The Costs of Caring: Quantifying Compassion Fatigue and Compassion Satisfaction in Burn Therapists.

Recovery from a severe burn injury requires early and aggressive therapy, which is often painful and distressing to the patient. Burn therapists who guide these interventions may be prone to experiencing secondary trauma and compassion fatigue through repeated exposure to difficult situations. At the same time, therapists may gain a sense of purpose and altruism from their work, fostering compassion satisfaction. Despite being well documented in other health professions, compassion fatigue and compassion satisfaction have not been sufficiently explored among burn therapists. This study aimed to quantify and characterize burn therapists' compassion fatigue and satisfaction using the Professional Quality of Life scale and to answer the question of what job-related factors may impact these outcomes. A total of 143 burn therapists participated in this study. Results revealed compassion fatigue subsale scores of burnout and secondary traumatic stress in the low or moderate range and compassion satisfaction scores in the moderate or high ranges for all participants. This study presents new knowledge for the field of burn care in its quantification of professional quality of life in burn therapists. While burn therapists experienced moderate-to-high levels of compassion satisfaction in their work, burnout and stress also approached moderate levels. Years of practice was a significant predictor of compassion. Although the reasons for this are not clear, it may be related to increased competence or confidence in practice and may suggest a need for different support strategies for practitioners at each stage of their burn therapy career.

Exploring key job demands and resources in Norwegian child mental health services: a cross-sectional study of associations with and relationship between compassion satisfaction, burnout, secondary traumatic stress and turnover intention.

Background: Burnout, secondary traumatic stress, and high turnover rates among child mental health clinicians are a challenge, not only for the individual therapist and the organization but also for the successful implementation of evidence-based practices. However, little is known about which and how job-and implementation-related factors are associated with burnout, secondary traumatic stress, and turnover intention as well as compassion satisfaction among child therapists. In the present study, we aimed to explore these factors and related mechanisms by integrating the "professional quality of life" and the "job demands-resources" models of occupational health. Methods: We measured the perceived professional quality of life and turnover intention among a national sample of 256 therapists working in Norwegian Child and Adolescence Mental Health Clinics (n = 44) that implemented Trauma-Focused Cognitive Behavior Therapy (TF-CBT). Seventeen Job-and implementation-related resources and demands were also measured using the General Nordic Questionnaire for Psychological and Social Factors at Work and the Implementation Component Questionnaire. Path analysis was used to test whether burnout and compassion satisfaction mediate the relationship between job demands and resources on one hand, and secondary traumatic stress and turnover intention on the other hand. Results and discussion: Results revealed that two job resources, i.e., positive challenges at work and mastery of work, were significant predictors of all professional outcomes. The proposed model was only partly supported. That is, while burnout did mediate the relationship between some job demands (i.e., work-family interference and role conflict) and job resources (i.e., human resource primacy, positive challenges, and mastery of work) with secondary traumatic stress and turnover intention, compassion satisfaction did not mediate the relationship between job resources and turnover intention. Moreover, in addition to their indirect effects via burnout, role conflict and organizational climate (human resource primacy) also directly affected turnover intention. These findings propose that interventions that reduce burnout should be prioritized to improve the professional quality of life and turnover intention among child therapists. Theoretically, it seems that compassion satisfaction and work engagement act differently.

CREAS e covid-19: desafios e perspectivas da psicologia no Norte de Minas / CREAS and covid-19: challenges and perspectives for Northern Minas Gerais psychology / CREAS y covid-19: desafíos y perspectivas de la psicología en el Norte de Minas

Este artigo analisa os desafios e estratégias de atuação de psicólogas(os) nos Centros de Referência Especializados de Assistência Social (CREAS) do norte de Minas Gerais durante a pandemia de covid-19. Trata-se de um estudo descritivo, quanti-qualitativo, de corte transversal e com análise de conteúdo e estatística para a interpretação de dados primários e meio de questionário eletrônico, emergiram os seguintes eixos temáticos: (a) Perfil sociodemográfico das(os) trabalhadoras(es); (b) Medidas de prevenção à contaminação para quem? Impactos da pandemia na práxis da psicologia no CREAS; (c) Chegada das demandas no CREAS; e (d) Tenuidade entre as potencialidades e vicissitudes do uso das tecnologias digitais. Observou-se que a inserção das(os) trabalhadoras(es) nos CREAS é marcada por contratos temporários, altas jornadas de trabalho e baixa remuneração. Além disso, com a pandemia de covid-19, têm enfrentado obstáculos como a falta de equipamentos de proteção individual (EPI) e de prevenção ao vírus. A chegada de demandas aos CREAS também foi afetada pela pandemia, como apontam as análises estatísticas dos registros mensais de atendimento dos municípios. As tecnologias digitais se configuraram como a principal estratégia adotada no ambiente de trabalho dos CREAS. Conclui-se que, se por um lado, a pandemia engendrou e acentuou obstáculos para a práxis da psicologia; por outro, a imprevisibilidade desse cenário e a potência da psicologia norte-mineira possibilitaram diversas estratégias para assistir os usuários.(AU)

This article analyses the challenges and strategies over the psychologists activity at the Specialized Reference Centers for Social Assistance (CREAS), from the north of the state of Minas Gerais during the COVID-19 pandemic. It is a descriptive, quantitative-qualitative study on content and statistics analysis for interpretation of primary and secondary data, with 19 psychologists participating. From interviews made with electronic questionnaires, the following theatrical axes emerged: (a) Social demographic profile of workers; (b) Prevention measures over contamination directed to which public? The impacts of the pandemic over the practice of psychology at CREAS; (c) Demand reception at CREAS; and (d) Tenuity between potentialities and vicissitudes of the use of digital technologies. The workers insertion at CREAS is notably marked by transitory working contracts, long labor journeys, and low wages. Furthermore, the COVID-19 pandemic is causing hindrances such as the lack of personal protection equipment (PPE) and virus prevention. The demands received by CREAS were also affected by the pandemic, as shown in the statistics analysis from monthly county treatment records. The digital technologies were the main strategy enforced by the working environment at CREAS. In conclusion, if on the one hand, the pandemic produced and increased obstacles for the practice of Psychology, on the other hand, the unpredictability of this scenery and the capacity of the psychology of the north of Minas Gerais enabled diverse strategies to attend the users.(AU)

Este artículo analiza los desafíos y las estrategias en la actuación de psicólogas(os) en los Centros de Referencia Especializados de Asistencia Social (CREAS) del norte de Minas Gerais (Brasil) durante la pandemia de la COVID-19. Se trata de un estudio descriptivo, cualicuantitativo, de cohorte transversal, con análisis de contenido y estadísticas para la interpretación de datos primarios y secundarios, en el cual participaron 19 psicólogas(os). De las entrevistas en un cuestionario electrónico surgieron los siguientes ejes temáticos: (a) perfil sociodemográfico de los(as) trabajadores(as); (b) medidas de prevención de la contaminación ¿para quién? Impactos de la pandemia en la praxis de la psicología en CREAS; (c) la llegada de demandas a CREAS y; (d) la tenuidad entre las potencialidades y vicisitudes del uso de tecnologías digitales. Se observó que la inserción de las(os) trabajadoras(es) en el CREAS está marcada por contratos laborales temporales, largas jornadas y baja remuneración. Además, con la pandemia de la COVID-19, se han enfrentado a obstáculos como la falta de equipo de protección personal (EPP) y prevención del virus. La llegada de demandas al CREAS también se vio afectada por la pandemia, como lo demuestran los análisis estadísticos de los registros mensuales de atención de los municipios. Las tecnologías digitales se han convertido en la principal estrategia adoptada en el entorno laboral de los CREAS. Se concluye que si, por un lado, la pandemia engendró y acentuó obstáculos a la praxis de la Psicología, por otro, la imprevisibilidad de este escenario y el poder de la Psicología en el norte de Minas Gerais posibilitaron varias estrategias para asistir a los usuarios.(AU)

Demandas e recursos para predição da síndrome de burnout em psicólogos clínicos / Demands and resources for burnout syndrome on clinical psychologists / Demandas y recursos para la predicción del síndrome de burnout en psicólogos clínicos

O modelo de demandas e recursos foi utilizado para identificar o poder preditivo do estilo pessoal do terapeuta e do trabalho emocional (demandas), e da inteligência emocional e autoeficácia profissional (recursos) sobre as dimensões da síndrome de Burnout (SB), em uma amostra de 240 psicólogos clínicos brasileiros. Os dados foram coletados por meio de plataforma online, tendo como instrumentos de pesquisa um Questionário de dados sociodemográficos e laborais, o Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, o Cuestionario del Estilo Personal del Terapeut, o Questionário de Avaliação Relacionado a Demandas Emocionais e Dissonância da Regra da Emoção, Medida de Inteligência Emocional, e Escala de Autoeficácia Geral Percebida. Os resultados obtidos revelaram um modelo preditor das dimensões da SB, constituído pelas variáveis dissonância emocional, automotivação, demandas emocionais, instrução, envolvimento e autoeficácia. Ressalta-se a relevância de estratégias voltadas para a prevenção da SB nessa categoria profissional, bem como a necessidade de ações que visem a promoção e o desenvolvimento da inteligência emocional e da autoeficácia como fortalecimento dos recursos emocionais para atuação na prática clínica.(AU)

The Model of Demands - Resources was used to identify the predictive power of therapist's personal style, emotional work (Demands), Emotional intelligence, and professional self-efficacy (Resources) over the Burnout syndrome dimensions in a sample of 240 Brazilian clinical psychologists. The data was collected by an on-line platform using a Labor and social demographic data questionnaire, a work Burnout Syndrome Evaluation questionnaire (CESQT - Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo), the short version of the Therapist Personal Style Questionnaire (EPT-C Cuestionario del Estilo Personal del Terapeuta), an Evaluation questionnaire related to emotional demands and emotion rule dissonance, and the Emotional Intelligence Measure (EIM) and Perceived General Self-Efficacy Scale (GPSS) as research instruments. Results showed a predictor model of Burnout syndrome constituted by the variables Emotional dissonance, Self-motivation, Emotional demands, Instruction, Involvement, and Self-efficacy. We emphasize the relevance of strategies to prevent Burnout Syndrome in this professional category and the need for actions to promote and develop emotional intelligence and self-efficacy as a strengthening factor of the emotional resources to work as a clinical psychologist.(AU)

Se utilizó el modelo demandas y recursos para identificar el poder predictivo del estilo personal del terapeuta y del trabajo emocional (demandas), y de la inteligencia emocional y autoeficacia profesional (recursos) sobre las dimensiones del síndrome de Burnout (SB), en una muestra de 240 psicólogos clínicos brasileños. Los datos se recolectaron de una plataforma en línea, utilizando como instrumentos de investigación un cuestionario de datos sociodemográficos y laborales, el Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, el Cuestionario del Estilo Personal del Terapeuta, el Cuestionario de Evaluación Relacionado con Demandas Emocionales y Disonancia de la Regla de la Emoción, la Medida de Inteligencia Emocional y Escala de Autoeficacia General Percibida. Los resultados obtenidos revelaron un modelo predictor de las dimensiones de SB, constituido por las variables disonancia emocional, automotivación, exigencias emocionales, instrucción, implicación y autoeficacia. Se destaca la relevancia de las estrategias dirigidas a la prevención del SB en esta categoría profesional, así como la necesidad de acciones dirigidas a promover y desarrollar la inteligencia emocional y la autoeficacia como fortalecimiento de los recursos emocionales para trabajar en la práctica clínica.(AU)

Estresse ocupacional entre psicólogos atuantes na atenção primária à saúde no contexto pandêmico / Occupational stress in psychologists working in primary health care in the context of the pandemic / Estrés laboral entre los psicólogos que trabajan en atención primaria de salud en el contexto de la pandemia

Este estudo analisa o estresse ocupacional entre psicólogos que atuavam na Atenção Primária à Saúde durante a pandemia ocasionada pela covid-19, assim como as características sociodemográficas e laborais dos participantes e sua relação com o estresse ocupacional. Participaram da pesquisa 70 psicólogos atuantes em 51 unidades básicas de saúde das regiões Oeste e Extremo Oeste catarinense. Para coleta de dados, um questionário sociodemográfico e a versão reduzida da Job Stress Scale (JSS) foram aplicados. A análise dos dados foi realizada por meio da estatística descritiva e inferencial. Identificou-se que 35,7% dos psicólogos apresentaram alto desgaste no trabalho; 28,6% baixo desgaste; 27,1% se mostraram em trabalho passivo; e 8,6% em trabalho ativo. No modelo de regressão linear, os fatores associados à dimensão Demanda da JSS foram: possuir filho (a) (coeficiente -1,49; IC 95% -2,75 a -0,23) e afastamento do trabalho nos últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Os psicólogos com hipertensão arterial sistêmica autorreferida apresentaram, em média, 3,96 pontos a menos no escore de Apoio social (IC 95% -7,06 a -0,85), quando comparados aos não hipertensos, e entre os psicólogos que trabalhavam no turno da manhã identificou-se aumento de 4,46 pontos, em média, no escore de Apoio social (IC 95% 0,90 a 8,02) em relação aos profissionais do turno manhã e tarde. Evidenciou-se que um número significativo de psicólogos apresentava-se em alto desgaste no trabalho, com potenciais implicações para sua saúde e atuação profissional.(AU)

This study analyzed occupational stress among psychologists who worked in Primary Health Care during the COVID-19 pandemic and participants' sociodemographic and work characteristics and their relationship with occupational stress. In total, 70 psychologists working in 51 basic health units in the West and Far West regions of Santa Catarina participated in this research. A sociodemographic questionnaire and the short version of the Job Stress Scale (JSS) were applied to collect data. Data were analyzed by descriptive and inferential statistics. In total, 35.7% of psychologists showed high stress at work; 28.6%, low burn out; 27.1%, passive work; and 8.6%, active work. The factors in the linear regression model that were associated with the JSS demand dimension referred to having children (coefficient −1.49; 95% CI −2.75 to −0.23) and absence from work in the last 12 months (coefficient 1.88; 95% CI 0.60 to 3.15). Psychologists with self-reported systemic arterial hypertension showed, on average, 3.96 points lower in the Social Support score (95% CI −7.06 to −0.85) than non-hypertensive ones and psychologists who worked in the morning shift, an average increase of 4.46 points in the Social Support score (95% CI 0.90 to 8.02) in relation to professionals working in the morning and afternoon shifts. A significant number of psychologists had high stress at work, with potential implications to their health and professional performance.(AU)

Este estudio evalúa el estrés laboral entre los psicólogos que trabajaron en la atención primaria de salud durante la pandemia provocada por la COVID-19, así como las características sociodemográficas y laborales de ellos y su relación con el estrés laboral. En la investigación participaron setenta psicólogos que trabajan en 51 unidades básicas de salud en las regiones oeste y lejano oeste de Santa Catarina (Brasil). Para la recolección de datos se aplicó un cuestionario sociodemográfico y la versión corta de la Job Stress Scale (JSS). El análisis de los datos se realizó mediante estadística descriptiva e inferencial. Se identificó que el 35,7% de los psicólogos presentaban alto estrés en el trabajo; el 28,6% tenían poco desgaste; el 27,1% se encontraban en trabajo pasivo; y el 8,6% en trabajo activo. En el modelo de regresión lineal, los factores asociados a la dimensión demanda de la JSS fueron: tener hijo (coeficiente -1,49; IC 95% -2,75 a -0,23) y baja laboral en los últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Los psicólogos con hipertensión arterial sistémica autoinformada presentaron un promedio de 3,96 puntos más bajo en la puntuación de apoyo social (IC 95% -7,06 a -0,85) en comparación con los no hipertensos, y entre los psicólogos que trabajaban en el turno de la mañana, se identificó un aumento promedio de 4,46 puntos en la puntuación de apoyo social (IC 95% 0,90 a 8,02) con relación a los profesionales que laboran en el turno de mañana y tarde. Quedó evidente que un número significativo de psicólogos se encontraba en situación de alto estrés en el trabajo, con posibles implicaciones para su salud y desempeño profesional.(AU)

Assessment of Compassion Fatigue and Empathy Levels in Nurses During the COVID-19 Outbreak: Turkey's Case.

This study was conducted to determine the compassion fatigue level of nurses and to review several variables believed to be associated with it; in addition, an assessment is made of empathy levels in the same group. This is a cross-sectional study conducted from December 2021 to May 2022 on nurses working at a city hospital linked to the Turkish Ministry of Health. The study group consisted of 616 nurses. A Personal Information Form, the Compassion Fatigue-Short Scale (CF-SS), and the Jefferson Scale of Empathy were used to collect data. Data were collected through face-to-face interviews. Student's t-test, One-Way Analysis of Variance, and Multiple Linear Regression Analysis were used for data analysis. The statistical significance value was accepted as p < 0.05. The study group consisted of 499 (81.0%) females and 117 (19.0%) males, and their ages ranged from 20 to 51, with a mean age of 29.2 ± 6.9 years. The scores obtained from the CF-SS ranged from 16 to 130, with a mean score of 70.96 ± 25.04. The level of compassion fatigue was found to be higher in participants with a low family income, those who work more than 40 h a week, those who chose their profession unwillingly, those who are not satisfied with their profession, and those with a history of contact with a COVID-19 patient (p < 0.05 for each group). There was a significant association between levels of compassion fatigue and empathy (r = 0.92; p = 0.220). The level of compassion fatigue was found to be moderate in the nurses observed. The factors affecting the level of compassion fatigue included gender, family income, reasons for choosing nursing as a profession, the number of patients given daily care by the nurses, satisfaction with their profession, and history of contact with a COVID-19 patient. More extensive studies focusing on the association between compassion fatigue and empathy in nurses are needed.

The Cost of Caring: Compassion Fatigue among Peer Overdose Response Workers in British Columbia.

Background: The drug toxicity crisis has had dramatic impacts on people who use drugs. Peer overdose response workers (peer responders), i.e., individuals with lived/living experience of drug use who work in overdose response settings, are particularly susceptible to negative physical and mental health impacts of the crisis. Despite that, the mental health impacts on peer responders have yet to be studied and measured. Methods: The Professional Quality of Life survey (Version 5) was completed by 47 peer responders at two organizations in British Columbia between September 2020 and March 2021 to assess compassion satisfaction and compassion fatigue. The Likert scale responses were converted into numerical values and scores were calculated for each sub-scale. The mean score was calculated for each sub-scale and categorized as low, medium, or high, based on the instructions for Version 5 of the instrument. Results: Our study uncovered a high mean score for compassion satisfaction, low mean score for burnout, and medium mean score for secondary traumatic stress among peer responders. These results may be due to the participants' strong feelings of pride and recognition from their work, as well as the low number of participants that felt they had too much to do at work. Conclusion: Although peer responders derive pleasure and fulfillment from their jobs, i.e., compassion satisfaction, they also sometimes face burnout and stress due to continuous exposure to the trauma of the people they support. These results shed light on the areas that need to be targeted when creating supports for peer responders.

The Impacts of Working With Victims of Sexual Violence: A Rapid Evidence Assessment.

AIM: Supporting clients who have experienced trauma can lead to trauma symptoms in those working with them; workers in the sexual violence field are at heightened risks of these. This article collated and critically appraised papers, published from 2017 onward, in the area of people assisting victims of sexual violence. It explores the impacts and effects the work has on them, their coping and self-care mechanisms, and organizational support offered to them. DESIGN: A question-based rapid evidence assessment with a triangulated weight of evidence approach was used. Academic and nonacademic databases were searched. Twenty-five papers were included for analysis based on the inclusion/exclusion criteria. RESULTS: Most studies were of medium to high methodological quality. Negative impacts included trauma symptoms, disrupted social relationships, behavioral changes, and emotional and psychological distress. Ability to manage negative impacts was influenced by overall organizational support, availability of training, supervision and guidance, workloads and caseload characteristics, individual characteristics, and their coping and self-care mechanisms. Positive impacts included empowering feelings, improved relationships, compassion satisfaction, and posttraumatic growth. CONCLUSIONS: Impacts are significant. Support at work and in personal life increases staff's ability to cope and find meaning in their role. Implications for research and practice are discussed.

Sobre dias em que me senti sem ar: desassossegos do pesquisar / On days when i felt breathless: unrest of search / Sobre días que me sentí sin aliento: disurbios de investigación

Resumo Conceitos como o de alteridade, encontro de saberes, polifasia cognitiva, o princípio de familiaridade e de representações sociais operaram na complexa tarefa de compreender como os encontros entre profissionais e usuários sustentavam e/ou transformavam as práticas de acolhimento. Entretanto, a experiência da minha pesquisa de doutorado me levou a questionar os próprios conceitos utilizados da Teoria das Representações Sociais. Ao final do ensaio, após discutir aspectos teórico-metodológicos, o princípio de familiaridade e a questão da tensão e dos afetos nas representações sociais, espero evidenciar como o movimento provocado pelo encontro com usuários e profissionais de uma Rede de Atenção Psicossocial levou-me a questionar pontos essenciais da teoria: o papel domesticador das representações, a forma ainda estática de evidenciar os fenômenos, a separação entre um sujeito que representa e o objeto representado e a dificuldade em usar suas ferramentas conceituais para acompanhar processos me fazem repensar meu lugar e minha função de pesquisador.

Abstract Concepts such as alterity, encounter of knowledge, cognitive polyphasia, the principle of familiarity and the very concept of social representations operated in the complex task of understanding how the encounters between professionals and users supported and / or transformed user embracement practices. However, the experience of my doctoral research led me to question the very concepts used in the Theory of Social Representations. At the end of the essay, after discussing theoretical and methodological aspects, the principle of familiarity and the issue of tension and affects in social representations, I hope to show how the movement caused by the encounter with users and professionals of a Psychosocial Care Network, led me to question essential points of the theory: the domesticating role of representations, the still static way of showing phenomena, the separation between a subject that represents and the object represented and the difficulty in using their conceptual tools to accompany processes makes me rethink my place and role as a researcher.

Resumen Conceptos como la alteridad, el encuentro de saberes, la polifasia cognitiva, el principio de familiaridad y el concepto mismo de representaciones sociales operaron en la compleja tarea de comprender cómo los encuentros entre profesionales y usuarios apoyaron y / o transformaron las prácticas de acogimiento. Sin embargo, la experiencia de mi investigación doctoral me llevó a cuestionar los propios conceptos utilizados en la Teoría de las Representaciones Sociales. Al final del ensayo, después de discutir aspectos teóricos y metodológicos, el principio de familiaridad y el tema de tensión y afectos en las representaciones sociales, Espero mostrar cómo el movimiento provocado por el encuentro con usuarios y profesionales de una Red de Atención Psicosocial, me llevó a cuestionar puntos esenciales de la teoría: el rol domesticador de las representaciones, la forma todavía estática de mostrar los fenómenos, la separación entre un sujeto que representa y el objeto representado y la dificultad para utilizar sus herramientas conceptuales para acompañar procesos, me hace repensar mi lugar y rol como investigador.

Suicide risk assessment fears, attitudes and behaviours of lifeline crisis supporters.

Lifeline Australia operates crisis support services through Lifeline Crisis Supporters. An integral part of their role is to conduct online suicide risk assessments with help-seekers. However, there is limited literature regarding suicide risk assessment practices for this population. This study aimed to examine how suicide prevention training, vicarious trauma and fears impacted suicide risk assessment behaviours of Lifeline Crisis Supporters. A cross-sectional survey design was used to recruit a volunteer convenience sample of 125 Lifeline Australia Crisis Supporters (75.2% females; Mage  = 54.9) in 2018 to participate in an online survey. Findings revealed that those with more suicide-specific training had less risk assessment-related fears, and that fears were not related to attitudes towards suicide prevention. There was no significant relationship between vicarious trauma and amount of training or years of experience in the role. Further, participants with higher levels of vicarious trauma demonstrated significantly more negative attitudes towards suicide prevention. Overall, training appears to be a significant factor in suicide risk assessment practice behaviours of Lifeline Crisis Supporters, highlighting a need for ongoing training and support for them. This research also suggests that whilst fears exist, they do not significantly impair Lifeline Crisis Supporters' ability to undertake suicide risk assessment.

Mental health needs in a large urban school district: Findings from a web-based survey.

OBJECTIVE: To explore the mental health needs of students, and the professional development and support needs of teachers and school health professionals, as a way to foster community engagement and help set priorities for a comprehensive school mental health system in the Detroit Public Schools Community District (DPSCD). SETTING: The study team surveyed all DPSCD staff in June 2019 and all students in grades 8-12 between October and December 2019. STUDY DESIGN: A descriptive study based on anonymous, web-based surveys focused on student trauma exposure and mental health symptoms, student mental health resource utilization, staff burnout, and professional development needs. DATA COLLECTION: All students (grades 8-12) and district staff were eligible to participate; the student survey was made available in six languages. Parents/guardians could opt children out; schools could exclude children unable to complete the survey independently. Student surveys were administered in school; staff surveys were sent via email. PRINCIPAL FINDINGS: Thirty-four percent of DPSCD students reported moderate/severe depression symptoms; 22% had seriously considered suicide in the past year. Rates exceed national averages; 37% of students with severe depression and 34% of those with suicidal ideation had not accessed mental health supports. Staff indicated high levels of burnout and substantial interest in learning about self-care strategies or coping with vicarious trauma. Over 75% of teachers and school mental health professionals expressed interest in learning about best practices for supporting students impacted by trauma or mental illness. CONCLUSIONS: A large number of DPSCD students are experiencing symptoms of depression and anxiety, and many students who need care are not accessing it. Addressing the mental health needs of students is a high priority for staff, but they need more training and support, as well as support for their own vicarious trauma and high levels of burnout.

Secondary traumatic stress in iranian midwives: stimuli factors, outcomes and risk management.

BACKGROUND: The present qualitative study was conducted to explain the experiences of secondary traumatic stress (STS) and its related factors in midwives working in maternity wards. METHODS: Data were collected using semi-structured interviews with 11 midwives working in the maternity wards of hospitals in Urmia, Iran, through in-depth interviews with open-ended questions. Data were analyzed using the conventional content analysis approach. RESULTS: The results of data analysis led to the extraction of three themes, seven main categories, and 18 subcategories. The first theme was "STS stimuli," with the two categories of "Discriminatory approach to midwifery" and "The nature of the midwifery profession". The second theme was "Traumatic outcomes", which included the subcategories of "Psychological-emotional trauma", "Physical trauma" and "Social trauma". The third theme was "Risk management", which had the two subcategories of "Reactive approach" and "Proactive approach". CONCLUSIONS: The results showed that, in addition to the traumatic nature of events that midwives experience during work as the secondhand victims, factors such as governance-organizational structure, unbalanced distribution of power, and poor supportive laws undermine their professional role and provide conditions conducive to STS. Therefore, avoiding traumatic situations and scientific and skill self-empowerment were the most important strategies adopted by the midwives in this study to prevent risky situations and cope with the consequences of STS. The participation of midwifery stakeholders in policy-making and adopting supportive legislation in redefining the position and role of midwives can play a major role in reducing STS and sustaining their role and position in maternal care.

Economic Precarity, Financial Strain, and Job-Related Stress Among Philadelphia's Public Mental Health Clinicians.

OBJECTIVE: Efforts to improve mental health treatment delivery come at a time of rising inequality and cuts or insufficient increases to mental health funding. Public mental health clinicians face increased demands, experience economic stress, and treat underresourced patients disproportionately burdened by trauma. The authors sought to understand clinicians' current economic and psychological conditions and the relationship of these conditions to the delivery of an evidence-based intervention (EBI) designed to treat posttraumatic stress disorder among youths. METHODS: In July 2020, 49 public mental health clinicians from 16 Philadelphia clinics who were trained in an EBI, trauma-focused cognitive-behavioral therapy (TF-CBT), were surveyed by e-mail. Respondents reported on their economic precarity, financial strain, burnout, secondary traumatic stress (i.e., the stress response associated with caring for people exposed to trauma), and TF-CBT use. Associations between clinicians' job-related stressors and their use of TF-CBT were examined with mixed models. Content coding was used to organize clinicians' open-ended responses to questions regarding financial strain related to the COVID-19 pandemic. RESULTS: Clinicians' economic precarity, financial strain, and job-related stress were high; 37% of clinicians were independent contractors, 44% of whom wanted a salaried position. Of 37 clinicians with education debt, 38% reported owing ≥$100,000. In the past year, 29% of clinicians reported lack of personal mental health care because of cost, and 22% met the cutoff for experiencing secondary traumatic stress symptoms. Education debt was negatively associated with use of TF-CBT (p<0.001). CONCLUSIONS: The stress of providing care in underresourced clinical settings may interfere with efforts to integrate scientific evidence into mental health care.

Psychological demands of health professionals in the initial phase of the COVID-19 pandemic

Abstract Recent literature emphasizes how the specific stressors of the COVID-19 outbreak affect the general population and frontline professionals, including those conducting support or backup activities in health units, which can lead to vicarious traumatization. Vicarious traumatization has been used to describe negative emotional reactions in mental health professionals who assist or treat victims of traumatic events. Thus, the aim of this article is to report the actions used in the face of the psychological demands of professionals in a hospital, who were not on the frontline of COVID-19. We collected their sociodemographic information and checked the psychological impact using the depression, anxiety, and stress scale (DASS-21), which was followed by a psychoeducational program (topics related to COVID-19 control and prevention), and individual psychological care for the most severe cases. A total of 118 professionals participated in this study; they were between 20 and 67 years old. Mild to moderate anxiety was observed in 36.5% of the medical teams, 83.3% of the administrative staff, and 65.7% of general service workers, while stress symptoms were observed in 80.2%, 83.3%, and 59.9%, respectively. Depressive symptoms (35.3%) were more frequent in general service workers. The medical teams reported the benefits of primary psychological care, while the other professionals demanded more institutional support services related to the prevention and use of personal protective equipment. This study highlights relevant psychological demands that have repercussions on the daily lives of professionals. The psychoeducational program was considered positive regarding clarification actions. However, it was not perceived as effective in reducing fear, which may result from vicarious traumatization and requires other intervention modalities.

A Wellness Program to Decrease Pediatric Postanesthesia Care Unit Staff Compassion Fatigue.

INTRODUCTION: Health care workers, especially those in pediatrics, have a high risk for compassion fatigue (CF). A wellness program (WP) might help decrease CF and increase compassion satisfaction (CS). METHOD: This project implemented and evaluated a WP in a pediatric postanesthesia care unit at a large children's hospital. The project evaluated the effectiveness of a WP using pre- and post-WP surveys, which assessed CF (i.e., burnout and secondary traumatic stress), CS, and overall satisfaction with the WP. RESULTS: Overall results demonstrated decreases in CF and increases in CS, self-care, healthy behaviors, and knowledge of CF. The perceived level of teamwork, morale, recognition, social support, and positive coworker interactions also increased. Overall, 77% of the respondents thought the WP helped decrease CF. DISCUSSION: Implementing a WP that incorporates social support, education, and healthy behaviors had significant benefits, including a reduction in CF.

Promoting health and wellbeing across community nursing teams: role of the specialist practitioner district nurse.

There is a growing concern around the health and wellbeing of community nurses due to the high complexities of and demand on district nursing services. It is well recognised that district nursing services have no limits to their capacity, and they have been dealing with an increasing caseload, with no increases in resources or staff. Consequently, this has left community nurses feeling exhausted and experiencing burnout, which, in the long term, can lead to compassion fatigue, which can in turn compromise patient safety. Specialist practitioner qualified district nurses (SPQDN) require the skills and knowledge to promote health and wellbeing, in order to provide a positive work environment and limit work-related stress and burnout despite the challenges encountered. This article explores possible strategies to promote health and wellbeing among community nurses and the barriers that SPQDNs encounter in doing so.

Building skills and resilience in child abuse pediatricians: A novel program to address Secondary Traumatic Stress.

BACKGROUND: Secondary traumatic Stress (STS) is an increasingly recognized phenomenon experienced by clinicians working with patients who have experienced trauma firsthand. STS is experienced in a range of clinical settings; medical trainees and those working in Child Abuse Pediatrics (CAP) are at particular risk of experiencing STS. To date, there are no interventions described to address STS experienced by medical trainees in the context of CAP training. OBJECTIVE: The aim of this project was to design and pilot an innovative program to increase resilience and address STS symptoms among fellows in a CAP training program. PARTICIPANTS AND SETTING: The Therapeutic Group Sessions (TGS) program was developed for CAP fellows at the Hospital for Sick Children, Toronto, Canada. METHODS: The intervention involved mandatory, monthly small group sessions facilitated by a consistent mental health professional throughout fellowship. Sessions included low intensity focusing activities, sharing impactful work-related experiences, mental health professional-led discussion of strategies and reflection on the session. Written evaluations were completed to understand the perceived impact on fellows and were analyzed for themes. RESULTS: Fellows reported improvements in perceived STS symptoms and increased feelings of resilience. Unanticipated positive outcomes were described including, a highly bonded fellowship group and transferrable skills gained in supportive communication. Programs developed to support clinicians in other settings are reviewed and compared to the TGS program. CONCLUSIONS: This is the first program aimed at improving resilience and addressing STS among child abuse fellows. Outcomes demonstrated numerous positive impacts that are widely applicable to the broader clinical setting.

Assessment of Professional Quality of Life in the Alabama Physical Therapy Workforce.

OBJECTIVE: The purposes of this study were to 1) determine the level of professional quality of life among physical therapists and physical therapist assistants in Alabama and 2) to identify personal or professional factors that may contribute to compassion satisfaction (CS), burnout, and secondary traumatic stress (STS). METHODS: This study used a cross-sectional design and mixed-methods survey methodology to calculate odds ratios for factors affecting professional quality of life. Respondents completed a survey that included the Professional Quality of Life (ProQOL) scale, an open-ended question regarding their experience with professional burnout, and personal and professional demographics. RESULTS: Of the 742 physical therapists and physical therapist assistants in Alabama who completed the survey, the majority experienced moderate-high levels of CS and moderate-low levels of burnout and STS. Regression analyses indicated clinicians working 40 or more hours per week in patient care had greater odds for low-moderate CS and moderate-high burnout and STS subscale scores. Clinicians in our sample licensed between 6 to 15 or more than 30 years and those working in private outpatient settings had reduced odds of having moderate-high burnout, whereas those working 16 or more years had significantly increased odds for high CS scores. Responses to the open-ended question indicated workload demands and documentation as the top factors contributing to clinician burnout, while the connections with patients and coworkers help minimize such feelings. CONCLUSION: Individuals later in their career may develop protective factors to mitigate feelings of burnout compared to those early in their career. Also, clinicians working 40 or more hours per week may be more vulnerable to experiencing low-moderate CS and moderate-high burnout. Thus, individual clinicians and employers must evaluate personal, occupational, and systemic factors that contribute to reduced professional quality of life to inform preventive strategies for mitigating burnout.

The reflective risk assessment model of professional quality of life in Chinese nurses.

AIM: To apply the reflective risk assessment model in a Chinese health care setting to investigate the relationships between professional quality of life and mental health risk profiles. BACKGROUND: Few studies have connected the quality of work life with contributing and coexisting factors such as depression, anxiety and stress, but none to date in a Chinese health care setting. METHOD: A cross-sectional survey of 950 registered Chinese nurses was employed. RESULTS: 299 of 861 participants (34.7%) were categorized into four of five professional quality of life risk profiles, consistent with the reflective risk assessment model. Significant differences were seen with large-sized effects in the mean scores of stress, anxiety and depression among the participants, with participants of the very distressed profile having significantly higher mean scores in stress, anxiety and depression, followed by the at-risk profile group. CONCLUSION: The reflective risk assessment model and professional quality of life five risk profiles are supported by this study. IMPLICATIONS FOR NURSING MANAGEMENT: The reflective risk assessment model can be used to detect risk factors for mental health in nurses and for the design of interventions that promote nurses' mental health.

Employee Wellness Pilot Program.

BACKGROUND: Mental health professionals caring for the veteran population are at increased risk for compassion fatigue, burnout, and secondary traumatic stress based on the nature of their work. While mental health professionals may experience positive outcomes from providing compassionate care to veterans, compassion fatigue can lead to instability of the workforce. METHODS: A pilot employee wellness program was implemented over a 9-week period, offering a different wellness module weekly during the employee lunch hour. Demographic data were collected pre-program, and mental health employees were surveyed pre- and post-program using an intent to stay scale and the Professional Quality of Life Scale version 5 (ProQOL-5) to measure compassion satisfaction, burn out, and secondary traumatic stress. FINDINGS: Pre-program participants (N = 42) reported significant differences in intent to stay in their current position for the next year compared to the post-program group (N = 15). Pre-program participants reported no intent to leave their current position, apply for internal or external positions, or retire in the following year. However, post-program participants reported intent to leave their current positions, apply to internal or external positions, or retire. Pre- and post-program compassion satisfaction scores increased and burnout and secondary traumatic stress scores decreased; these scores were not significantly different between groups. CONCLUSIONS/APPLICATION TO PRACTICE: While no significant differences were found between ProQOL-5 subscale scores, the change in participants' scores may indicate some change, potentially as a result of the intervention. This pilot program offered a creative solution to organizations with limited resources to combat occupation-related compassion fatigue.