Adapting the Stress First Aid Model for Frontline Healthcare Workers during COVID-19.

The coronavirus pandemic has generated and continues to create unprecedented demands on our healthcare systems. Healthcare workers (HCWs) face physical and psychological stresses caring for critically ill patients, including experiencing anxiety, depression, and posttraumatic stress symptoms. Nurses and nursing staff disproportionately experienced COVID-19-related psychological distress due to their vital role in infection mitigation and direct patient care. Therefore, there is a critical need to understand the short- and long-term impact of COVID-19 stress exposures on nursing staff wellbeing and to assess the impact of wellbeing programs aimed at supporting HCWs. To that end, the current study aims to evaluate an evidence-informed peer support stress reduction model, Stress First Aid (SFA), implemented across units within a psychiatric hospital in the New York City area during the pandemic. To examine the effectiveness of SFA, we measured stress, burnout, coping self-efficacy, resilience, and workplace support through self-report surveys completed by nurses and nursing staff over twelve months. The implementation of SFA across units has the potential to provide the workplace-level and individual-level skills necessary to reduce stress and promote resilience, which can be utilized and applied during waves of respiratory illness acuity or any other healthcare-related stressors among this population.

Concordant Actions in Suicide Assessment Model.

This article offers an alternative conceptualization from which a health care provider can consider and respond to client-based suicidal ideation and behavior. Pragmatically explored through the prism of locus of control, Rogerian psychotherapy principles, Peplau's theory of interpersonal relations, and the work of Kay Redfield Jamison, the Concordant Actions in Suicide Assessment (CASA) model frames clinical decision making along a continuum defined by concordant and state-based action. Therein, cognitive reframes are offered to illustrate how to apply the CASA model in clinical practice.

Military Culture Implications for Mental Health and Nursing Care.

With over 13 years of war and military combat operations, the number of veterans, military families, and service members with mental health needs continues to increase across civilian and federal healthcare services. Knowledge about severe battle wounds, traumatic brain injury, and traumatic stress has influenced the delivery of healthcare. The invisible wounds of war associated with brain injury and traumatic stress will increase clinical care challenges into the foreseeable future. The purpose of this article is to describe two interrelated concepts, military cultural competence and stress injuries. The authors also differentiate stress reactions versus stress injury. Nurses with military cultural competence and knowledge about stress injuries will be better able to deliver patient-centered care to patients with military culture experiences.

Comparison of chronic disease prevalence between U.S. Navy ships without medical doctors and a similar shore-based population.

OBJECTIVE: Most U.S. Navy ships operate without embarked physicians, employing Independent Duty Corpsmen to provide primary and emergency medical care to crewmembers. We sought to characterize the burden of chronic disease faced by Independent Duty Corpsmen aboard Navy ships and compare it to that of a similar shore-based population. METHODS: We conducted cross-sectional analyses of shipboard and shore-based samples using 1,305 records from Norfolk, Virginia-based U.S. Navy ships without doctors between March and May 2007, and records for Norfolk shore-based sailors from the same time frame matched 3:1 on age, sex, and race against the shipboard sample. RESULTS: Asthma prevalence was 2.0% and 5.9% for the shipboard and shore-based samples, respectively (p < 0.0001). Cervical dysplasia among women was 16.2% and 23.1% (p = 0.3687). Depression was 4.6% and 8.4% (p < 0.0001). Diabetes was 1.0% and 2.3% (p = 0.0096). Hyperlipidemia was 20.6% and 21.4% (p = 0.5597). Hypertension was 25.5% and 36.1% (p < 0.0001). Total prevalence for any of the above conditions was 42.5% and 50.9% (p = 0.0001). CONCLUSION: Over 42% of shipboard sailors have one or more chronic health conditions. Even though the studied conditions were significantly less prevalent aboard ship than in the comparable shore-based sample, nonphysician practitioners aboard ships must be prepared to diagnose and treat chronic diseases.

Fleet leaders' attitudes about subordinates' use of mental health services.

Mental disorders are a significant source of medical and occupational morbidity for sailors. Stigma, fear of negative career impact, and subordinates concern about leaders' attitudes are significant barriers to the use of mental health services. Semistructured interviews and military policies were data sources used to analyze the language, knowledge, and attitudes of Navy surface fleet leaders about mental illness and mental health treatment using Foucault's concept of discourse analysis. A discourse is a system of knowledge that influences language, perceptions, values, and social practices. The results showed that leaders' concerns about sailors' mental combat readiness, not mental illness stigma, was the dominant discourse about mental illness and mental health services use. In particular, organizational differences between the surface warfare and the mental health communities may influence leaders' attitudes more than stigma. This study provides an elaborated view of mental health knowledge and power within a Navy community.