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1.
Front Public Health ; 10: 904550, 2022.
Article in English | MEDLINE | ID: covidwho-2154831

ABSTRACT

Objective: After the unprecedented coronavirus disease 2019 (COVID-19) outbreak, the health status of the general population has suffered a huge threat, and the mental health of front-line healthcare providers has also encountered great challenges. Therefore, this study aims to: (1) investigate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among healthcare providers, and (2) verify the moderating role of self-efficacy in the influence of PTSD on mental health. Methods: A cross-sectional study was conducted using an online survey of 1993 participants. The presence of depression, anxiety, self-efficacy, and PTSD was evaluated using screening tests from March 1. Sociodemographic and COVID-19-related data were also collected. A data analysis was performed using descriptive statistics, Pearson's correlation coefficient, and multiple linear regression. Results: The prevalence of PTSD among healthcare providers was 9.3%. PTSD was negatively correlated with self-efficacy (r = -0.265, P < 0.01), anxiety (r = -0.453, P < 0.01), and depression (r = 0.708, P < 0.01). Profession, daily working hours, maximum continuous working days, and daily sleep time were influencing factors of PTSD. A binary logistic regression analysis showed that physicians (OR = 2.254, 95% CI = 1.298, 3.914) and nurses (OR = 2.176, 95% CI = 1.337, 3.541) were more likely to experience PTSD than other healthcare providers. Conclusion: Self-efficacy has a moderating effect on the influence of PTSD on anxiety and depression. This suggests that health managers need to respond to the current psychological crisis of healthcare providers, implement appropriate psychological interventions, and minimize the psychological harm caused by COVID-19.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , COVID-19/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Health Personnel/psychology , Humans , Mental Health , Prevalence , Stress Disorders, Post-Traumatic/epidemiology
2.
J Psychiatr Pract ; 28(5): 354-361, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2152270

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has taken a significant toll on people worldwide, and in particular, on the health care workers (HCWs) who have worked on the frontlines in the fight against the pandemic. The goal of this study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and related factors in HCWs in the era of COVID-19. METHODS: This cross-sectional survey study was conducted between September 15, and October 15, 2020, among HCWs in Turkey. The survey consisted of self-administered questionnaires, which included questions about sociodemographic variables, experiences caring for patients with COVID-19, and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), a trauma screening tool. The online survey was completed by 1833 HCWs. Univariate and multivariate logistic regression analyses were used to identify independent predictors of PTSD. RESULTS: The mean age of the participants was 32.7±7.0 years; 81.9% were physicians, and 56.5% were female. The rates of COVID-19 history in the respondents, a family member, or a coworker were 13.6%, 32.3%, and 12.6%, respectively. Among the HCWs who participated, 39.9% met the criteria for PTSD. Compared with the physicians, the nonphysician HCWs had a higher rate of PTSD (49.5% vs. 36%) (P<0.001) and higher PCL-5 scores (53.31±19.6 vs. 42.5±20.3) (P<0.001). In addition, 9.7% of the surveyed HCWs reported having suicidal ideation during the COVID-19 pandemic. Independent predictors of PTSD in HCWs were working on a COVID-19 unit, feeling isolated, suicidal ideation, being a nonphysician HCW, fear of spreading coronavirus to family, female sex, and a history of having COVID-19. CONCLUSIONS: HCWs were at risk for impairment in mental well-being in the era of COVID-19, with a significant number experiencing PTSD as well as suicidal ideation. Therefore, HCWs, especially those who are working on a COVID-19 unit and are female, should be monitored regularly for PTSD.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Health Personnel , Humans , Male , Pandemics , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology
3.
Pan Afr Med J ; 42: 210, 2022.
Article in English | MEDLINE | ID: covidwho-2145203

ABSTRACT

Introduction: mental health nurses (MHNs) work in potentially high-stress settings, in particular in low-income countries during the COVID-19 pandemic the risk might be high. This multi-centre, cross-sectional study explored the prevalence of psychological distress and post-traumatic stress disorder (PTSD) symptoms among Ugandan MHNs and investigated associations between these mental health outcomes and lifestyle factors. Methods: in this cross-sectional study, participants completed the Kessler-6 (K-6), PTSD checklist for DSM-5 (PCL-5), simple physical activity questionnaire (SIMPAQ), physical activity (PA) vital sign (PAVS), Pittsburgh sleep quality index (PSQI, and alcohol use disorder identification test-concise (AUDIT-C). Spearman Rho correlations and Mann Whitney U tests were applied. Results: of 108 included MHNs (age =34.8±10.0 years; 55.6% female) 92.6% had psychological distress (K-6≥13), 44.4% elevated PTSD symptoms (PCL-%≥41), 74.1% was physically inactive (less than 150min/week on PAVS), 75.9% reported poor sleep quality (PSQI>-5) and 24.4% harmful drinking (AUDIT-C≥3 for women and -≥4 for men). SIMPAQ exercise correlated with K-6 (rho =-0.36, P<0.001) and PCL-5 (rho=-0.24, P=0.013), SIMPAQ walking with PCL-5 (rho =-0.31, P<0.001). Mental health nurses meeting the PA guidelines reported lower PCL-5 scores than those who did not (P<0.005). Conclusion: in Uganda, the mental health burden is high during the COVID-19 pandemic among MHNs and associated with an unhealthy lifestyle. The effectiveness and efficacy of resilience programs for MHNs focusing on unhealthy lifestyle patterns should be explored.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Male , Female , Humans , Young Adult , Adult , Mental Health , COVID-19/epidemiology , Cross-Sectional Studies , Pandemics , Uganda/epidemiology , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/diagnosis , Life Style
4.
BMC Psychiatry ; 22(1): 706, 2022 Nov 15.
Article in English | MEDLINE | ID: covidwho-2139199

ABSTRACT

BACKGROUND: Occupation groups like police officers and fire fighters are exposed to a number of traumatic events which put them at a risk of developing post-traumatic stress disorder (PTSD). Previous studies have found the prevalence of PTSD in police officers to vary between 7 and 19%. However, most of these studies have been undertaken in western setting with little research having been undertaken in sub-Saharan Africa including Uganda. OBJECTIVE: To determine the prevalence and factors associated with post-traumatic stress disorder among field police patrol officers serving in Kampala Metropolitan Police (KMP) North Region. METHODS: This was a cross sectional study that was conducted on 392 field police patrol officers serving in KMP North Region. Diagnosis of PTSD was undertaken using the Clinician Administered PTSD Scale for DSM-5. In order to assess for psychiatric comorbidities, the study used the Mini International Neuropsychiatric Interview (M.I.N.I.) RESULTS: In this study, the prevalence of PTSD was 7.4%. An additional 62.5% had sub-threshold PTSD, which was defined as, the presence of at least one PTSD symptom but not meeting full criteria for PTSD diagnosis. The factors found to be significantly associated with PTSD were all related to the presence of psychiatric comorbidities, namely the presence of: a current major depressive episode (aOR = 4.7; 95% CI: 1.5- 14.8; p = .009); an alcohol use disorder (aOR = 5.1; 95% CI: 2.0-13.0; p = .001); and presence of dissociation symptoms (aOR = 6.7; 95% CI: 2.0-22.2; p = .002). CONCLUSION: PTSD is one of the common psychiatric disorders experienced by serving police officers in Uganda. The tendency of PTSD in this group to co-occur with other psychiatric disorders means that any treatment program to address it should be part of a comprehensive multi-disorder mental health treatment programme in the police office.


Subject(s)
Depressive Disorder, Major , Stress Disorders, Post-Traumatic , Humans , Police/psychology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Prevalence , Cross-Sectional Studies , Uganda/epidemiology
5.
Front Public Health ; 10: 1004558, 2022.
Article in English | MEDLINE | ID: covidwho-2123476

ABSTRACT

Background: Any infectious disease outbreak may lead to a negative detrimental psychological impact on individuals and the community at large, however; there was no systematic review nor meta-analysis that examined the relationship between the psychological/mental health impact of SARS and COVID-19 outbreak in Asia. Methods and design: A systematic search was conducted using PubMed, EMBASE, Medline, PsycINFO, and CINAHL databases from 1/1/2000 to 1/6/2020. In this systematic review and meta-analysis, we analyzed the psychological impact on confirmed/suspected cases, healthcare workers and the general public during the Severe Acute Respiratory Syndrome (SARS) outbreak and Coronavirus disease (COVID-19) epidemics. Primary outcomes included prevalence of depression, anxiety, stress, post-traumatic stress disorder, aggression, sleeping problems and psychological symptoms. Result: Twenty-three eligible studies (N = 27,325) were included. Random effect model was used to analyze the data using STATA. Of these studies, 11 were related to the SARS outbreak and 12 related to COVID-19 outbreaks. The overall prevalence rate of anxiety during SARS and COVID-19 was 37.8% (95% CI: 21.1-54.5, P < 0.001, I2 = 96.9%) and 34.8% (95% CI: 29.1-40.4), respectively. For depression, the overall prevalence rate during SARS and COVID-19 was 30.9% (95% CI: 18.6-43.1, P < 0.001, I2 = 97.3%) and 32.4% (95% CI: 19.8-45.0, P < 0.001, I2 = 99.8%), respectively. The overall prevalence rate of stress was 9.4% (95% CI: -0.4 -19.2, P = 0.015, I2 = 83.3%) and 54.1% (95% CI: 35.7-72.6, P < 0.001, I2 = 98.8%) during SARS and COVID-19, respectively. The overall prevalence of PTSD was 15.1% (95% CI: 8.2-22.0, P < 0.001) during SARS epidemic, calculated by random-effects model (P < 0.05), with significant between-study heterogeneity (I2 = 93.5%). Conclusion: The SARS and COVID-19 epidemics have brought about high levels of psychological distress to individuals. Psychological interventions and contingent digital mental health platform should be promptly established nationwide for continuous surveillance of the increasing prevalence of negative psychological symptoms. Health policymakers and mental health experts should jointly collaborate to provide timely, contingent mental health treatment and psychological support to those in need to reduce the global disease burden. Systematic review registration: CRD42020182787, identifier PROSPER.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , COVID-19/epidemiology , Health Personnel , Stress Disorders, Post-Traumatic/epidemiology , Anxiety/epidemiology , Prevalence
6.
Int J Environ Res Public Health ; 19(19)2022 Sep 22.
Article in English | MEDLINE | ID: covidwho-2110054

ABSTRACT

OBJECTIVE: The current study will evaluate the association that the COVID-19 pandemic has had with health-care workers and identify the factors that influenced the female gender being more affected. METHODS: This is a cross-sectional study conducted in two hospitals in Arequipa (a Peruvian city). The participants were health-care workers. We applied a questionnaire with sociodemographic information and three scales: the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Primary Care Post-Traumatic Stress Disorder (PTSD) Screen for DSM-5. The main outcomes were anxiety, depression, and PTSD scores. The exposure of interest was gender. The scores of the scales were estimated by medians and percentiles 25-75 (p25-p75), and we used linear regression to estimate the crude and adjusted coefficients and their respective confidence intervals at 95% (CI 95%). RESULTS: There were 109 participants, and 43.1% were women. The anxiety, depression, and PTSD median (p25-p75) scores in the study population were 6 (2-11), 6 (2-10), and 1 (0-3), respectively. The adjusted analysis showed that the female sex had 4.48 (CI 95% 2.95-6.00), 4.50 (CI 95% 2.39-6.62), and 1.13 (CI 95% 0.50-1.76) higher points on average for the scales of anxiety, depression, and PTSD symptoms in comparison to males, respectively. CONCLUSIONS: Female health-care workers showed increased scores of mental health issues in comparison to male health-care workers.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Anxiety/epidemiology , Anxiety/psychology , Anxiety Disorders/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , Humans , Male , Pandemics , Peru/epidemiology , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology
7.
J Occup Environ Med ; 64(11): 934-941, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2107643

ABSTRACT

OBJECTIVE: To determine to what extent did health care workers experience the pandemic as a severe stress event. METHODS: This cross-sectional evaluation of 8299 health care workers, representing a 22% response rate, utilized machine learning to predict high levels of escalating stress based on demographics and known predictors for adverse psychological outcomes after trauma. RESULTS: A third of health care workers experienced the pandemic as a potentially traumatic stress event; a greater proportion of health care workers experienced high levels of escalating stress. Predictive factors included sense of control, ability to manage work-life demands, guilt or shame, age, and level of education. Gender was no longer predictive after controlling for other factors. Escalating stress was especially high among nonclinical academics and clinical private practitioners. CONCLUSION: Findings suggest adverse effects on total worker health, care quality, professionalism, retention, and acute and chronic mental health.


Subject(s)
COVID-19 , Disasters , Stress Disorders, Post-Traumatic , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Self-Assessment , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Health Personnel/psychology
8.
Psychiatr Danub ; 32(3-4): 521-526, 2020.
Article in English | MEDLINE | ID: covidwho-2100774

ABSTRACT

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic emerged in Wuhan, China and has spread all over the world and affected global mental health. Pregnant women may be particularly vulnerable and experience high levels of distress during an infectious disease outbreak. The aim of this study was to determine anxiety and post-traumatic stress disorder (PTSD) symptoms in pregnant women during the COVID-19 pandemic. SUBJECTS AND METHODS: This cross-sectional study surveyed a total of 283 pregnant women within the period of May 11 to May 28,2020. During their regular antenatal visit, pregnant women were invited to participate in the study. The self-created personal information form was used to assess the main characteristics of the participants. Anxiety and PTSD symptoms of the pregnant women were measured by the Spielberger State-Trait Anxiety Inventory (STAI) and Impact of Events Scale-Revised (IES-R), respectively. RESULTS: The mean age of the pregnant women was 29.20±5.55 years. Regarding gestational age, 72 (25.4%), 86 (30.4) and 125 (44.2) were in the first, second and third trimesters, respectively. The mean gestational age was 23.82±11.05 weeks. The mean STAI-S and STAI-T scores were 39.52±10.56 within the cut-off value (39-40) of the instrument and 42.74±8.33, respectively. Furthermore, the mean total IES-R score was 36.60±15.65 within the cut-off value (24) of the instrument. Multiple regression analysis revealed that pregnancy complication (p=0.01) and employment status of husband (p=0.04) were the best predictors of state anxiety. Additionally, the presence of COVID-19-related symptoms (p=0.01) and educational level (p=0.01) were found to predict PTSD symptoms. CONCLUSIONS: Pregnant women would be likely to experience high levels of anxiety and PTSD symptoms during the COVID-19 pandemic's delay phase. The results should sensitize the medical team to increased anxiety and PTDS symptoms of the pregnant women in order to prevent negative outcomes for women and their fetuses.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adult , Anxiety/epidemiology , China , Cross-Sectional Studies , Depression , Female , Humans , Pandemics , Pregnancy , Pregnant Women , SARS-CoV-2 , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress, Psychological , Young Adult
9.
Eur J Psychotraumatol ; 13(2): 2127185, 2022.
Article in English | MEDLINE | ID: covidwho-2097170

ABSTRACT

Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic - as a psychosocial stressor - affected the aetiological processes of mental disorders. Previous research has shown that stress potentiates associative (fear) learning and analogue symptoms of posttraumatic stress disorder (PTSD) and that analogue PTSD symptoms can emerge in response to associative learning. Objective: We investigated whether distress in response to the COVID-19 outbreak support the development of intrusions and rumination after exposure to a non-COVID-19-related analogue trauma. Moreover, we examined if these effects are mediated by the strength of associative learning during analogue trauma. Method: 122 undergraduate university students participated in an online experiment between March and July 2020. They completed questionnaires measuring distress and rumination related to the COVID-19 outbreak. On a subsequent day, they went through an associative learning task, in which neutral stimuli were paired with the appearance of a highly aversive film clip. Subjective ratings were assessed as indicators of associative learning. On the next day, participants documented film-related intrusions and rumination. Results: COVID-19-related distress but not rumination was associated with post-film intrusion and rumination load. These effects were mediated by associative learning. Conclusions: The current findings are in line with the assumptions that stress enhanced both associative learning and PTSD symptoms. Specifically, they indicate that prolonged psychosocial stress - like during the COVID-19 outbreak - is linked to individual differences in memory processing of aversive events. Further confirmatory research is needed to replicate these results.


Antecedentes: El brote de COVID-19 a principios de 2020 se asoció con un aumento inmediato de problemas de salud mental en un porcentaje significativo de la población general. Por lo tanto, es crucial investigar cómo la pandemia de COVID-19, como estresor psicosocial, afectó los procesos etiológicos de los trastornos mentales. Investigaciones anteriores han demostrado que el estrés potencia el aprendizaje asociativo (miedo) y los síntomas análogos del trastorno de estrés postraumático (TEPT) y que los síntomas análogos del TEPT pueden surgir en respuesta al aprendizaje asociativo.Objetivo: Investigamos si el malestar psicológico en respuesta al brote de COVID-19 contribuye al desarrollo de intrusiones y rumiación después de la exposición a un trauma análogo no relacionado con COVID-19. Además, examinamos si estos efectos están mediados por la fuerza del aprendizaje asociativo durante el trauma analógico.Método: 122 estudiantes universitarios de pregrado participaron en un experimento en línea entre marzo y julio de 2020. Completaron cuestionarios que midieron el malestar psicológico y la rumiación relacionados con el brote de COVID-19. Al día siguiente, realizaron una tarea de aprendizaje asociativo, en la que se emparejaron estímulos neutrales con la exposición a un clip de película altamente aversivo. Las calificaciones subjetivas se evaluaron como indicadores de aprendizaje asociativo. Al día siguiente, los participantes documentaron intrusiones y rumiaciones relacionadas con la película.Resultados: El malestar psicológico relacionado con COVID-19, pero no la rumiación, se asoció con la intrusión posterior a la película y la carga de rumiación. Estos efectos fueron mediados por el aprendizaje asociativo.Conclusiones: Los hallazgos actuales están en línea con las suposiciones de que el estrés potenció tanto el aprendizaje asociativo como los síntomas del TEPT. Específicamente, indican que el estrés psicosocial prolongado, como el ocurrido durante el brote de COVID-19, está relacionado con diferencias individuales en el procesamiento de la memoria de eventos aversivos. Se necesita más investigación confirmatoria para replicar estos resultados.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , Stress Disorders, Post-Traumatic/epidemiology , Pandemics , Memory/physiology , Fear/psychology
10.
WMJ ; 121(3): E34-E37, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2093113

ABSTRACT

INTRODUCTION: We present a case report of a physician assistant who experiences posttraumatic stress disorder (PTSD) from providing care to patients affected with COVID-19. We believe this case is important as it will reveal the unfortunate impact COVID-19 has on the mental health of health care professionals. CASE PRESENTATION: A 51-year-old White woman presented to our clinic with a 1-year history of panic attacks, mood swings, difficulty sleeping, nightmares, social withdrawal, guilt, and depression. DISCUSSION: Cross-sectional, survey-based studies have highlighted PTSD rates in health care workers during the pandemic, but these studies have not explored how exactly PTSD presents on the individual level. CONCLUSIONS: This case presents a compelling reflection on what could be a larger trend of increasing mental health issues as a direct result of the COVID-19 pandemic and emphasizes the need for better mental health support and infrastructure to be in place for the well-being of the health care workers in this country.


Subject(s)
COVID-19 , Physician Assistants , Stress Disorders, Post-Traumatic , Female , Humans , Middle Aged , COVID-19/epidemiology , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/therapy , Stress Disorders, Post-Traumatic/etiology , Cross-Sectional Studies , Intensive Care Units , Depression
11.
PLoS One ; 17(10): e0275774, 2022.
Article in English | MEDLINE | ID: covidwho-2089416

ABSTRACT

BACKGROUND: Post-traumatic stress disorder (PTSD) remains a significant treatment challenge among Canadian veterans. Currently accessible pharmacological and non-pharmacological interventions for PTSD often do not lead to resolution of PTSD as a categorical diagnosis and have significant non-response rates. Sudarshan Kriya Yoga (SKY), a complementary and integrative health (CIH) intervention, can improve symptoms of PTSD. In response to the COVID-19 pandemic, this intervention has pivoted to virtual delivery and may be reaching new sets of participants who face multiple barriers to care. OBJECTIVE: To evaluate the implementation and effectiveness of virtually delivered Sudarshan Kriya Yoga (SKY) on decreasing PTSD symptom severity, symptoms of depression, anxiety, and pain, and improving quality of life in Canadian veterans affected by PTSD. METHODS AND ANALYSIS: Using a mixed-methods approach guided by the RE-AIM framework, we will conduct a hybrid type II effectiveness and implementation study of virtually delivered Sudarshan Kriya Yoga (SKY) for Canadian veterans. Effectiveness will be evaluated by comparing virtually delivered SKY to a waitlist control in a single-blinded (investigator and data analyst) randomized controlled trial (RCT). Change in PTSD symptoms (PCL-5) is the primary outcome and quality of life (SF-36), symptoms of depression (PHQ-9), anxiety (GAD-7), and pain (BPI) are secondary outcomes. The SKY intervention will be conducted over a 6-week period with assessments at baseline, 6-weeks, 12-weeks, and 30 weeks. The reach, effectiveness, adoption, implementation, and maintenance of the intervention will be evaluated through one-on-one semi-structured interviews with RCT participants, SKY instructors, health professionals, and administrators that work with veterans. DISCUSSION: This is the first investigation of the virtual delivery of SKY for PTSD in veterans and aims to determine if the intervention is effective and implementable at scale.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Veterans , Yoga , Humans , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/therapy , COVID-19/epidemiology , Canada/epidemiology , Pain , Randomized Controlled Trials as Topic
12.
Eur J Psychotraumatol ; 13(2): 2128028, 2022.
Article in English | MEDLINE | ID: covidwho-2087642

ABSTRACT

Background: Moral injury is defined as the strong emotional and cognitive reactions following events which clash with someone's moral code, values or expectations. During the COVID-19 pandemic, increased exposure to Potentially Morally Injurious Events (PMIEs) has placed healthcare workers (HCWs) at risk of moral injury. Yet little is known about the lived experience of cumulative PMIE exposure and how NHS staff respond to this. Objective: We sought to rectify this knowledge gap by qualitatively exploring the lived experiences and perspectives of clinical frontline NHS staff who responded to COVID-19. Methods: We recruited a diverse sample of 30 clinical frontline HCWs from the NHS CHECK study cohort, for single time point qualitative interviews. All participants endorsed at least one item on the 9-item Moral Injury Events Scale (MIES) [Nash et al., 2013. Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646-652] at six month follow up. Interviews followed a semi-structured guide and were analysed using reflexive thematic analysis. Results: HCWs described being routinely exposed to ethical conflicts, created by exacerbations of pre-existing systemic issues including inadequate staffing and resourcing. We found that HCWs experienced a range of mental health symptoms primarily related to perceptions of institutional betrayal as well as feeling unable to fulfil their duty of care towards patients. Conclusion: These results suggest that a multi-facetted organisational strategy is warranted to prepare for PMIE exposure, promote opportunities for resolution of symptoms associated with moral injury and prevent organisational disengagement. HIGHLIGHTS Clinical frontline healthcare workers (HCWs) have been exposed to an accumulation of potentially morally injurious events (PMIEs) throughout the COVID-19 pandemic, including feeling betrayed by both government and NHS leaders as well as feeling unable to provide duty of care to patients.HCWs described the significant adverse impact of this exposure on their mental health, including increased anxiety and depression symptoms and sleep disturbance.Most HCWs interviewed believed that organisational change within the NHS was necessary to prevent excess PMIE exposure and promote resolution of moral distress.


Antecedentes: El daño moral se define como las fuertes reacciones emocionales y cognitivas que siguen a los eventos que chocan con el código moral de una persona, sus valores o expectativas. Durante la pandemia de COVID-19, el aumento de la exposición a Eventos Potencialmente Dañinos para la Moral (PMIEs, por su sigla en inglés) ha puesto a los trabajadores de la salud (HCWs, por su sigla en inglés) en riesgo de daño moral. Aún se conoce poco sobre la experiencia vivida de la exposición acumulada a PMIE y cómo el personal del Servicio Nacional de Salud de Inglaterra (NHS en su sigla en inglés) responde a esto.Objetivo: Buscamos rectificar esta brecha de conocimiento a través de la exploración cualitativa de las experiencias vividas y perspectivas del personal clínico de primera línea de NHS que respondió al COVID-19.Métodos: Reclutamos una muestra diversa de 30 HCWs clínicos de primera línea de la cohorte del estudio CHECK del NHS, para entrevistas cualitativas de una sola vez. Todos los participantes aprobaron al menos un ítem de los 9 de la Escala de Eventos de Daño Moral (MIES) [Nash y cols., 2013. Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646­652] en el seguimiento a los 6 meses. Las entrevistas siguieron una guía semi-estructurada y fueron analizadas utilizando análisis temático reflexivo.Resultados: Los HCWs describieron estar expuestos de forma rutinaria a conflictos éticos, creados por exacerbación de problemas sistémicos pre-existentes que incluían falta de personal y de recursos. Encontramos que los HCWs experimentaron un rango de síntomas de salud mental primariamente relacionados a percepciones de traición institucional y al sentirse incapaces de cumplir con su deber de cuidado hacia los pacientes.Conclusión: Estos resultados sugieren que se requiere una estrategia organizacional multifacética para preparar para la exposición a PMIE fomentar oportunidades de resolución de los síntomas asociados al daño moral y prevenir la separación organizacional.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , Stress Disorders, Post-Traumatic/epidemiology , Pandemics , Health Personnel/psychology , Morals
13.
WMJ ; 121(3): E34-E37, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2084243

ABSTRACT

INTRODUCTION: We present a case report of a physician assistant who experiences posttraumatic stress disorder (PTSD) from providing care to patients affected with COVID-19. We believe this case is important as it will reveal the unfortunate impact COVID-19 has on the mental health of health care professionals. CASE PRESENTATION: A 51-year-old White woman presented to our clinic with a 1-year history of panic attacks, mood swings, difficulty sleeping, nightmares, social withdrawal, guilt, and depression. DISCUSSION: Cross-sectional, survey-based studies have highlighted PTSD rates in health care workers during the pandemic, but these studies have not explored how exactly PTSD presents on the individual level. CONCLUSIONS: This case presents a compelling reflection on what could be a larger trend of increasing mental health issues as a direct result of the COVID-19 pandemic and emphasizes the need for better mental health support and infrastructure to be in place for the well-being of the health care workers in this country.


Subject(s)
COVID-19 , Physician Assistants , Stress Disorders, Post-Traumatic , Female , Humans , Middle Aged , COVID-19/epidemiology , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/therapy , Stress Disorders, Post-Traumatic/etiology , Cross-Sectional Studies , Intensive Care Units , Depression
14.
Int J Environ Res Public Health ; 19(20)2022 Oct 19.
Article in English | MEDLINE | ID: covidwho-2082300

ABSTRACT

Military personnel represent a frontline group exposed to multiple stressors. These factors have increased during the COVID-19 pandemic, predisposing to the development of suicidal risk (SR). Given the few studies conducted in this population, we evaluated the prevalence of SR and its associated factors during the health emergency. A cross-sectional survey study was conducted in person among 514 participants in Lambayeque, Peru in 2021. The outcome was SR, and the exposures were depression (PHQ-9), anxiety (GAD-7), PTSD (PCL-C), and other sociodemographic variables. The prevalence of SR was 14.0% (95% CI: 11.12-17.31%) and was significantly higher in people with a family history of mental health (PR: 2.16; 95% CI: 1.13-4.15) and in those with moderate clinical insomnia (PR: 2.21; 95% CI: 1.19-4.12). Military personnel with high resilience had a lower prevalence of SR (PR: 0.54, CI: 0.31-0.95). Anxiety was associated with a higher prevalence of SR (PR: 3.27; 95% CI: 1.76-6.10). Our findings show that at least 1 out of 10 military personnel are at risk of suicide. Special attention should be paid to the associated factors to develop interventions and reverse their consequences. These results may be useful in policy implementation and general statistics of SR in the local and regional context.


Subject(s)
COVID-19 , Military Personnel , Stress Disorders, Post-Traumatic , Suicide , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Military Personnel/psychology , Pandemics , Peru/epidemiology , Anxiety/epidemiology , Anxiety/psychology , Depression/epidemiology , Depression/psychology , Health Personnel/psychology , Stress Disorders, Post-Traumatic/epidemiology
15.
Psychiatr Danub ; 34(3): 602-605, 2022.
Article in English | MEDLINE | ID: covidwho-2081409

ABSTRACT

An increase of psychopathology such as post-traumatic stress disorder (PTSD) is described in patients affected with COVID-19 that stayed at an intensive care unit (ICU). However, data on follow-up and on impact of contextual factors are limited. In a single-center, observational study, PTSD symptomatology was prevalent among 38% of participants (n=8), persisting in clinical PTSD in 2 participants after one year. In patients with initial PTSD symptoms, scores on depression, anxiety and insomnia scales were significantly higher. A higher mental burden due to avoidance of contact and a reduced quality of life was also retained in patients with PTSD symptoms.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/therapy , Stress Disorders, Post-Traumatic/diagnosis , Quality of Life , Critical Care , Anxiety/epidemiology , Intensive Care Units , Depression
16.
Brain Behav ; 12(11): e2785, 2022 11.
Article in English | MEDLINE | ID: covidwho-2074926

ABSTRACT

BACKGROUND: In December 2019, coronavirus disease (COVID-19) was first reported in Wuhan, China, and has had a negative psychological impact on the medical staff. However, the long-term psychological effects of COVID-19 were still unclear. We aimed to assess the posttraumatic stress disorder (PTSD) and depression among medical staff 2 years after COVID-19 pandemic in Wuhan, China. METHODS: We conducted a multicenter study in five general hospitals in Wuhan, China. PTSD was assessed using the PTSD Checklist-5. Depression was measured by the Center for Epidemiologic Studies Depression Scale. Multivariate adjusted logistic regression models were used to evaluate the association among demographic variables, depressive indicators, and PTSD. RESULTS: In a sample of 1795 medical staff, 295 (16.40%) participants reported PTSD and 329 (18.30%) reported depression. After multivariate adjusted logistic regression analyses, participants involved in COVID-19 clinical work, unsafe working environment, poor doctor-patient relationship, unhealth status, work dissatisfaction, and low family support were at a high risk for PTSD and depression 2 years after the outbreak of COVID-19 pandemic. CONCLUSIONS: Although it has been more than 2 years after the COVID-19 pandemic outbreak, the mental health of medical staff remains a concern. In particular, medical staff involved in the clinical care of COVID-19 patients showed a higher risk of PTSD and depression 2 years after the COVID-19 pandemic. This study may provide some useful suggestions for psychological interventions for medical staff.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , COVID-19/epidemiology , Physician-Patient Relations , Anxiety/psychology , Medical Staff , China/epidemiology
17.
Int J Environ Res Public Health ; 19(20)2022 Oct 18.
Article in English | MEDLINE | ID: covidwho-2071484

ABSTRACT

This study examined the longitudinal changes of movement behaviors and their relationships with posttraumatic stress disorder (PTSD) among university students during the coronavirus disease 2019 in China. A total of 569 university students completed online surveys twice (Time 1: between December 2020 and January 2021; Time 2: between November and December 2021). Physical activity, sedentary behavior, sleep duration and quality, as well as PTSD were self-reported. According to Canadian 24-h movement guidelines, the longitudinal shifts in each movement behavior from Time 1 to Time 2 were divided into four categories (consistently meeting the guidelines, from meeting to not meeting the guidelines, from not meeting to meeting the guidelines, and consistently not meeting the guidelines). Generalized linear mixed models were conducted using 410 valid responses (20.2 ± 1.0 years old at Time 2, 41.2% males). From Time 1 to Time 2, 22.2%, 2.0%, and 45.6% of the students consistently met the physical activity, sedentary behavior, and sleep guidelines, respectively. Compared to those who consistently met the sedentary behavior guideline, students who consistently failed to meet or changed from meeting to not meeting the guidelines had higher levels of PTSD. Students who had poor sleep quality at both time points or changed from good to bad sleep quality had higher levels of PTSD than those who maintained good sleep quality over time. Compared to those who consistently failed to meet the guideline, students who consistently met the PA guideline had higher levels of PTSD. These findings highlight the needs to improve and maintain healthy behaviors for mental health.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Male , Humans , Young Adult , Adult , Female , COVID-19/epidemiology , Stress Disorders, Post-Traumatic/epidemiology , Universities , Pandemics , Canada/epidemiology , Sleep/physiology , Students/psychology
18.
Int J Environ Res Public Health ; 19(20)2022 Oct 12.
Article in English | MEDLINE | ID: covidwho-2071423

ABSTRACT

This study analyzed changes in the psychological health of students who were in the final year of their nursing degree during the COVID-19 pandemic and later served as nursing professionals in hospitals. Methods: A prospective longitudinal study was conducted over two periods of time (the first in April 2020 and the second 6 months later, in December 2020) with 296 students for a T0 baseline (rate response 68.83%) and 92 students for a T1 post-test sample (response rate 31.08%). The data were electronically collected using the Hospital Anxiety and Depression Scale, the Life Satisfaction Questionnaire, the Resilience Scale, and a post-traumatic stress questionnaire. The mean age of the sample participants was 24.17 years (SD = 5.51), and 89.11% were female. During the pandemic, 14.11% of students showed scores that indicated depression, and 32.61% showed scores that indicated anxiety. In December 2020, 86.5% of the participants were working as nurses, and the percentages of those with anxiety (12%) and depression (4.3%) were significantly lower than in the first sample period. A total of 20.7% of the participants had post-traumatic stress. High scores for resilience were significantly associated with better quality of life and lower levels of anxiety, depression, and post-traumatic stress. Conclusions: Although the percentages of participants with anxiety and depression decreased, they still presented with mental health problems.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Students, Nursing , Humans , Female , Young Adult , Adult , Male , COVID-19/epidemiology , Mental Health , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Quality of Life , Longitudinal Studies , Prospective Studies , Depression/epidemiology , Depression/psychology , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Anxiety/epidemiology , Anxiety/psychology
19.
Int J Environ Res Public Health ; 19(20)2022 Oct 11.
Article in English | MEDLINE | ID: covidwho-2071418

ABSTRACT

The world is still in the grip of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with putative psychological consequences for healthcare workers (HCWs). Exploring the prevalence of post-traumatic stress disorder (PTSD) during the first SARS-CoV-1 epidemic in 2003 may inform us of the long-term effects of the actual pandemic, as well as putative influencing factors such as contact with the virus, time effects, or the importance of some sociodemographic data. This information may help us develop efficient preventive strategies. Therefore, we conducted a systematic review and meta-analysis on the prevalence of PTSD in HCWs following the SARS-CoV-1 in 2003. PubMed, Embase, Google Scholar, Psychinfo, and Web of Science were searched until September 2022. Random-effects meta-analyses were stratified by the time of follow-up. We included 14 studies: 4842 HCWs (32.0 years old, 84% women). The overall prevalence of PTSD was 14% (95CI 10 to 17%). The prevalence of PTSD was 16% (8 to 24%) during the epidemic, 19% (16 to 22%) within 6 months after the epidemic, and 8% (4 to 13%) more than one year after the end of the epidemic. The longest follow-up was three years after the epidemic, with 10% of HCWs with PTSD. Nevertheless, the prevalence of PTSD was significantly lower more than one year after the end of the epidemic than the first six months after the epidemic (Coefficient -10.4, 95CI -17.6 to -3.2, p = 0.007). In conclusion, the prevalence of PTSD in HCWs was high during the first epidemic of SARS-CoV in 2003 and remained high in the long term. The lessons from the SARS-CoV-1 epidemic may help prevent a wave of PTSD following the latest COVID-19 pandemic.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Female , Humans , Adult , Male , Pandemics/prevention & control , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , COVID-19/epidemiology , Prevalence , Health Personnel/psychology
20.
Eur J Psychotraumatol ; 13(2): 2129359, 2022.
Article in English | MEDLINE | ID: covidwho-2070040

ABSTRACT

Background: Although symptoms of posttraumatic stress disorder (PTSD) have been associated with the COVID-19 pandemic experiences, no study has explored yet the association of specific COVID-19 narratives with peritraumatic distress, the precursor of PTSD. Objective: To explore the worst experiences associated with peritraumatic distress during the first wave of the COVID-19 pandemic. Method: Adult residents (N = 1098), from the US (n = 741) and Italy (n = 357), completed an online survey including socio-demographic data, COVID-19-related experiences, the Peritraumatic Distress Inventory and an open question on their worst experiences during the first period of the COVID-19 pandemic (April-May 2020). A thematic content analysis (TCA) was conducted on the answers to the open question and a classification and regression tree (CART) analysis was used to identify the themes that best predicted the clinical levels of peritraumatic distress. Results: The main TCA themes related to participants' worst COVID-19 experiences were anxiety, threat, loss, anger, stress and constriction. Threat was the most prevalent theme and correlated with experiences such as being quarantined, being infected and a loved one receiving the diagnosis. US participants' descriptions of their worst experiences related more to life-threat and loss, while Italians reported more threat to the world, stress, social isolation, and feeling trapped. In the CART analysis, the main predictor (79.9%) was perceiving negative effects from the COVID-19 crisis. Among them, a COVID-related threat to self-experience was the most robust predictor. In its absence, being deprived of resources or experiencing high levels of anxiety were other robust predictors. Conclusions: The study provided evidence of the utility of a mixed-method approach in conceptualizing experiences associated with the COVID-19 pandemic and the risk of traumatic symptoms. Its findings may inform healthcare interventions and policies for tackling the new challenges posed by the COVID-19 pandemic. HIGHLIGHTS Clinically significant levels of peritraumatic distress symptoms were prevalent during the COVID-19 pandemic.Clinically significant levels of peritraumatic distress during the COVID-19 pandemic were related to experiences of life-threat, resource deprivation, and anxiety, cross-cutting the themes articulated by the thematic content analysis of anxiety, threat, loss, anger, stress and constriction.The US and Italian participants' descriptions of their worst experiences differed in subtle but important ways, with Americans reporting more life-threat and losses compared to Italians reporting more threat to the world, stress, social isolation, and feelings of being trapped.


Antecedentes: Aunque los síntomas del trastorno de estrés postraumático (TEPT) se han asociado con las experiencias de la pandemia de COVID-19, ningún estudio ha explorado aún la asociación de las narrativas específicas de COVID-19 con el distres peritraumático, el precursor del TEPT.Objetivo: Explorar las peores experiencias asociadas al distres peritraumático durante la primera ola de la pandemia COVID-19.Método: Adultos residentes (N = 1098), de los EE.UU. (n = 741) e Italia (n = 357), completaron una encuesta en línea que incluía datos sociodemográficos, experiencias relacionadas con la COVID-19, el Inventario de Distrés Peritraumático y una pregunta abierta sobre sus peores experiencias durante el primer período de la pandemia de la COVID-19 (abril-mayo de 2020). Se realizó un análisis de contenido temático (TCA, en sus siglas en inglés) sobre las respuestas a la pregunta abierta y se utilizó un análisis de árbol de clasificación y regresión (CART, en sus siglas en inglés) para identificar los temas que mejor predecían los niveles clínicos de distres peritraumático.Resultados: Los principales temas del TCA relacionados con las peores experiencias de COVID-19 de los participantes fueron la ansiedad, la amenaza, la pérdida, la ira, el estrés y la constricción. La amenaza fue el tema más prevalente y se correlacionó con experiencias como estar en cuarentena, estar infectado y que un ser querido recibiera el diagnóstico. Las descripciones de los participantes estadounidenses de sus peores experiencias estaban más relacionadas con la amenaza a la vida y la pérdida, mientras que los italianos informaron más de la amenaza al mundo, el estrés, el aislamiento social y la sensación de estar atrapados. En el análisis CART, el principal predictor (79,9%) fue la percepción de efectos negativos de la crisis COVID-19. Entre ellos, la experiencia de amenaza a sí mismo relacionada con la COVID fue el predictor más sólido. En su ausencia, estar privado de recursos o experimentar altos niveles de ansiedad fueron otros predictores sólidos.Conclusiones: El estudio aportó pruebas de la utilidad de un abordaje de métodos mixtos para conceptualizar las experiencias asociadas a la pandemia de COVID-19 y el riesgo de síntomas traumáticos. Sus hallazgos pueden servir de base a las intervenciones y políticas sanitarias para afrontar los nuevos retos que plantea la pandemia de COVID-19.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Humans , Pandemics , Quarantine , Stress Disorders, Post-Traumatic/epidemiology , United States/epidemiology
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