Effectiveness of a Fire Disaster PFA Simulation Game: A Single-Blinded Trial.

OBJECTIVE: As societies become more complex, disasters are increasing in frequency and magnitude. To respond to the psychological problems that may arise in such situations, it is necessary to develop the psychological first aid (PFA) training program that is more engaging for disaster relief workers and less limited in time and space. This study aimed to investigate the effectiveness of a web-based PFA simulation game for disaster relief workers to provide to fire disaster victims. METHODS: This was a non-randomized controlled experimental study with 30 participants in the experimental and control groups. The experimental group learned through the web-based PFA simulation game developed in this study, and the control group was provided with written educational materials regarding general disaster. The effects of time between groups and interaction between groups were tested. RESULTS: Compared to the control group, the experimental group showed significant effects on core competencies in disaster response, self-efficacy, and problem-solving process, and the persistence of the effects was also significantly different. CONCLUSION: The web-based PFA simulation game was found to be effective in improving core competencies in disaster response, self-efficacy, and problem-solving process of disaster relief workers. These results suggest that simulation games can be an effective learning method for learning PFA for disaster relief workers. Since it is difficult to learn through direct participation in disaster situations, a web-based simulation game may be a more effective way to improve and maintain the competence of PFA.

The effect of psychological first-aid virtual education on the communication skills of nurses in disasters: a randomized controlled trial.

BACKGROUND: Disasters have affected the physical and mental health of people around the world. Since nurses are frontlines in disasters, it seems necessary to prepare for this responsibility. This study investigates the effect of psychological first-aid virtual education on the communication skills of nurses in disasters such as COVID pandemic. METHODS: In a randomized controlled trial, 55 nurses were selected by purposive sampling method from two hospitals in Isfahan and Tehran, Iran in December-November 2022 and randomly replaced in the intervention group who participated in psychological first aid virtual training and control group. The data were collected through the personal information form and Communication Skills -Test-Revised (CSTR). RESULTS: Two groups were homogeneous in terms of communication skills (p = 0.177), the total score of communication skills was significant between the two groups after the intervention (p < 0.0001). Regarding communication skills, in the pre-intervention phase, the subscale of "the ability to receive and send messages" and "insight into the communication process" the difference before the intervention was not significant between the two groups (p > 0.05). However, it was significant between the two groups after the intervention (p < 0.05), and regarding "emotional control", "listening skills", and "communication along with assertiveness" the difference before and after the intervention was not significant between the two groups (p > 0.05). CONCLUSION: Pre-disaster training and virtual education can increase nurses' communication skills in their ability to handle a disaster such as COVID pandemic. Virtual education of post-disaster psychological interventions is suggested. TRIAL REGISTRATION: IRCT20220923056023N1; date: 2023-01-31.

Psychological first aid practice self-efficacy of nurses in disasters.

In the present cross-sectional study, we determined the self-efficacy of nurses to apply psychological first aid (PFA) during disasters. The study sample consisted of 580 nurses working in Turkey. The data were collected online between July and November 2022 using the "Personal Information Form" and the "PFA Application Self-Efficacy Scale." The data were analyzed using descriptive statistical methods (number, percentage, mean, and standard deviation), generalized linear models, Bonferroni correction, and linear regression analysis. The mean PFA scale scores of male nurses, nurses working in intensive care units, working as service nurses, nurses who have previously received PFA training and applied PFA in disaster situations were higher. Moreover, 91.3% of nurses did not receive PFA training and 90.3% did not receive PFA service earlier, 31.0% did not apply for PFA, 18.3% did not know about PFA. The mean score of the PFA practice self-efficacy scale of nurses was 131.61 ± 19.41. There exists an urgent requirement to develop nurses' PFA application self-efficacy. It is recommended that nurses should be provided repeated PFA training and applied studies focusing on PFA interventions.

Feasibility and acceptability of a culturally adapted psychological first aid training intervention (Preparing Me) to support the mental health and well-being of front-line healthcare workers in China: a feasibility randomized controlled trial.

Background: Psychological first aid (PFA) training helps to prepare healthcare workers (HCWs) to manage trauma and stress during healthcare emergencies, yet evidence regarding its effectiveness and implementation is lacking.Method: A two-arm feasibility randomized controlled trial design was conducted in a Chinese tertiary hospital. Participants were randomly allocated to receive either a culturally adapted PFA training (the intervention arm) or psychoeducation (the control arm). Feasibility indicators and selected outcomes were collected.Results: In total, 215 workers who expressed an interest in participating in the trial were screened for eligibility, resulting in 96 eligible participants being randomly allocated to the intervention arm (n = 48) and control arm (n = 48). There was a higher retention rate for the face-to-face PFA training session than for the four online group PFA sessions. Participants rated the PFA training as very helpful (86%), with a satisfaction rate of 74.25%, and 47% reported being able to apply their PFA skills in responding to public health emergencies or providing front-line clinical care. Positive outcome changes were observed in PFA knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth. Their scores on depression, anxiety, stress, and burnout measures all declined. Most of these changes were sustained over 3 months (p < .05). Repeated measures analysis of variance found statistically significant interaction effects on depression (F2,232 = 2.874, p = .046, ηp2 = .031) and burnout (F2,211 = 3.729, p = .018, ηp2 = .037), indicating a greater reduction in symptoms of depression and burnout with PFA compared to psychoeducation training.Conclusion: This culturally adapted PFA training intervention was highly acceptable among Chinese HCWs and was feasible in a front-line care setting. Preliminary findings indicated positive changes for the PFA training intervention on knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth, especially a reduction of depression and burnout. Further modifications are recommended and a fully powered evaluation of PFA training is warranted.

Psychological first aid (PFA) training was culturally adapted and evaluated to help prepare healthcare workers to manage trauma and stress during healthcare emergencies.This culturally adapted PFA training was highly acceptable among Chinese healthcare workers and was feasible in a front-line care setting.Preliminary findings show positive changes for the PFA training intervention on knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth, especially a reduction of depression and burnout.

Diversity and training delivery trends in psychological first aid during COVID-19: Implications for researchers and practitioners.

OBJECTIVE: Psychological first aid (PFA) refers to evidence-supported intervention by nonmental health professionals to assist those affected by disaster to achieve stability. This study probed the level of PFA academic discourse on three important topics (race/ethnicity, general training and delivery, and online training delivery) and explored PFA training delivery trends. METHOD: This study reviewed all available abstracts in the Web of Science database from 1975 to 2021 with keyword searches for PFA. The corpus linguistic analyses using #Lancsbox 6.0 and Sketch Engine explored the usage rate of PFA and how the PFA was used. The study also examined race/ethnicity, learning delivery except for online, and online training delivery methods. The change in online PFA training delivery with the advent of the COVID-19 pandemic was analyzed using Tau with the subcorpora (2012-2020, 2020-2021). RESULTS: The race and diversity usage rates were only 6.11 per 10,000 counts, while the substantive discourse was on PFA service and delivery. There was a significant increase in PFA online training since COVID-19 started (Tau = 0.667, p = 0.041, SETau = 0.333). CONCLUSIONS: Training and delivering online PFA is the safest method to meet the need for psychological aid during the global health crisis. Additionally, there is a significant need to address multicultural competency in PFA training and service delivery. PFA as an early critical intervention should be promoted as an early government response. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

'The phoenix that always rises from the ashes': an exploratory qualitative study of the experiences of an initiative informed by principles of psychological first aid following the Beirut blast.

Background: On 4 August 2020, an explosion occurred in Beirut, Lebanon. Hundreds of people were killed, thousands injured and displaced. An initiative was rapidly initiated to provide remote support informed by psychological first aid for the mental health of Lebanese young adults affected by the blast. However, little is known about recipients' experiences of such initiatives.Objective: This study aimed to qualitatively explore the experiences of supporters and recipients in the community-led initiative following the blast.Method: We recruited a diverse sample of four supporters and four Lebanese recipients who took part in the Beirut initiative. Semi-structured interviews were conducted with participants. Reflexive thematic analysis was used to analyse the qualitative data.Results: We developed five themes from the qualitative interviews, which highlighted ideas around accessibility, alienation, the relationship, elements of the safe space created by the initiative, and unmet needs and areas for improvement. Recipients described the detrimental impact of the blast on their mental health within the Lebanese context and beyond. Recipients and supporters elucidated complex experiences of the support and its impact.Conclusions: Our findings suggest remote support has the potential to be acceptable for young adults in Lebanon. Further research into support informed by psychological first aid after similar crisis events is warranted.

Following the Beirut blast on 4 August 2020, an initiative was implemented to provide remote mental health support to Lebanese young adults.Reflexive thematic analysis was used to analyse qualitative data from interviews with supporters and recipients after support sessions were completed to identify themes across diverse experiences and views.Participants described a feeling of alienation after the blast, the development of a meaningful relationship between supporter and recipients, and gratitude for having a safe space to process and share difficult feelings. Possible avenues for improvement and implementation were suggested.

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Association Between Attitudes Toward Trauma Informed Care and Psychological First-Aid Training Experience Among Health Care Professionals in Japan.

OBJECTIVE: Trauma informed care (TIC) is an important approach for people who have experienced trauma. Although psychological first aid (PFA) may be effective training in TIC, no study reported an association between PFA training and TIC. This study aimed to investigate the association between PFA training and attitudes toward TIC among health care professionals in Japan. METHODS: Japanese health care professionals were recruited for a survey conducted from May 21 to June 18, 2021. TIC was assessed by the Attitudes Related to Trauma Informed Care Scale 10-item short form (ARTIC-10). A question about PFA training participation was originally developed through discussion among researchers. Univariate and multiple linear regression analyses were used to examine the association between the PFA experience and ARTIC-10. RESULTS: In total, 484 (3.6%) health care professionals completed all questions. Among them, 77 (15.9%) had experienced PFA training. Univariate and multiple linear regression analyses showed that PFA experience (B = 0.19, 95% CI: 0.02-0.36, P = 0.03; B = 0.17, 95% CI: 0.01-0.34, P = 0.04) was significantly associated with ARTIC-10. CONCLUSIONS: This study was the first to show an association between PFA training and attitudes toward TIC among health care professionals, which was a significant result for future research on PFA training, TIC, and trauma care.

EFFECT OF PSYCHOLOGICAL FIRST AID ON MENTAL HEALTH IN HOSPITALIZED STABLE COVID-19 PATIENTS: A PRE-POST RESEARCH DESIGN.

BACKGROUND: The COVID-19 pandemic is known to affect mental health of sufferers. Psychological First Aid (PFA) is a mental health service for individuals in crisis, which can be provided to anyone regardless of age and it does not require mental health expertise. Its effect on mental health issues of COVID-19 patients has not been studied effectively. The present study aimed to assess the psychological impact and effect of PFA on mental health in stable COVID-19 hospitalized patients. SUBJECTS AND METHODS: This was an interventional study with a pre-post research design in a tertiary government teaching hospital in eastern India. 93 stable patients who were admitted in a period of a month with COVID-19 were included in the study after obtaining appropriate consent. They were provided PFA (both structured individual and group sessions) by trained nurses. The Depression, Anxiety, and Stress scale (DASS-21) was used to assess depression, anxiety, and stress in the patients before and after intervention. RESULTS: The mean age of study population which comprised of 68.8% males was 56.2 ± 13.7 years. Median scores for depression, anxiety and stress were 4, 6 and 6 on admission and 0, 2 and 2 respectively before discharge after intervention (P<0.001). 13%, 25.9% and 8.6% were the combined percentages scores of patients with varying levels of depression, anxiety and stress at the time of admission which were reduced to 4.3% (P=0.046), 5.4% (P=0.001), 2.2% (P=0.03) respectively before discharge after intervention within one week. CONCLUSION: PFA may be a cost-effective intervention in stable COVID-19 admitted patients who had depression, anxiety, and stress.

Content analysis of psychological first aid training manuals via topic modelling.

Background: Psychological First Aid (PFA) is practiced worldwide. This practice in English is guided through a small collection of training manuals. Despite ubiquitous practice and formal training materials, little is known about what topics are covered and in what depth in these influential manuals. As such, we analyzed the topic structure of these training manuals.Objective: To model the PFA manuals' topics with the goal of identifying a set of topics with recurrent themes and evaluating the extent to which each manual demonstrated those themes.Method: This machine learning study employed an unsupervised topic modelling design using Latent Dirichlet Allocation. The variables are (1) the distribution of a word across documents and (2) the distribution of a word across topics. The level of measurement for all variables is continuous. The unit of analysis is words. Preprocessing and data analysis were carried out using the Orange Data Mining Toolbox (Demsar et al., 2013). This programme is a Python GUI.Results: Results indicated a ten-topic structure to the universe of the English PFA training manuals. These topics were: (1) Refugees, (2) Orientation Activities, (3) Community-Based Applications, (4) PTSD & Other Psychological Issues, (5) Training Materials, (6) Specific Helper Instructions, (7) PFA Scholarship, (8) MHPSS, (9) General Curriculum, and (10) Australian Specific Delivery. The depth of discourse on each topic varied widely between manuals.Conclusions: The Academics of the PFA topic shows a strong representation of the corpus and suggests current training manuals have stayed true to its evidence-supported practice. The topic of Community-Based Applications strongly represents the corpus and suggests that training models incorporate community-based applications. The scientific foundation and practical implementation of the training guides are essential elements. Limitations and implications were also discussed.

Little is known about what topics are covered and in what depth in the influential PFA English manuals.We conducted a topic modelling study using Latent Dirichlet Allocation, aiming to discover a set of topics with recurring themes and analyze the degree to which each manual exhibited those topics.Results indicated a 10-topic structure to the universe of the English PFA training manuals.The training manuals' scientific basis and practical application are key components, while notable gaps presented.

Effectiveness of Psychological First Aid E-learning on the Competence and Empathy of Nurses in Disasters: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to determine the effect of psychological first-aid (PFA) E-learning on the competence and empathy of nurses in disasters. METHODS: In a randomized controlled trial, 50 nurses were randomly assigned to 2 intervention and control groups, and psychological first-aid training sessions were implemented for the intervention group. The data were collected using the personal information form, a researcher-made questionnaire to measure competence, and the Davis Empathy Questionnaire. RESULTS: Two groups were homogeneous in terms of competency (P = 0.691) and empathy (P = 0.363) in the preintervention phase. The intervention group had more competence in the next stage than before the intervention (P < 0.0001). In the post-intervention phase, the intervention group had more competence compared with the control group (P < 0.0001). The overall effect size of PFA E-learning training on the nurses' competency was 1.9. Regarding empathy, in the post-intervention phase, the subscale of personal distress (P = 0.014) was significantly lower in the intervention group and the perspective-taking subscale was higher than in the control group (P < 0.0001). However, there was no significant difference between the groups in terms of all scores of empathy and the subscale of empathic concern (P > 0.05). The overall effect size of PFA E-learning training on the nurses' empathy was 0.44. CONCLUSIONS: It is suggested to provide training, including a PFA E-learning model, for nurses and other therapists in disaster situations.

Psychological First Aid for Wilderness Trauma: Interventions for Expedition or Search and Rescue Team Members.

When exposed to actual or threatened death or serious injury in austere settings, expedition members are at risk of acute stress reactions, as are search and rescue members involved with extricating the patient. Acute stress reactions are a normal response to significant trauma and commonly resolve on their own. If they do not, they can lead to post-traumatic stress disorder (PTSD), a set of persistent symptoms that cause significant effects on the person's life. Medication has a limited preventive role in the field for treatment of stress partly because so few are trained to administer it. Contrastingly, psychological first aid can be performed by lay team members with minimal training. Psychological first aid consists of interventions attempting to encourage feelings of safety, calm, self-efficacy, connection, and hope. These are interventions that provide guidance to not make the situation emotionally worse and might have a preventive effect on later development of PTSD. They are valuable in the field not only for the patient but also for affected team members as well as for search and rescue team members who may be indirectly affected by the trauma and experience repercussions later.

Effectiveness of Psychological First Aid e-Orientation among the General Population in Muntinlupa, the Philippines.

This present study examined the effectiveness of the Psychological First Aid (PFA) e-orientation as well as face-to-face PFA orientation among the general population in Muntinlupa City, the Philippines. The e-orientation group consisted of 150 participants who received a two-hour PFA e-orientation (male: 47, female: 97, others: 6, mean age: 33.4 (SD = 12.1)), the face-to-face (F2F) group consisted of 139 participants who received a two-hour face-to-face PFA orientation (male: 41, female: 95, others: 3, mean age: 35.0 (SD = 13.8)), and the control group consisted of 117 participants who received a two-hour face-to-face health promotion orientation for obesity (male: 48, female: 65, others: 4, mean age: 34.2 (SD = 13.8)). In order to see the effect of these interventions, the confidence to provide PFAs was compared between the pre- and post-interventions in each group with paired t-tests. Further, the number of correct answers regarding the knowledge on PFA was also compared between the pre- and post-interventions utilizing a McNemar test. The results demonstrated that the mean scores on the confidence increased significantly in the e-orientation (pre: 25.1 (SD = 4.7), post: 26.1 (SD = 5.3), p = 0.02) and F2F (pre: 26.2 (SD = 6.0), post: 29.6 (SD = 6.9), p < 0.01) groups. Regarding knowledge on PFA, in the e-orientation group, the number of those who answered correctly increased significantly in a question (pre: 10, post: 24, p = 0.01), and there was a trend for improvement in another question (pre: 63, post: 76, p = 0.06). In the F2F group, the number of those who answered correctly increased significantly in two questions (pre: 21, post: 38, p < 0.01, and pre: 5, post: 14, p = 0.05), and there were trends for improvement in two questions (pre: 69, post: 82, p = 0.06, and pre: 17, post: 27, p = 0.09), while in the control group, there were no significant differences in any of the questions between pre- and post-intervention. The results suggest that both the PFA e-orientation and face-to-face orientation are effective for the general population in terms of increasing confidence and knowledge related to PFA.

Psychological First Aid principles within a community-led arts initiative: lessons from the Blacksmiths' Tree.

Psychological First Aid (PFA) is widely used in the early phases of disaster recovery, despite limited empirical evidence supporting its application. PFA aims to reduce distress and encourage adaptive coping and is grounded in five principles: the promotion of hope, self- and collective efficacy, social connectedness, safety, and calm. Drawing on a constructivist perspective, this study analysed interview transcripts from Forged from Fire: The Making of the Blacksmiths' Tree, a documentary film about a community-led arts project initiated after the 2009 bushfires in Victoria, Australia. Using a reflexive process that employed deductive and inductive coding, the research investigated the presence of PFA principles in participants' experiences of the Blacksmiths' Tree project and whether themes not accounted for by PFA were also salient. The findings supported the PFA principles and generated two additional themes: grassroots and community leadership; and healing through creation and expression. The implications for disaster recovery in community settings are also presented.

Mental Health First Aid training for paramedic students: An evaluation study.

BACKGROUND: The combination of first-year placements, an increasing proportion of mental health callouts, and the high incidence of mental illness in health-professional tertiary students means standard curricula may not adequately prepare early-year paramedic students for mental health challenges. METHODS: A retrospective online survey was used to explore the experiences of paramedic students who have completed Mental Health First Aid (MHFA) training within their undergraduate studies. The content-validated survey explored the relevance, appropriateness, and novelty of MHFA training, and invited participants to reflect on the course strengths and weaknesses. RESULTS: The majority of 102 respondents, predominantly female first- and second-year paramedic students aged 18-24 years, agreed the content was relevant (86%) and appropriate (88%), with 73% agreeing they would recommend to other university students. Thematic analysis identified strengths of the course as perceived increases in mental health literacy and empowerment to act on mental health concerns. A weakness was students perceived the course did not prepare them adequately for clinical practice. CONCLUSION: The inclusion of MHFA early in paramedic curricula is appropriate and relevant, increasing mental health literacy and empowering students to recognise and act upon mental health concerns. Application of practical scenarios may further enhance student learning experiences.

We need to build the evidence: A systematic review of psychological first aid on mental health and well-being.

Ensuring effective mental health and psychosocial support is crucial following exposure to a potentially traumatic event and can have long-term consequences for individuals, families, and communities. Psychological first aid (PFA) has become a widespread intervention of choice following exposure to conflict or disaster; however, its impact is unknown. This systematic review assessed PFA efficacy in improving the mental health and psychosocial well-being of individuals exposed to potentially traumatic events. We searched PubMed, PsycINFO, PTSDpubs, and EMBASE for peer reviewed studies evaluating programmatic outcomes of PFA, or an adapted intervention, published in English before March 9, 2021. Studies evaluating training outcomes or program feasibility were excluded. The primary outcomes were reported measures of participant mental health and psychosocial well-being, with narrative results presented for each. The Cochrane Risk of Bias tool was applied. Of 9,048 potentially eligible citations, 12 studies with a total of 1,437 participants met the inclusion criteria. Only one study was a randomized controlled trial. The findings from all studies suggest a positive impact of PFA, with most reporting reduced symptoms of anxiety, depression, posttraumatic stress, and distress, as well as improved ratings of mood, the experience of safety, connectedness, and a sense of control, among youth and adults. Risk of bias was generally high. Inconsistent intervention components, insufficient evaluation methodologies, and a high risk of bias within the reviewed studies present challenges in assessing PFA efficacy, and an imbalance between popular support for PFA and scant evidence of outcome data exists. Further research is needed to justify the proliferation of PFA.

Implementing Psychological First Aid for Healthcare Workers During the COVID-19 Pandemic: A Feasibility Study of the ICARE Model.

Maintaining the resilience of healthcare workers (HCWs) during the protracted COVID-19 pandemic is critical as chronic stress is associated with burnout, inability to provide high-quality care, and decreased attentiveness to infection prevention protocols. Between May and July 2020, we implemented the ICARE model of psychological first aid (PFA) in a novel online (i.e., telehealth) format to address the psychological support needs of HCWs during the COVID-19 pandemic. We found that HCWs needed psychological support related to obtaining clear information about pandemic policies and guidelines, navigating new rules and responsibilities, and processing overwhelming and conflicting emotions. The HCWs in our program repeatedly expressed appreciation for the support we provided. Future directions include establishing online discussion forums, increasing opportunities for individual support, and training HCWs to provide peer support using PFA. This program has far-reaching potential benefit to HCWs and to society at large in the context of a pandemic.

Uptake and effects of psychological first aid training for healthcare workers' wellbeing in nursing homes: A UK national survey.

AIMS: Psychological First Aid is a brief intervention based on international guidance from the World Health Organisation. Free to access online training in the intervention was introduced during the COVID-19 pandemic in UK. We aimed to determine the uptake of Psychological First Aid training among healthcare workers in care homes in the UK and to assess its effects on their wellbeing. DESIGN: This was a sequential mixed methods design. METHODS: Healthcare workers (nurses and carers) working in care homes in the UK were surveyed about their uptake of Psychological First Aid, their stress, coping efficacy and the key concepts of Psychological First Aid (safety, calmness, hopefulness, connectedness, and accomplishment). Those that completed the Psychological First Aid training were asked to share their experiences via qualitative survey. Data collection was conducted between June and October 2021. Analyses included descriptive statistics and regression analysis. A six step thematic analysis was used to interpret the qualitative data. RESULTS: 388 participants responded to the survey. The uptake of Psychological First Aid training was 37 (9.5%). Psychological first aid was a significant predictor for coping efficacy (ß = 17.54, p = .001). Participants with a physical or mental health condition experienced higher stress and lower coping regardless of PFA training. Four themes were identified from the qualitative analysis: self-awareness and growth, relationships with others, overcoming stress and accessibility. CONCLUSION: While this study suggests some benefits to healthcare workers in care home settings undergoing PFA the poor uptake of the training warrants further investigation. IMPACT: Care home staff need psychological support. This gap remains as few completed PFA training. This is the first study in UK and worldwide to look at the effects of psychological first aid on stress and coping in this population and it warrants further investigation.