Developing local crisis leadership - A research and training agenda.

The crisis triggered by Covid-19 has exposed the interdependencies of modern society and sparked interest in local response to protracted and complex crisis situations. There has been a growing awareness and interest in the key roles of political and professional stakeholders, their emotional regulation and how they influence team performance and outcomes in dealing with uncertainty and complex crisis situations. While cognitive and behavioral aspects of crisis leadership are well researched, less is understood about how one can mitigate negative emotions, instill trust, or restore public faith and support of security forces and emergency response teams during crises. In addressing this gap, we propose a simplified conceptual roadmap for research and training of local crisis leadership. In this, we emphasize complex problem solving, team interaction, team context and technology and team training design. These four factors represent significant barriers if neglected. On the other side, they may be considerable force multipliers when better understood and managed. We suggest how seven research and training questions could be linked to the four conceptual factors and guide an evidence-based approach to develop local crisis leadership.

Distributed team processes in healthcare services: a scoping review.

Objective: High-quality healthcare services is delivered by teams rather than individuals and depends heavily on multidisciplinary cooperation between dispersed healthcare professionals. The aim of this scoping review is to identify common barriers and innovative applications of technology supporting team processes and patient safety, in geographically dispersed healthcare services. Methods: Studies were identified from searches in APA PsychINFO, Epistemonikos and Medline databases, from 2010 to 2023. A detailed search strategy was performed, and studies were included, based on prior established criteria. Results: Among the 19 studies that fulfilled our inclusion criteria, the majority (85%) were from Europe or North America, and most studies (53%) were quantitative, with a cross-sectional study design. Several reported observed distributed team processes in training and education. Most studies described barriers and detailed how innovative approaches and technological solutions were introduced to improve communication, coordination, and shared mental models in distributed healthcare settings. A small proportion of studies (16%) used health services data to examine interpersonal exchange and team processes. Conclusion: The scoping review offer recommendations to enhance future research on distributed team processes in healthcare services.

Changes in contamination-related obsessions and compulsions during the COVID-19 pandemic: A Norwegian longitudinal study.

Background: Early stages of the COVID-19 pandemic have been associated with increasing obsessive-compulsive symptoms (OCS), but less is known regarding these symptoms' long-term trajectories. The aim of this study was to examine changes in contamination-related OCS in the Norwegian public during early and late stages of the pandemic, as well as characteristics that might be associated with these changes. Methods: In a longitudinal online survey, 12 580 participants completed self-report questionnaires in April 2020, including a retrospective assessment of contamination-related OCS severity (DOCS-SF) prior to COVID-19. In December 2020, 3405 (27.1%) of the participants completed the survey again. Results: In April, participants retrospectively recalled that their contamination-related OCS were lower prior to COVID-19 (d = 1.09). From April to December, symptoms slightly decreased (d = -0.16). The proportion of participants scoring above the clinical cut-off on DOCS-SF (≥16) changed accordingly from 2.4% pre-COVID to 27.8% in April and 24.0% in December. Previous severity of contamination-related OCS and symptoms of distress related to COVID-19 were the most powerful predictors of contamination-related OCS severity during the pandemic. Conclusions: Elevated levels of contamination-related OCS were detected at both early and late stages of the pandemic, but the long-term symptom trend seems to be slightly declining.

Personality traits and hardiness as risk- and protective factors for mental distress during the COVID-19 pandemic: a Norwegian two-wave study.

BACKGROUND: Several risk factors for anxious-depressive symptomatology during the COVID-19 pandemic have been established. However, few studies have examined the relationship between personality traits, hardiness, and such symptomatology during the pandemic. These constructs might serve as risk- and/or protective factors for such mental distress through the pandemic. METHODS: A sample of 5783 Norwegians responded to a survey at two time points within the first year of the pandemic. The first data collection was in April 2020 (T1) and the second in December 2020 (T2). Measures included the Ten-Item Personality-Inventory, the Revised Norwegian Dispositional Resilience Scale, and the Patient Health Questionnaire Anxiety and Depression Scale. Analyses were performed using Pearson's correlations, multiple linear regression, and a moderation analysis. RESULTS: Anxious-depressive symptomatology in early phases (T1) of the pandemic was the strongest predictor for the presence of such symptomatology 9 months after the outbreak (T2). Personality and hardiness correlated significantly with mental distress at T1 and T2. Personality traits explained 5% variance in symptoms when controlling for age, gender, solitary living, negative economic impact, and mental distress at baseline. Higher neuroticism predicted higher mental distress, whereas higher conscientiousness and extraversion predicted less mental distress. Hardiness did not explain variance in outcome beyond personality traits. Hardiness did not significantly moderate the relationship between neuroticism and mental distress. CONCLUSION: Individuals with high levels of neuroticism had greater difficulties adapting to the circumstances of the COVID-19 pandemic and were more prone to mental distress. Contrastingly, higher conscientiousness and extraversion may have served as protective factors for mental distress during the pandemic. The current findings might aid identification of vulnerable individuals and groups. Consequently, preventive interventions could be offered to those who need it the most.

Crisis leadership in COVID-19: A qualitative study of Norwegian business leaders.

Background: On March 11, 2020, the World Health Organization declared the novel coronavirus outbreak a global pandemic. The crisis that follows presented significant adverse challenges for organizations and business leaders around the world. The present study aims to explore how the extreme context of the COVID-19 influenced crisis leadership, with emphasis on coping and adaptive approaches, in Norwegian leaders during the early stage of the pandemic. Materials and methods: A group of 11 Norwegian business leaders from different private sector companies were subject to an in depth, semi structured interview after the first 9 months of COVID-19. A sensemaking perspective and the Cognitive Activation Theory of Stress (CATS) were used to interpret the results. Results: The pandemic called for crisis leadership and a rapid adaptation to a radically changed situation. Restructuring of organizational processes and introduction of new routines were followed by support and caring for their employees during the first wave of the pandemic. All the leaders coped well with the situation, and some were excited over the opportunity to make a difference in this demanding and stressful situation. Many emphasized that the pandemic was an external threat, resulting in an acceptance of the situation, more transparency, collaboration, and generosity within the organization. Especially the willingness to change was challenged in a positive way. A more blurred line between office and home, and absence of social activities were mentioned as negative outcomes.

Coordinating Mechanisms Are More Important Than Team Processes for Geographically Dispersed Emergency Dispatch and Paramedic Teams.

In recent decades there has been an increased emphasis on non-technical skills in medical teams. One promising approach that relates teamwork to medical efficiency is the theory of Shared Mental Models (SMM). The aim of the present study was to investigate the suitability of the Shared Mental Model approach for teamwork between operators in emergency medical communication centers and the first line ambulance personnel in real-life settings. These teams collaborate while working from geographically dispersed positions, which makes them distinct from the kinds of teams examined in most previous research on team effectiveness. A pressing issue is therefore whether current models on co-located teams are valid for medical distributed teams. A total of 240 participants from 80 emergency medical teams participated in the study. A team effectiveness model was proposed based on identified team coordinating mechanisms and the "Big five" team processes. Path analyses showed that SMM was positively associated with team effectiveness (i.e., performance satisfaction and situational awareness) and negatively related to mission complexity. Furthermore, the coordinating mechanisms of SMM and Closed Loop Communication was positively related to "Big five" team scores. However, no effects were found for the "Big five" team processes on effectiveness, which could indicate that the model needs to be adjusted for application to geographically dispersed teams. Possible implications for team training of distributed emergency response teams are discussed.

Mental health symptoms during the first months of the COVID-19 outbreak in Norway: A cross-sectional survey study.

BACKGROUND: The COVID-19 pandemic has led to major social and economic changes that could impact public mental health. The main aim of the current study was to investigate mental health in Norway during the COVID-19 outbreak (since the first confirmed case on 26 February 2020). METHODS: The results are from the first wave of the data collection (1 April-2 June 2020), which took place during the outbreak along with its initial restrictions. A total of 19,372 (11,883 students) people participated in a cross-sectional web-based survey. RESULTS: A total of 21.8% scored above the cut-off for depression and 23.7% for anxiety. Severity of symptoms was associated with the accumulation of risk factors, such as possible/confirmed infection for oneself or one's family, female/other sex, students, having mental health problems, increased use of tobacco, increased use of alcohol, less exercise, losing one's job, suffering economic impact and lower education. CONCLUSIONS: COVID-19 could have a negative association with public mental health, especially for certain risk groups. Future data-collection waves will provide further insight into the development of symptoms following the pandemic.

A brief intervention for PTSD versus treatment as usual: Study protocol for a non-inferiority randomized controlled trial.

BACKGROUND: Although existing treatment methods are effective in alleviating PTSD symptoms, several barriers to care exist, such as waiting times, avoidant tendencies, shame and stigma, potentially leading to fewer people seeking therapy or premature dropouts. A potential solution to battling these barriers is Brain Working Recursive Therapy (BWRT), a single-session exposure-oriented intervention for PTSD. Although not yet subjected to empirical investigation, clinical experiences suggest an often immediate and long-lasting effect following the intervention related to patient's symptomatology and functional abilities. METHODS: The current study protocol outlines a plan to conduct the first non-inferiority randomized controlled trial aimed to explore the efficacy of BWRT compared to treatment as usual (TAU), operationalized as any evidence-based trauma treatment method administered in Norwegian out-patient clinics. Eighty-two participants will be allocated at a 1:1 ratio to one of the following treatment conditions: (1) BWRT or (2) treatment as usual. Participants will be compared on several variables, including changes in PTSD symptoms (primary objective), and changes in perceived quality of life, rumination, functional and cognitive ability (secondary objective). Data collection will take place baseline (T1), within three weeks post treatment (T2) and at 6-month follow-up (T3). DISCUSSION: Should BWRT prove to be non-inferior to treatment as usual, this brief intervention may be an important contribution to future psychological treatment for PTSD, by making trauma treatment more accessible and battling current barriers to care. TRIAL REGISTRATION: 191548, 24.05.2021. ClinicalTrials.gov PRS: Release Confirmation.

Learning from the COVID-19 pandemic among migrants: An innovative, system-level, interdisciplinary approach is needed to improve public health.

The effects of the COVID-19 pandemic are amplified among socially vulnerable groups, including international migrants, in terms of both disease transmission and outcomes and the consequences of mitigation measures. Migrants are overrepresented in COVID-19 laboratory-confirmed cases, hospital admissions, intensive care treatment and death statistics in all countries with available data. A syndemic approach has been suggested to understand the excess burden in vulnerable populations. However, this has not stopped the unequal burden of disease in Norway. Initially, the disease was mainly imported by Norwegians returning from skiing holidays in the Alps, and the prevalence of infection among migrants in Norway, defined as people born abroad to foreign parents, was low. Later, confirmed cases in migrants increased and have remained stable at 35-50% - more than twice the proportion of the migrant population (15%). To change this pattern, we need to understand the complex mechanisms underlying inequities in health and their relative and multiplying impacts on disease inequalities and to test the effect of counterfactual policies in order to reduce inequalities in disease burden. Yet, the current paradigm in the field of migration and health research, that is, the theories, research methods and explanatory models commonly applied, fail to fully understand the differences in health outcomes between international migrants and the host population. Here, we use the Norwegian situation as a case to explain the need for an innovative, system-level, interdisciplinary approach at a global level.

Does psychological capital moderate the relationship between worries about accidents and sleepiness?

The present study investigated psychological capital (PsyCap) as a protective factor in the relationship between worries about accidents and sleepiness among seafarers. The hypothesis that strong PsyCap weakens the relationship between worries about accidents and sleepiness was tested in a cross-sectional sample of 397 maritime workers. In contrast to expectations, the findings indicated a reverse buffering effect in that PsyCap only had a protective impact on sleepiness when worries about accidents were low. For workers that were highly worried, a strong PsyCap was associated with increased levels of sleepiness. The established associations remained consistent after controlling for workers' years of experience as seafarers, and their ratings of psychological safety climate. An interpretation of this finding is that seafarers with high levels of PsyCap will be attentive when the threat level is serious, but will not be bothered when exposed to everyday strain and hassles associated with their work situation.

Hardiness, avoidance coping, and alcohol consumption in war veterans: A moderated-mediation study.

Military personnel often engage in excessive alcohol use after returning from deployments. Thus far, research has paid scant attention to personality factors that may increase or diminish the risk for increased alcohol consumption in this population. The present study explores how psychological hardiness, avoidance coping, and stress exposure may interact to influence alcohol consumption patterns in soldiers following deployment. U.S. Army National Guard soldiers (N = 357) were surveyed shortly after returning from combat operations in Afghanistan. Conditional process analysis was used to test for mediation and moderation effects. Mediation effects were further tested in a replication sample of Norwegian Army soldiers (N = 230) deployed to Kosovo. Findings show that hardiness is a significant (negative) predictor of increased alcohol use and that this relation is mediated by avoidance coping. Further, this effect was moderated by combat stress exposure in the U.S. sample, such that the mediation is stronger for those with greater exposure (moderated-mediation). Avoidance coping also mediated the effects of hardiness on alcohol consumption in the Norwegian sample. These findings suggest that avoidance coping and hardiness may be fruitful areas for interventions aimed at reducing risky drinking in high-stress groups like the military.

Sleep and Fatigue Among Seafarers: The Role of Environmental Stressors, Duration at Sea and Psychological Capital.

BACKGROUND: Seafaring is an inherently stressful environment. Because working time and leisure time is spent in the same confined environment for a prolonged period of time, many stressors present in seafaring can also be conceived of as chronic. We explored the effects of duration at sea, seafaring experience, environmental stressors, and psychological capital (PsyCap) on the sleep quality and fatigue of seafarers. PsyCap is a construct that draws upon ideas from positive psychology and positive organizational behavior, and is intended to capture an individual's psychological capacities that can be developed and utilized for performance improvements. METHODS: We collected survey data from a sample of seafarers working in the offshore re-supply industry (n = 402) and a sample of seafarers working on board combined passenger and cargo ships (n = 340). RESULTS: PsyCap emerged as a robust predictor with statistically significant relations to fatigue and sleep quality in both samples. PsyCap also interacted with duration at sea in explaining fatigue in seafarers working on board the passenger and cargo ships. Seafarers on passenger and cargo ships also reported significantly higher levels of fatigue than those working in the offshore re-supply industry. CONCLUSION: Coupled with emerging research showing that PsyCap is trainable, our results suggest that maritime organizations could have much to gain by being cognizant of and developing routines for continually developing the PsyCap of their employees.

The combined influence of hardiness and cohesion on mental health in a military peacekeeping mission: A prospective study.

A large number of studies have shown that hardiness and cohesion are associated with mental health in a military context. However, most of them are presented without controlling for baseline mental health symptoms, which is their most significant source of error. The present study investigates the combined effect of hardiness and cohesion in a prospective design, controlling for baseline levels of symptoms among Norwegian personnel serving in a peacekeeping operation in Kosovo. Multivariate regression analyses were performed in which self-reported mental health complaints were regressed on our explanatory variables. Our findings suggest that both cohesion and hardiness contributed to increased stress resiliency, as measured by a lower level of reported mental health complaints. Our baseline measure of mental health accounted for a larger proportion of the variance than our other predictors. A significant interaction between cohesion and hardiness suggested a combined effect, over and above the individual contributions of the predictors. For individuals who scored high on hardiness, cohesion levels did not influence levels of mental health complaints. Individuals who scored low on hardiness, on the other hand, reported lower levels of mental health complaints when cohesion levels were high.

Distributed situation awareness in complex collaborative systems: A field study of bridge operations on platform supply vessels.

This study provides empirical data about shipboard practices in bridge operations on board a selection of platform supply vessels (PSVs). Using the theoretical concept of distributed situation awareness, the study examines how situation awareness (SA)-related information is distributed and coordinated at the bridge. This study thus favours a systems approach to studying SA, viewing it not as a phenomenon that solely happens in each individual's mind but rather as something that happens between individuals and the tools that they use in a collaborative system. Thus, this study adds to our understanding of SA as a distributed phenomenon. Data were collected in four field studies that lasted between 8 and 14 days on PSVs that operate on the Norwegian continental shelf and UK continental shelf. The study revealed pronounced variations in shipboard practices regarding how the bridge team attended to operational planning, communication procedures, and distracting/interrupting factors during operations. These findings shed new light on how SA might decrease in bridge teams during platform supply operations. The findings from this study emphasize the need to assess and establish shipboard practices that support the bridge teams' SA needs in day-to-day operations. PRACTITIONER POINTS: Provides insights into how shipboard practices that are relevant to planning, communication and the occurrence of distracting/interrupting factors are realized in bridge operations.Notes possible areas for improvement to enhance distributed SA in bridge operations.

Mental readiness for maritime international operation: procedures developed by Norwegian navy.

Seafarer's mental health is vital for a well-functioning organisation. Neglecting mental health status on board could be extremely costly for both the crew affected as well as the company. The present article outlines an extensive programme implemented in the Royal Norwegian Navy for personnel deployed in international operations. The challenges involved in international operations bare similarities to onboard personnel in civilian maritime operations. The program utilised by the Royal Norwegian Navy is extensive and not immediately applicable to civilian maritime companies. However, elements of this program could be used with limited resources. Questionnaire based screening, before, during and at the end of a contract period could result in early detections of mental health problems and increased retaining of personnel. This should be done by health professionals. Early targeting of at risk personnel could prevent serious costs for the individual as well as the company.

Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate.

Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents.

Fatigue in seafarers working in the offshore oil and gas re-supply industry: effects of safety climate, psychosocial work environment and shift arrangement.

This study examined the influence of safety climate and psychosocial work environment on the reported fatigue of seafarers working in the offshore oil and gas re-supply industry (n = 402). We found that seafarers who reported high psychological demands and perceived the organisational-level safety climate negatively,reported significantly more mental fatigue, physical fatigue, and lack of energy. In addition, seafarers who reported having high levels of job control reported being significantly less mentally fatigued. We also found some combined effects of safety climate and shift arrangement. Organisational-level safety climate did not influence the levels of physical fatigue in seafarers working on the night shift. On the contrary, seafarers working during the days reported to be more physically fatigued when they perceived the organisational-level climate to be negative compared with the positive. The opposite effect was found for group-level safety climate: seafarers working during the nights reported to be more physically fatigued when they perceived the group-level climate to be negative compared with the positive. The results from this study point to the importance of taking into consideration aspects of the psychosocial work environment and safety climate,and their potential impact on fatigue and safety in the maritime organisations.

Relationships between work environment factors and workers' well-being in the maritime industry.

BACKGROUND: The aim of this study was to determine whether physical and psychosocial work factors are related to the levels of job satisfaction and intentions to leave in the maritime industry, and to determine whether there exist cross-cultural differences in work factors, job satisfaction and intentions to leave between European and Filipino crew members. MATERIAL AND METHODS: Using a cross-sectional survey design, the variables were assessed in a sample of 541 seafarers from 2 large Norwegian shipping companies. Work factors included safety perceptions,leadership, job demands, harassment, and team cohesion. RESULTS: The findings show that physical and psychosocial work factors are important correlates of both intentions to leave and job satisfaction, with safety perceptions, job demands, and team cohesion as the strongest and most consistent factors. As for cross-cultural differences, the findings show that European and Filipino respondents differ with regard to safety perceptions, laissez-faire leadership, authentic leadership,exposure to harassment, team cohesion, and intentions to leave. No differences were established with regard to overall job satisfaction. CONCLUSIONS: The findings support occupational stress models which emphasise the importance of situational factors in the understanding of well-being among workers. Shipping companies should therefore always take these factors into consideration when developing and implementing interventions aimed at improving employee well-being.