Assessing the Presence of Post-Traumatic Stress and Turnover Intention Among Nurses Post–Middle East Respiratory Syndrome Outbreak: The Importance of Supervisor Support

Jung, Heeja; Jung, Sun Young; Lee, Mi Hyang; Kim, Mi Sun

doi:10.1177/2165079919897693

Cited by 131 publications

(185 citation statements)

References 28 publications

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“…Furthermore, we found that hospital teams can impact HWs’ wellbeing, both positively and negatively. During the MERS pandemic, increased comradery among colleagues [ 34 , 40 ] and supervisor support [ 34 , 41 ] were also found to improve HW morale and resiliency. Providing resources that foster team bonding and assist with conflict resolution are important to improve HWs’ experiences during the COVID-19 pandemic and future outbreaks.…”

Section: Discussionmentioning

confidence: 99%

A hybrid inductive-abductive analysis of health workers’ experiences and wellbeing during the COVID-19 pandemic in the United States

Hennein

Lowe

2020

PLoS ONE

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The COVID-19 pandemic puts health workers at increased risk of adverse mental health outcomes. However, no studies have assessed health workers’ experiences using qualitative methods during the COVID-19 outbreak in the United States to identify novel factors that could relate to their mental health. In May 2020, we distributed an online survey to health workers across 25 medical centers throughout the United States. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care-Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise and associated cutoff values were used to assess rates of probable major depression, generalized anxiety disorder, post-traumatic stress disorder, and alcohol use disorder, respectively. To provide insight into the factors shaping these and other mental health conditions, we included two open-ended questions asking respondents to recount their most upsetting and hopeful experiences during the COVID-19 pandemic and how it made them feel. Using a hybrid inductive-abductive approach and thematic content analysis, we created a Social Ecological Model to represent themes among health workers’ experiences within five ecological levels: individual, interpersonal, organization, community, and public policy. Of the 1,132 participants who completed the survey, 14.0% had probable major depression, 15.8% probable generalized anxiety disorder, 23.1% probable post-traumatic stress disorder, and 42.6% probable alcohol use disorder. Individual level themes included participants’ personal health and self-care behaviors. Interpersonal level themes included the health of their social circle, family functioning, and social support. Organization level themes included their hospital’s management, resources, patient care, routine, and teams. Themes in the community level included the media, scientific knowledge about COVID-19, morale, behavior, and support of health workers. Lastly, government and health system leadership and shelter-in-place policy were themes within the public policy level. Our findings provide insights into novel factors that have impacted health workers’ wellbeing during the COVID-19 pandemic. These factors should be further explored to inform interventions and public policy that mitigate mental health morbidities among health workers during this and future outbreaks.

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Section: Discussionmentioning

confidence: 99%

A hybrid inductive-abductive analysis of health workers’ experiences and wellbeing during the COVID-19 pandemic in the United States

Hennein

Lowe

2020

PLoS ONE

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“…This finding was also seen following MERS, with one study in South Korea demonstrating 57% of nurses suffered PTSD. 62 Overall, while being a HCW confers some psychologically protective elements, the evidence suggests being a HCW leads to worse outcomes. 59 NICE recommends assessment for all who have sustained trauma, using active monitoring to follow-up with subthreshold symptoms and offer cognitive behavioural therapy, cognitive processing therapy or eye movement desensitisation and reprocessing in those who are symptomatic in the postacute and intermediate phases.…”

Section: Psychological Sequelae and Rehabilitation Recommendationsmentioning

confidence: 99%

The Stanford Hall consensus statement for post-COVID-19 rehabilitation

O’Sullivan²,

et al. 2020

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The highly infectious and pathogenic novel coronavirus (CoV), severe acute respiratory syndrome (SARS)-CoV-2, has emerged causing a global pandemic. Although COVID-19 predominantly affects the respiratory system, evidence indicates a multisystem disease which is frequently severe and often results in death. Long-term sequelae of COVID-19 are unknown, but evidence from previous CoV outbreaks demonstrates impaired pulmonary and physical function, reduced quality of life and emotional distress. Many COVID-19 survivors who require critical care may develop psychological, physical and cognitive impairments. There is a clear need for guidance on the rehabilitation of COVID-19 survivors. This consensus statement was developed by an expert panel in the fields of rehabilitation, sport and exercise medicine (SEM), rheumatology, psychiatry, general practice, psychology and specialist pain, working at the Defence Medical Rehabilitation Centre, Stanford Hall, UK. Seven teams appraised evidence for the following domains relating to COVID-19 rehabilitation requirements: pulmonary, cardiac, SEM, psychological, musculoskeletal, neurorehabilitation and general medical. A chair combined recommendations generated within teams. A writing committee prepared the consensus statement in accordance with the appraisal of guidelines research and evaluation criteria, grading all recommendations with levels of evidence. Authors scored their level of agreement with each recommendation on a scale of 0–10. Substantial agreement (range 7.5–10) was reached for 36 recommendations following a chaired agreement meeting that was attended by all authors. This consensus statement provides an overarching framework assimilating evidence and likely requirements of multidisciplinary rehabilitation post COVID-19 illness, for a target population of active individuals, including military personnel and athletes.

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“…For GAD-7 the scores were classified as; normal (0-4), mild (5-7), moderate (8)(9)(10)(11)(12)(13)(14) and severe (15)(16)(17)(18)(19)(20)(21). For the PHQ-9 scores; normal (0-4), mild (5-9), moderate (10)(11)(12)(13)(14) and moderately severe (15)(16)(17)(18)(19) and severe (20)(21)(22)(23)(24)(25)(26)(27). These cut-offs have been well established in the literature [36][37][38].…”

Section: Outcomes and Covariatesmentioning

confidence: 99%

PTSD symptoms among health workers and public service providers during the COVID-19 outbreak

2020

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In the frontline of the pandemic stand healthcare workers and public service providers, occupations which have proven to be associated with increased mental health problems during pandemic crises. This cross-sectional, survey-based study collected data from 1773 healthcare workers and public service providers throughout Norway between March 31, 2020 and April 7, 2020, which encompasses a timeframe where all non-pharmacological interventions (NPIs) were held constant. Post-traumatic stress disorder (PTSD), anxiety and depression were assessed by the Norwegian version of the PTSD checklist (PCL-5), General Anxiety Disorder-7, and Patient Health Questionnaire-9 (PHQ-9), respectively. Health anxiety and specific predictors were assessed with specific items. Multiple regression analysis was used for predictor analysis. A total of 28.9% of the sample had clinical or subclinical symptoms of PTSD, and 21.2% and 20.5% were above the established cutoffs for anxiety and depression. Those working directly in contrast to indirectly with COVID-19 patients had significantly higher PTSD symptoms. Worries about job and economy, negative metacognitions, burnout, health anxiety and emotional support were significantly associated with PTSD symptoms, after controlling for demographic variables and psychological symptoms. Health workers and public service providers are experiencing high levels of PTSD symptoms, anxiety and depression during the COVID-19 pandemic. Health workers working directly with COVID-19 patients have significantly higher levels of PTSD symptoms and depression compared to those working indirectly. Appropriate action to monitor and reduce PTSD, anxiety, and depression among these groups of individuals working in the frontline of pandemic with crucial societal roles should be taken immediately.

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Assessing the Presence of Post-Traumatic Stress and Turnover Intention Among Nurses Post–Middle East Respiratory Syndrome Outbreak: The Importance of Supervisor Support

Cited by 131 publications

References 28 publications

A hybrid inductive-abductive analysis of health workers’ experiences and wellbeing during the COVID-19 pandemic in the United States

A hybrid inductive-abductive analysis of health workers’ experiences and wellbeing during the COVID-19 pandemic in the United States

The Stanford Hall consensus statement for post-COVID-19 rehabilitation

PTSD symptoms among health workers and public service providers during the COVID-19 outbreak

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