. Referrals were accepted from movement disorder specialists, community Parkinson's practitioners and palliative care specialists. Referring clinicians all actively applied primary palliative care approaches within their existing services. Aims of the meeting were to facilitate holistic management of complex needs, support advance care planning (ACP) and consider referral to specialist palliative care services. Result 37 patients in total were discussed over a 2-year period (although the service was limited for a time due to COVID pressures). On average 3 new patients were discussed per meeting. Reasons for referral included motor and non-motor symptoms, support with ACP, medication advice, caregiver concerns and emotional distress. Meeting outcomes included medication adjustments, expediting reviews, hospice support, carer support, and referral to other services. Since the meetings started 23 (62%) patients have died. Of these, 30% died in hospital compared with the national average of 43.4%. The average between discussion at the meeting and death was 139 days. The meeting has generated education opportunities, triggered joint assessments and a professionals' framework for the palliative management of patients with a movement disorder. Conclusions We present the experience of an MDT embedded within an early integrated palliative care service for movement disorders. The MDT has strengthened partnership working and findings suggest that alongside active primary palliative care, specialist palliative care for PD can be sustainable and resource efficient in a UK setting.

"Everyone is just trying to make it to the end of the shift": Neuropsychology review of staff experiences in acute stroke services at NHNN

Introduction: Effective multidisciplinary team working enhances patient care and staff performance and reduces length of stay. In stroke services, this has recently been strained by challenges of staff shortages, team exhaustion and COVID-19, in addition to SSNAP data reporting responsibilities. Consequently, psychological distress has heightened in these healthcare workers. Understanding staff experiences in stroke team environments is crucial to staff retention, wellbeing, and reshaping effective multidisciplinary processes. Method(s): Clinical staff in emergency, hyperacute, and acute stroke units at our hospital were invited in May 2022 to complete an online questionnaire based on validated measures of teamwork, stress, and burnout. Result(s): Twenty-seven respondents represented across therapy, medical (29.6%), and nursing (29.6%) teams. Teamworking was rated as positive by most staff (63%), relating this to open communication and diverse, specialised stroke knowledge. Over 75% of the sample experienced moderate to high burnout, with prevalent experiences of emotional exhaustion. External pressures to meet SSNAP requirements was a time resource barrier that lowered sense of both personal achievement and input into directing work duties. Stress was in the severe-dangerous range for 37% of respondents. Key themes identified for improvement were opportunities for education and service development, and efficiency of knowledge sharing. Conclusion(s): Our multidisciplinary stroke teams reported high levels of stress and burnout, associated with challenging staff to patient ratios, and feeling professional autonomy is compromised to meet stroke service standards. Positive experiences of teamworking were viewed as partially protective against further distress escalations. Results highlight the critical need for novel implementations focusing on team support and development.