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1.
J Nurs Adm ; 52(3): E9-E11, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1769460

ABSTRACT

Because of the pandemic's impact on morbidity and mortality, nursing leaders have witnessed a marked increase in the number of staff who experience crisis and extreme stress during their shift. This hospital's Engagement and Resilience Council aimed to mediate this stress by implementing resilience-building interventions during moments of peaked stress. Preliminary data show these interventions may markedly improve stress levels in frontline caregivers by up to 52% in some clinical settings.


Subject(s)
Crisis Intervention/methods , Nursing Staff, Hospital/psychology , Occupational Stress/therapy , Humans , Shared Governance, Nursing
3.
Crit Care Med ; 49(10): 1739-1748, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1475872

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 pandemic has overwhelmed healthcare resources even in wealthy nations, necessitating rationing of limited resources without previously established crisis standards of care protocols. In Massachusetts, triage guidelines were designed based on acute illness and chronic life-limiting conditions. In this study, we sought to retrospectively validate this protocol to cohorts of critically ill patients from our hospital. DESIGN: We applied our hospital-adopted guidelines, which defined severe and major chronic conditions as those associated with a greater than 50% likelihood of 1- and 5-year mortality, respectively, to a critically ill patient population. We investigated mortality for the same intervals. SETTING: An urban safety-net hospital ICU. PATIENTS: All adults hospitalized during April of 2015 and April 2019 identified through a clinical database search. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 365 admitted patients, 15.89% had one or more defined chronic life-limiting conditions. These patients had higher 1-year (46.55% vs 13.68%; p < 0.01) and 5-year (50.00% vs 17.22%; p < 0.01) mortality rates than those without underlying conditions. Irrespective of classification of disease severity, patients with metastatic cancer, congestive heart failure, end-stage renal disease, and neurodegenerative disease had greater than 50% 1-year mortality, whereas patients with chronic lung disease and cirrhosis had less than 50% 1-year mortality. Observed 1- and 5-year mortality for cirrhosis, heart failure, and metastatic cancer were more variable when subdivided into severe and major categories. CONCLUSIONS: Patients with major and severe chronic medical conditions overall had 46.55% and 50.00% mortality at 1 and 5 years, respectively. However, mortality varied between conditions. Our findings appear to support a crisis standards protocol which focuses on acute illness severity and only considers underlying conditions carrying a greater than 50% predicted likelihood of 1-year mortality. Modifications to the chronic lung disease, congestive heart failure, and cirrhosis criteria should be refined if they are to be included in future models.


Subject(s)
COVID-19/therapy , Crisis Intervention/standards , Resource Allocation/methods , Academic Medical Centers/organization & administration , Academic Medical Centers/statistics & numerical data , Adult , COVID-19/epidemiology , Crisis Intervention/methods , Crisis Intervention/statistics & numerical data , Female , Hospitalization/statistics & numerical data , Humans , Male , Massachusetts , Middle Aged , Resource Allocation/statistics & numerical data , Retrospective Studies , Safety-net Providers/organization & administration , Safety-net Providers/statistics & numerical data , Standard of Care/standards , Standard of Care/statistics & numerical data , Urban Population/statistics & numerical data
5.
J Psychiatr Pract ; 27(3): 152-163, 2021 May 05.
Article in English | MEDLINE | ID: covidwho-1290432

ABSTRACT

Crisis intervention psychotherapy (CIP) is an underutilized form of therapy that can be offered as a treatment during psychiatric disasters and emergencies, and it may be especially useful during the age of Coronavirus Disease 2019 (COVID-19). CIP is a problem-solving, solution-focused, trauma-informed treatment, utilizing an individual or systemic/family-centered approach. CIP is a brief form of psychotherapy delivered as a companion or follow-up to psychological first aid. Crisis psychotherapy is designed to resolve a crisis and restore daily functioning. CIP can be adapted as a single session for a COVID-19 mental health emergency or for a hotline or as 2 to 20 sessions of treatment with COVID-19 patients and families offered virtually on a psychiatric inpatient unit, through a consultation-liaison service, or in outpatient settings. This article reviews the history of critical incident stress management and the use of its replacement, psychological first aid. The history and core principles of crisis psychotherapy and 8 core elements of treatment are described. The use of digital and virtual technology has enabled the delivery of crisis psychotherapy during the COVID-19 pandemic. A case study of a family impacted by COVID-19 is reported as an illustration. The use of a 6-week timeline, an ecological map, and a problem-solving wheel-and-spoke treatment plan are demonstrated.


Subject(s)
COVID-19/psychology , Crisis Intervention , Family Therapy , Psychotherapy, Brief , Telemedicine , Crisis Intervention/methods , Crisis Intervention/standards , Family Therapy/methods , Family Therapy/standards , Humans , Psychotherapy, Brief/methods , Psychotherapy, Brief/standards , Telemedicine/methods , Telemedicine/standards
6.
Nurs Leadersh (Tor Ont) ; 33(4): 29-34, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1094392

ABSTRACT

The COVID-19 pandemic is an unprecedented time for leaders to lead. The uncertainty and complexity have been overwhelming, and for many of us, the tools available in our leadership toolboxes have been tested during the pandemic. In my experience, for nurse leaders to best lead during such challenging times, we need to truly understand what the front line needs from us in a crisis. I believe that six leadership practices are key for nursing leaders to support front-line engagement while navigating and leading teams through a crisis.


Subject(s)
Crisis Intervention/methods , Interprofessional Relations , Leadership , COVID-19/prevention & control , COVID-19/psychology , COVID-19/transmission , Humans , Pandemics/prevention & control , Uncertainty
7.
Am J Drug Alcohol Abuse ; 47(2): 154-159, 2021 03 04.
Article in English | MEDLINE | ID: covidwho-1066068

ABSTRACT

The ongoing pandemic has led to a sudden disruption of routine treatment services. Consequently, the already existing treatment gap for substance use disorders is likely to widen. There is an opportunity to expand the scope of Screening and Brief Intervention (SBI) to meet this unprecedented challenge. Its brevity, flexibility, and generalizability have positioned SBI to deal with additional systemic, structural, and attitudinal barriers that pertain to the pandemic. The standard content of SBI could be modified to adapt to the current context. SBI could also be used as a vehicle to render strategies for infection risk minimization. In this Perspective, we anticipate the challenges of expanding and implementing SBI in the present circumstances and present potential solutions. SBI, with adaptations, could bridge the augmented treatment gap for substance use disorders during COVID-19.


Subject(s)
COVID-19 , Crisis Intervention/methods , Substance-Related Disorders/therapy , Crisis Intervention/organization & administration , Humans , Substance-Related Disorders/diagnosis
8.
Pain Med ; 21(12 Suppl 2): S110-S117, 2020 12 12.
Article in English | MEDLINE | ID: covidwho-975315

ABSTRACT

BACKGROUND: Veterans with significant chronic pain from musculoskeletal disorders are at risk of substance misuse. Veterans whose condition is the result of military service may be eligible for a disability pension. Department of Veterans Affairs compensation examinations, which determine the degree of disability and whether it was connected to military service, represent an opportunity to engage Veterans in pain management and substance use treatments. A multisite randomized clinical trial is testing the effectiveness and cost-effectiveness of Screening, Brief Intervention, and Referral to Treatment for Pain Management (SBIRT-PM) for Veterans seeking compensation for musculoskeletal disorders. This telephone-based intervention is delivered through a hub-and-spoke configuration. DESIGN: This study is a two-arm, parallel-group, 36-week, multisite randomized controlled single-blind trial. It will randomize 1,100 Veterans experiencing pain and seeking service-connection for musculoskeletal disorders to either SBIRT-PM or usual care across eight New England VA medical centers. The study balances pragmatic with explanatory methodological features. Primary outcomes are pain severity and number of substances misused. Nonpharmacological pain management and substance use services utilization are tracked in the trial. SUMMARY: Early trial enrollment targets were met across sites. SBIRT-PM could help Veterans, at the time of their compensation claims, use multimodal pain treatments and reduce existing substance misuse. Strategies to address COVID-19 pandemic impacts on the SBIRT-PM protocol have been developed to maintain its pragmatic and exploratory integrity.


Subject(s)
Chronic Pain/drug therapy , Musculoskeletal Diseases/therapy , Pain Management , SARS-CoV-2/drug effects , Veterans/psychology , Adult , Chronic Pain/virology , Crisis Intervention/methods , Female , Humans , Male , Mass Screening/methods , Musculoskeletal Diseases/complications , Musculoskeletal Diseases/diagnosis , Pain Management/methods , SARS-CoV-2/pathogenicity , Single-Blind Method
9.
Ann Glob Health ; 86(1): 128, 2020 10 06.
Article in English | MEDLINE | ID: covidwho-887660

ABSTRACT

Background: COVID-19 first appeared in China in December 2019, with a high rate of infectivity and morbidity, which brought tremendous psychological pressure to healthcare workers. Purpose: To understand the psychological health status of healthcare workers during the COVID-19 outbreak and decline, and to provide a theoretical reference for the future establishment of a psychological crisis intervention system. Methods: Healthcare workers were recruited using convenience sampling and snowball sampling methods, and the electronic version of the SCL-90 scale and a sociodemographic questionnaire were administered. In the pretest, a total of 5018 responses were collected; after six weeks, random sampling was performed. The SCL-90 and measures of other epidemic-related problems were administered, with 1570 responses received; then, the final data analysis was performed. Results: After six weeks, the post-test GSI score; SCL-90 total score; and PST, PSDI, O-C, I-S, DEP, ANX, PHOB, PAR, PSY, and HOS scores were significantly lower than the corresponding pretest scores (p < 0.05). The results by occupational category showed that the scores of nursing staff decreased significantly for 12 indexes and that the scores of the doctors and other hospital staff also significantly decreased. There was a significant difference between the pretest (50.78 ± 28.18) and post-test (45.00 ± 28.49) scores for the degree of worry about the epidemic. Healthcare workers believed that the top three aspects of life affected by the epidemic were economic problems (816 people), interpersonal communication problems (731 people), and mental health (728 people). Conclusion: Over the course of the epidemic, the item scores generally declined significantly. Therefore, during an outbreak period, attention should be paid to psychological crisis interventions for healthcare workers; problems caused by psychological pressure, and even other psychological conditions, can be significantly alleviated to reduce the probability of subsequent health problems.


Subject(s)
Anxiety , Coronavirus Infections , Crisis Intervention/methods , Depression , Health Personnel/psychology , Pandemics , Pneumonia, Viral , Stress, Psychological , Adult , Anxiety/diagnosis , Anxiety/etiology , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Depression/diagnosis , Depression/etiology , Female , Humans , Male , Mental Health/statistics & numerical data , Occupational Stress/classification , Occupational Stress/diagnosis , Occupational Stress/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Psychiatric Status Rating Scales , SARS-CoV-2 , Stress, Psychological/diagnosis , Stress, Psychological/etiology
10.
Int Arch Occup Environ Health ; 94(2): 347-350, 2021 02.
Article in English | MEDLINE | ID: covidwho-777822

ABSTRACT

Due to the SARS CoV-2-virus (COVID-19), anxiety, distress, and insecurity occur more frequently. In particular, infected individuals, their relatives, and medical staff face an increased risk of high psychological distress as a result of the ongoing pandemic. Thus, structured psychosocial emergency concepts are needed. The University hospital of Essen has taken up this challenge by creating the PEC concept to reduce psychosocial long-term consequences for infected patients, relatives, and medical staff at the university hospital. The concept includes professional medical as well as psychological support to convey constructive coping strategies and the provision of adequate tools such as the low-threshold online training program (CoPE It), which is accessible via the webpage www.cope-corona.de .


Subject(s)
COVID-19/psychology , Crisis Intervention/methods , Emergency Service, Hospital , Medical Staff, Hospital/psychology , Stress, Psychological/therapy , Adaptation, Psychological , Hospitals, University , Humans , Occupational Stress/psychology , Occupational Stress/therapy , SARS-CoV-2 , Stress, Psychological/virology
11.
J Cancer Res Clin Oncol ; 146(10): 2713-2715, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-273053

ABSTRACT

OBJECTIVE: Public discussion and health-care systems worldwide have been focusing on the COVID-19 pandemic. Does it have an impact on cancer care today? MATERIALS AND METHODS: The PRIO ("Prevention and Integrative Oncology") Working Group (German Cancer Society) has initiated an online survey for physicians, medical staff and patients on April 16, 2020. Between April 16 and April 19, 47 doctors and 146 patients filled in the questionnaires. The survey is ongoing. We present the first data. RESULTS: A majority of German patients (76%) and physicians (71%) report moderate or high restriction in their daily life. A minority (patients 25%, physicians 13%) was not worried that necessary treatments or diagnostics were restricted. Organizing cancer care needs more time and efforts for 56% of all reporting doctors. 98% of all oncologists think that restriction of family visits has a negative impact on the mental health of cancer patients. Half of all participants (patients 43%, physicians 47%) expect negative consequences on the physical status of our patients. Patients feel the existing emotional stress in 34% of their physicians. 52% of physicians fear mental and/or physical longtime consequences for themselves. CONCLUSION: There is a high level of mental and physical stress triggered by the present COVID-19 management. After only a few weeks, human resources are limited. They will be the most important key for further health-care services for patients with cancer and other chronic diseases.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Crisis Intervention , Delivery of Health Care , Disease Outbreaks , Neoplasms/epidemiology , Pneumonia, Viral/epidemiology , COVID-19 , Coronavirus Infections/virology , Crisis Intervention/methods , Germany , Humans , Mental Health , Mental Health Services , Neoplasms/diagnosis , Neoplasms/psychology , Neoplasms/therapy , Pandemics , Physicians , Pneumonia, Viral/virology , SARS-CoV-2 , Surveys and Questionnaires
12.
Community Ment Health J ; 56(5): 786-792, 2020 07.
Article in English | MEDLINE | ID: covidwho-186618

ABSTRACT

This article describes a peer support project developed and carried out by a group of experienced mental health professionals, organized to offer peer psychological support from overseas to healthcare professionals on the frontline of the COVID-19 outbreak in Wuhan, China. This pandemic extremely challenged the existing health care systems and caused severe mental distress to frontline healthcare workers. The authors describe the infrastructure of the team and a novel model of peer support and crisis intervention that utilized a popular social media application on smartphone. Such a model for intervention that can be used elsewhere in the face of current global pandemic, or future disaster response.


Subject(s)
Coronavirus Infections/psychology , Crisis Intervention/methods , Health Personnel/psychology , Occupational Health , Peer Group , Pneumonia, Viral/psychology , Social Media , Social Support , Australia , COVID-19 , Canada , China , Humans , International Cooperation , Mental Health , Mobile Applications , Pandemics , Smartphone , United States
13.
Psychiatry Res ; 289: 113042, 2020 07.
Article in English | MEDLINE | ID: covidwho-154715

ABSTRACT

In order to manage the urgent psychological need for support in response to the anticipated reaction of the population to the COVID-19 pandemic, we developed a new psychological crisis intervention model by implementing a centralised psychological support system for all of Tunisia. We set up a helpline which is accessible throughout the country, including those without access to Internet. This model integrates medical students, child and adolescent psychiatrists, psychiatrists, psychologists and social services to provide psychological intervention to the general population and medical staff. It will make a sound basis for developing a more effective psychological crisis intervention response system.


Subject(s)
Coronavirus Infections/psychology , Crisis Intervention/methods , Hotlines/methods , Pneumonia, Viral/psychology , Psychosocial Support Systems , Adolescent , Adult , Betacoronavirus , COVID-19 , Child , Female , Health Plan Implementation , Humans , Male , Medical Staff/psychology , Middle Aged , Pandemics , SARS-CoV-2 , Tunisia/epidemiology , Young Adult
14.
Psychiatry Res ; 289: 113047, 2020 07.
Article in English | MEDLINE | ID: covidwho-141766

ABSTRACT

The Covid-19 pandemic is creating a vast and growing number of challenges for all. People with a history of opioid use disorder (OUD) also may be exposed to additional risks. Piedmont one of the areas most severely affected by the Covid-19 pandemic, with large numbers of people infected and related mortality. In the region, specialists responsible for OUD care identified the risk that the existing care system exposed patients to. Teams designed and implemented innovation approaches to enable continuation of care and reduce the inherent system risk to patients with OUD.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Crisis Intervention/methods , Opioid-Related Disorders/virology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Substance Abuse Treatment Centers/organization & administration , COVID-19 , Coronavirus Infections/psychology , Female , Humans , Male , Pneumonia, Viral/psychology , Program Evaluation , Risk Factors , SARS-CoV-2
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