RESUMO
Outcomes: 1. Define the factors contributing to increased PTSD incidence due to COVID-19 among hospice and palliative medicine professionals. 2. Implement measures to screen and proactively mitigate workplace related factors associated with increased risk of PTSD in pandemic- and potentially non-pandemic-related situations. The COVID-19 pandemic has affected more than 557 million people globally. In order to assess its psychological effect on healthcare workers in hospice and palliative medicine, a survey was solicited to AAHPM members. Participation was voluntary and anonymous, with all responses kept in confidence. The survey consisted of three parts: demographics, attitudes/sentiments relating to COVID-19, and the DSM-IV-TR Post-Traumatic Stress Disorder (PTSD) Checklist-Specific (PCL-S). The PCL-S has clinical and research utility to screen for PTSD in response to a specific stressor, in this case COVID-19. A total of 323 AAHPM members participated, of which 290 (89.8%) completed the PCL-S. Utilizing the most conservative and reliable scoring method for the PCL-S, 16.6% (48/290) met diagnostic criteria for symptomatic PTSD. Demographic factors including age, relationship status, child status, years of experience, geographical location, and gender did not affect odds of PTSD symptomology, yet non-male gender was associated with higher PCL-S scores (3.2 +/- 1.5;p = 0.38). Attitudes surrounding the use and perceived efficacy of telemedicine did not impact the incidence of PTSD. Those providing critical care services (33/156;21.2%) were at greater risk of symptomatic PTSD than those not providing critical care services to COVID-19 patients (15/135;11.1%;RR = 1.9[1.08-3.35];p=0.026). Furthermore, PCL-S scores increased as a function of the number of patients where critical care (but not non-critical care) was provided (p=0.0006). Increased workload (p=0.009) and having to perform new job duties (p=0.004) as a result of COVID-19 were also associated with symptomatic PTSD. Personal stress was also a contributory factor;the risk of symptomatic PTSD was higher among respondents reporting a friend, family member, or colleague's death from COVID-19 (23.8% vs. 13.1%;RR = 1.82[1.08-3.05]). As COVID-19 continues to impact us all, understanding factors affecting the mental health of an integral part of the healthcare workforce is crucial.Copyright © 2023
RESUMO
We study the effects of a sizeable ($526 PPP) one-time-only emergency cash transfer targeted at self-employed, sub-employed, and informal sector workers during the COVID-19 pandemic. The transfers were processed on a first-come, first-served basis until program funds were depleted, creating a plausible source of exogenous variation in program participation. Combining this discontinuity with a purpose-built phone survey, we find substantial positive effects on measures of food security and psychological well-being three to four months after reception. The point estimates for summary measures of business health outcomes and support for lockdowns are positive but imprecisely estimated. © 2023 Elsevier B.V.