ABSTRACT
Objective: The COVID-19 pandemic has prompted a surge in research focusing on mental health issues faced by society, with particular emphasis on the interplay between social support and anxiety. However, the results of these studies have often been controversial. Methods: To address this, we conducted a meta-analysis of 104 studies (N = 107,660) to investigate the relationship between anxiety and social support and the potential moderate variables. Results: Our meta-analysis revealed a negative correlation between social support and anxiety (r = -0.233). The study also demonstrated the variation in the relationship between social support and anxiety was moderated by cultural area (Q = 14.120, p < 0.05) and phrase of the pandemic (Q = 13.678, p < 0.05). Conclusion: The relationship between social support and anxiety can differ across different cultural areas and throughout the phrase of the pandemic. Consequently, we advocate for a nuanced assessment of the role of social support in mitigating public anxiety, taking into account the mediating effects of these factors in the context of major public emergencies.
Subject(s)
Anxiety , COVID-19 , Social Support , Humans , COVID-19/psychology , COVID-19/epidemiology , Anxiety/epidemiology , SARS-CoV-2 , Emergencies/psychology , Pandemics , Mental Health/statistics & numerical dataABSTRACT
INTRODUCTION: Morbidity from an emergency laparotomy (EmLap) is difficult to define and poorly understood. Morbidity is a holistic concept, reliant upon an interplay of bio-psychosocial outcomes that evolve long after discharge. To date, no previous study has explored the psychosocial outcomes following EmLap as a collective, nor their change over time. This study aims to describe the holistic morbidity following EmLap within the first year following surgery. METHODS AND ANALYSIS: This is a multicentre, mixed-methods prospective 12-month cohort study with two participant populations: patient participants and family caregivers (FCGs). A target of 160 adult patients who undergo EmLap and can give informed consent will be included in the patient participant group. Patient participants will be asked to complete three patient surveys, incorporating validated patient-reported outcome measures (PROMs) to assess bio-psychosocial outcomes (EuroQol five-dimension five-level (EQ5D-5L), Gastrointestinal Quality Life Index-36, Patient Health Questionnaire-9, Generalised Anxiety Disorder 7, International Trauma Questionnaire, Caregiver Interaction Scale and Fatigue Severity Scale) in the 12 months following surgery. A subgroup of 15 patient participants will be asked to take part in two semistructured interviews at 6 and 12 months. A target of 15 associated family caregivers will be included in the FCG group. FCGs will be asked to take part in a semi-structured interview at 6 months to assess the EmLap impact on the wider support network. The primary outcome will be a change in quality of life (EQ5D-5L) at 12 months. Secondary outcomes will be changes in bio-psychosocial status at 3 and 12 months. Qualitative analysis will allow contextualisation of PROMS and further explore themes of EmLap morbidity. It is anticipated that the results of this study will help inform and develop standards of aftercare for future EmLap patients. ETHICS AND DISSEMINATION: This study has received ethical approval (Wales REC7;12/WA/0297) and will be undertaken in accordance with the principles of Good Clinical Practice. We intend to disseminate study results in peer-reviewed journals and medical conferences, as well as a lay report to study participants. TRIAL REGISTRATION NUMBER: Clinical Trials.gov NCT05281627.
Subject(s)
Laparotomy , Quality of Life , Humans , Laparotomy/psychology , Prospective Studies , Adult , Patient Reported Outcome Measures , Caregivers/psychology , Emergencies/psychology , Female , Male , Research Design , Surveys and Questionnaires , Multicenter Studies as Topic , Postoperative Complications/psychologyABSTRACT
OBJECTIVE: To explore the different processes of the themes and emotional evolution of various stakeholders in the network public opinion of sudden public health emergencies at different stages of the public opinion evolution lifecycle. METHODS: This paper proposes a cross-platform analysis method for online public opinion during the public health emergencies based on stakeholders. Firstly, data from multiple platforms are collected and integrated. Secondly, stakeholders are categorized and the stages of public opinion evolution are determined based on stakeholder theory and lifecycle theory. Finally, the Latent Dirichlet Allocation (LDA)+Word2vec model and Convolutional Neural Network (CNN) model are used to analyze the themes and emotional evolution of stakeholders during different stages of public opinion evolution. RESULTS: There are differences in the evolution patterns of different types of stakeholders. The evolution process of stakeholders' focus points exhibits a two-stage transition from concentration to divergence. The focus points of stakeholders are closely associated with their respective social domains. The emotions of the public undergo a three-stage process of positive-negative-positive change. CONCLUSIONS: This study can provide a reference for the government to have a more comprehensive understanding of the development trend of public opinion and reduce the negative impact of public opinion.
Subject(s)
Emergencies , Public Health , Public Opinion , Stakeholder Participation , Humans , Stakeholder Participation/psychology , Emergencies/psychology , Neural Networks, Computer , Emotions , InternetABSTRACT
The unknownness and dread potential of a risk event shapes its perceived risk. A public health emergency of international concern (PHEIC) declaration by the World Health Organisation (WHO) is a signal for such an event. Understanding perceived risk then shapes risk-avoiding behaviours, important for health prevention. The review aims to consolidate the determinants of risk perception during a PHEIC, underscoring the need for grounding in context and theory. Studies published from 2010 until end-2020, searching PubMed, PsycINFO, MedlinePlus, PubPsych, and CINAHL, were included. Studies with only biological conceptualisations of risk, or no association to risk perception, were excluded. A total of 65 studies were included. Quality of the cross-sectional studies was assessed using Newcastle Ottawa Scale (NOS), yielding an average of 5.4 stars (out of 10). Factors were classified into three broad categories - individual, contextual, and media. Individual risk factors include emotions; beliefs, trust, and perceptions; immutable physical traits (sex, age, ethnicity); mutable traits (education, income, etc.); and knowledge, with no definitive correlation to risk perception. Contextual traits include pandemic experience, time, and location, with only time negatively correlated to risk perception. Media traits include exposure, attention, and framing of media, with no clear association to risk perception. One limitation is excluding a portion of COVID-19 studies due to censoring. Still, this lack of consensus highlights the need to better conceptualise "risk perception". Specifying the context and timing is also important since jurisdictions experience different outbreaks depending on outbreak histories. Using theories to ground risk perception research assists with these tasks.
Subject(s)
Public Health , Humans , Emergencies/psychology , Perception , Risk Assessment , COVID-19/epidemiology , COVID-19/psychology , COVID-19/prevention & control , Risk Factors , Health Knowledge, Attitudes, Practice , InternationalityABSTRACT
Background: Public health emergencies impose unique challenges on pregnant women, affecting their physiological, psychological, and social wellbeing. This study, focusing on the context of the corona virus disease in 2019 (COVID-19) pandemic in China, aims to comprehensively explore the experiences of pregnant women amidst diverse public health crises. Herein, we investigate the health education needs of pregnant Chinese women in regard to public health emergencies to provide a scientific foundation for the development of targeted health education strategies. Objective: The study described in this article aims to explore the health education needs of pregnant Chinese women in the context of public health emergencies specifying the types of emergencies of pandemics and to provide a scientific basis for targeted health education interventions. Methods: Thirteen pregnant women were purposively selected, and the rationale for this sample size lies in the qualitative nature of the study, seeking in-depth insights rather than generalizability. Data collection involved semi-structured interviews, and the Colaizzi, which is a structured qualitative technique used to extract, interpret, and organize significant statements from participant descriptions into themes, providing a comprehensive understanding of their lived experiences. Results: The analysis yielded six prominent themes encompassing the following areas: I. Personal protection and vaccine safety; II. Knowledge of maternal health; III. Knowledge of fetal health; IV. Knowledge of childbirth; V. Knowledge of postpartum recovery; and VI. Knowledge sources of health education for pregnant women and their expectations of healthcare providers. Theme I was analyzed with two sub-themes (needs for personal protection knowledge, vaccine safety knowledge needs); Theme II was analyzed with three sub-themes (nutrition and diet, exercise and rest, sexual life); Theme III was analyzed with three sub-themes (medications and hazardous substances, pregnancy check-ups, and fetal movement monitoring); Theme IV was analyzed with three sub-themes (family accompaniment, analgesia in childbirth, and choice of mode of delivery); Theme V was analyzed with one sub-theme (knowledge of postnatal recovery); Theme VI was analyzed with one sub-theme (expectations of Healthcare providers). Sub-themes within each main theme were identified, offering a nuanced understanding of the multifaceted challenges faced by pregnant women during public health emergencies. The interrelation between sub-themes and main themes contributes to a holistic portrayal of their experiences. Conclusion: The study emphasizes the need for healthcare professionals to tailor health education for pregnant women during emergencies, highlighting the role of the Internet in improving information dissemination. It recommends actionable strategies for effective health communication, ensuring these women receive comprehensive support through digital platforms for better health outcomes during public health crises.
Subject(s)
COVID-19 , Health Education , Pregnant Women , Public Health , Qualitative Research , Humans , Female , Pregnancy , China , Adult , Pregnant Women/psychology , SARS-CoV-2 , Emergencies/psychology , PandemicsABSTRACT
INTRODUCTION: Post Critical Incident Seminar (PCIS) is an intervention originally developed by the Federal Bureau of Investigation (FBI) for supporting law enforcement officers who have faced critical incidents (CIs) at work. In Finland, police forces have arranged modified PCIS regularly since 2012, but the first PCIS for emergency service personnel was organized in 2020. PCIS consists of psychoeducation, peer support, and mental health professional support/Eye Movement Desensitization and Reprocessing (EMDR). Previous international studies of PCIS are scarce. Our research question was this: After 6 months, how do emergency service personnel who have participated in the PCIS describe the impacts of PCIS on experiences and psychological state evoked by the CI that was the reason to apply for it? METHODS: The data consisted of individual interviews 6 months after attending the PCIS. The number of participants in this study was 15 (94%). The data was analyzed qualitatively with inductive content analysis. RESULTS: The impacts of PCIS on incident-related experiences and state 6 months afterward were divided into five main categories: social changes, new perspectives and sensations, incident-related components, future-oriented processes, and new abilities and actions. CONCLUSIONS: PCIS can have multilevel impacts on the experiences and psychological state caused by a CI. These impacts are reflected, for example, in their inner experience, choices, emotions, actions, and relationships with others in different areas of life. As a result of PCIS, the emergency service personnel's relationship with CIs in the past and the ability to function in the future can change. Further study is needed to investigate the long-term impacts of the PCIS.
Subject(s)
Emergencies , Police , Humans , Finland , Police/psychology , Emergencies/psychologyABSTRACT
The aim of this study was to investigate differences in the volunteering experience in two states of emergency in Israel: Operation Protective Edge (a military man-made emergency) and the first wave of the COVID-19 pandemic (a natural emergency). The sample included 993 volunteers, of whom 498 volunteered during Operation Protective Edge and 504 during the COVID-19 pandemic. A quantitative research design was used to investigate three aspects of the volunteering experience: motives for volunteering, satisfaction from volunteering, and commitment to volunteer. Social solidarity was the most prominent motive for volunteering in both emergencies. The level of the egoistic motives, the intrinsic satisfaction from volunteering, and long-term commitment to volunteering were higher during the COVID-19 pandemic than among the volunteers during the military operation. We used a qualitative research design to investigate the experience of special moments in volunteering. The profile of special moments experienced by the COVID-19 volunteers combined self and client experiences, whereas among Operation Protective Edge volunteers, special moments are reflected mainly in experiences related to the clients and the community.
Subject(s)
COVID-19 , Emergencies , Military Deployment , Pandemics , Volunteers , COVID-19/epidemiology , Emergencies/epidemiology , Emergencies/psychology , Humans , Israel/epidemiology , Military Deployment/psychology , Military Deployment/statistics & numerical data , Motivation , Pandemics/statistics & numerical data , Personal Satisfaction , Volunteers/psychology , Volunteers/statistics & numerical dataABSTRACT
RESUMO Objetivo: conhecer as vivências de prazer e sofrimento de trabalhadores de Enfermagem de serviços de urgência e emergência. Metodologia: pesquisa qualitativa descritiva. Foram entrevistados trabalhadores de Enfermagem de uma unidade de urgência e emergência de um hospital filantrópico e do Serviço de Atendimento Móvel de Urgência de uma cidade do Sul do Brasil. O material foi submetido à análise temática de conteúdo. Resultados: as vivências de prazer se relacionaram à identificação com o trabalho, à satisfação frente aos resultados exitosos, ao reconhecimento, ao trabalho em equipe e ao fortalecimento do sentido do trabalho. Já as vivências de sofrimento foram atribuídas ao contato com a morbimortalidade da população, aos conflitos e à precarização do trabalho. Conclusão: as vivências de prazer coexistem com as de sofrimento no cotidiano do trabalho de Enfermagem em urgência e emergência, sendo importantes espaços de fala e escuta para a ressignificação dos sentimentos e proteção à saúde mental no trabalho.
RESUMEN Objetivo: conocer las experiencias de placer y sufrimiento de los trabajadores de enfermería en los servicios de urgencia y emergencia. Metodología: investigación descriptiva cualitativa. Entrevistamos a trabajadores de enfermería de una unidad de urgencias y emergencias de un hospital filantrópico y del Servicio de Atención Móvil de Urgencias de una ciudad del sur de Brasil. El material se sometió a un análisis de contenido temático. Resultados: las vivencias de los trabajadores se relacionaron con la identificación con el trabajo, la satisfacción frente a los resultados exitosos, la reconciliación, el trabajo en equipo y el fortalecimiento del sentido del trabajo. Las experiencias de sufrimiento se atribuyeron al contacto con la morbilidad y la mortalidad de la población, los conflictos y la inseguridad laboral. Conclusión: las experiencias de placer conviven con las de sufrimiento en el trabajo diario de la enfermería en las urgencias y emergencias, siendo importantes espacios de palabra y escucha para la resignificación de los sentimientos y la protección de la salud mental en el trabajo.
ABSTRACT Objective: to know the experiences of pleasure and suffering of Nursing workers in urgent and emergency services. Methodology: descriptive qualitative research. Nursing workers from an urgency and emergency unit of a philanthropic hospital and from the Mobile Emergency Care Service of a city in southern Brazil were interviewed. The material was submitted to thematic content analysis. Results: the experiences of pleasure were related to identification with work, satisfaction with successful results, recognition, teamwork and strengthening the meaning of work. The experiences of suffering were attributed to the contact with the population's morbidity and mortality, to conflicts and to the precariousness of work. Conclusion: the experiences of pleasure coexist with those of suffering in the daily work of Nursing in urgency and emergency, being important spaces of speech and listening for the resignification of feelings and protection of mental health at work.
Subject(s)
Humans , Male , Female , Adult , Mental Health , Emergency Nursing , Socioeconomic Factors , Qualitative Research , Emergencies/psychology , Emergency Medical Services , Emergency Service, HospitalABSTRACT
Abstract, Background and objectives. COVID-19 has had a profound effect on mental health. Liaison psychiatry teams assess and treat people in mental health crises in emergency departments (EDs) and on hospital wards. During the first pandemic wave, new Mental Health Crisis Assessment Services (MHCAS) were created to divert people away from EDs. Our objective was to describe patterns in referrals to psychiatric liaison services across the North Central London care sector (NCL) and explore the impact of a new MHCAS. Methods. Retrospective study using routinely collected data (ED and ward referrals) from five liaison psychiatry services across NCL (total population 1.5 million people). We described referrals (per week and month) by individual liaison services and cross-sector, and patterns of activity (January 1st 2020 -September 31st 2020, weeks 139) compared with the same period in 2019. We calculated changes in the proportion of ED attendees (all-cause) referred to liaison psychiatry. Results. From 20192020, total referrals decreased by 16.5% (12,265 to 10,247), a 16.4% decrease in ED referrals (9528 to 7965) and 16.6% decrease in ward referrals (2737 to 2282). There was a marked decrease in referrals during the first pandemic wave (March/April 2020), which increased after lockdown ended. The proportion of ED attendees referred to liaison psychiatry services increased compared to 2019. Conclusions. People in mental health crisis continued to seek help via ED/MHCAS and a higher proportion of people attending ED were referred to liaison psychiatry services just after the first pandemic wave. MHCAS absorbed some sector ED activity during the pandemic.
Subject(s)
Humans , Health Sciences , Health Services , Mental Health Services/organization & administration , Emergencies/psychology , Crisis Intervention/organization & administration , Coronavirus 229E, HumanABSTRACT
BACKGROUND: Despite recent advances in the development and provision of mental health and psychosocial support (MHPSS) in humanitarian settings, inadequate supervision remains a significant barrier to successful implementation. The present study sought to incorporate broad stakeholder engagement as part of the first phase of development of a new Integrated Model for Supervision (IMS) for use within MHPSS and protection services in humanitarian emergencies. METHODS: Semi-structured interviews were conducted with 26 global mental health professionals. Data was analysed thematically, using a combination of inductive and deductive methods. Codes and themes were validated through co-author cross-checks and through a webinar with an expert advisory group. RESULTS: Results reinforce the importance of effective supervision to enhance the quality of interventions and to protect supervisees' wellbeing. Participants generally agreed that regular, supportive supervision on a one-to-one basis and as a separate system from line management, is the ideal format. The interviews highlight a need for guidance in specific areas, such as monitoring and evaluation, and navigating power imbalances in the supervisory relationship. Several approaches to supervision were described, including some solutions for use in low-resource situations, such as group, peer-to-peer or remote supervision. CONCLUSION: An integrated model for supervision (IMS) should offer a unified framework encompassing a definition of supervision, consolidation of best practice, and goals and guidance for the supervisory process.
Subject(s)
Emergencies/psychology , Mental Health/standards , Psychiatric Rehabilitation/methods , Psychiatric Rehabilitation/standards , Altruism , Humans , Psychosocial Support Systems , Qualitative ResearchABSTRACT
Importance: Delaying critical care for treatable conditions owing to fear of contracting COVID-19 in the emergency department (ED) is associated with avoidable morbidity and mortality. Objective: To assess and quantify how people decided whether to present to the ED during the COVID-19 pandemic for care unrelated to COVID-19 using conjoint analysis, a form of trade-off analysis that examines how individuals make complex decisions. Design, Setting, and Participants: This cross-sectional survey study was conducted using a nationwide sample from June 1, 2020, during the initial peak of the COVID-19 pandemic. Included participants were adults aged 18 years or older in the US who self-reported that they had not tested positive for COVID-19. Data were analyzed from July 2020 through May 2021. Exposures: Participants completed a self-administered online survey. Main Outcomes and Measures: Using a choice-based conjoint analysis survey, the relative importance was assessed for the following attributes for individuals in deciding whether to seek ED care for symptoms consistent with myocardial infarction or appendicitis: reduction in chance of dying because of ED treatment, crowdedness of ED with other patients, and chance of contracting COVID-19 in the ED. We also performed latent class analyses using conjoint data to identify distinct segments of the respondent population with similar choice patterns. Logistic regression was then used to explore whether patient sociodemographics and political affiliations were factors associated with decision-making. Results: Among 1981 individuals invited to participate, 933 respondents (47.1%) completed the survey; participants' mean (SD) age was 40.1 (13.0) years, and 491 (52.6%) were women. In latent class analyses, 158 individuals (16.9%) with symptoms of myocardial infarction and 238 individuals (25.5%) with symptoms of appendicitis prioritized avoidance of COVID-19 exposure in the ED (ie, chance of contracting COVID-19 in the ED or crowdedness of ED with other patients) over seeking appropriate care for symptoms. Having a usual source of care was a factor associated with lower odds of prioritizing avoidance of COVID-19 exposure (myocardial infarction scenario: adjusted odds ratio, 0.49 [95% CI, 0.32-0.76]; P = .001; appendicitis scenario: adjusted odds ratio, 0.57 [95% CI, 0.40-0.82]; P = .003), but most sociodemographic factors and political affiliations were not factors associated with decision-making. Conclusions and Relevance: This study found that up to one-quarter of individuals were willing to forgo potentially life-saving ED care to avoid exposure to COVID-19. These findings suggest that health care systems and public health organizations should develop effective communications for patients and the community at large that reassure and encourage timely health care for critical needs during the ongoing COVID-19 pandemic and other scenarios.
Subject(s)
COVID-19 , Decision Making , Emergencies/psychology , Emergency Medical Services , Patient Acceptance of Health Care/psychology , Adult , Choice Behavior , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Latent Class Analysis , Male , Middle Aged , Odds Ratio , Qualitative Research , SARS-CoV-2 , United StatesABSTRACT
BACKGROUND: In addition to their educational role, resilient schools have a good capacity in response to disasters. Due to the large student population, the schools can be a safe and secure environment during disasters, in addition to maintaining their performance after. Given the role and importance of the schools, the impact of culture and environment on resilience, without any indigenous and comprehensive tool for measuring the resilience in Iran, the study aimed to design and psychometrically evaluate the measurement tools. METHOD: This study was conducted using a mixed-method sequential explanatory approach. The research was conducted in two main phases of production on items based on hybrid model and the psychometric evaluation of the tool. The second phase included validity (formal, content and construction) and reliability (multiplex internal similarity, consistency and reliability). RESULT: The integration of systematic and qualitative steps resulted in entering 91 items into the pool of items. After formal and content validity, 73 items remained and 44 were omitted in exploratory factor analysis. A questionnaire with 5 factors explained 52.08% of total variance. Finally, after the confirmatory factor analysis, the questionnaire was extracted with 29 questions and 5 factors including "functional", "architectural", "equipment", "education" and "safety". Internal similarity and stability in all factors were evaluated as good. CONCLUSION: The result showed that the 29-item questionnaire of school resilience in emergencies and disasters is valid and reliable, that can be used to evaluate school resilience. On the other hand, the questionnaire on assessment of school resilience in disasters enables intervention to improve its capacity.
Subject(s)
Disasters , Emergencies/psychology , Psychometrics , Schools , Students/psychology , Surveys and Questionnaires , Adult , Female , Humans , MaleABSTRACT
BACKGROUND: The emergency medical service as a high-risk workplace is a danger to patient safety. A main factor for patient safety, but also at the same time a main factor for patient harm, is team communication. Team communication is multidimensional and occurs before, during, and after the patient's treatment. METHODS: In an online based, anonymous and single-blinded study, medical and non-medical employees in the emergency medical services were asked about team communication, and communication errors. RESULTS: Seven hundred and fourteen medical and non-medical rescue workers from all over Germany took part. Among them, 72.0% had harmed at least one patient during their work. With imprecise communication, 81.7% rarely asked for clarification. Also, 66.3% saw leadership behavior as the cause of poor communication; 46.0% could not talk to their superiors about errors. Of note, 96.3% would like joint training of medical and non-medical employees in communication. CONCLUSION: Deficits in team communication occur frequently in the rescue service. There is a clear need for uniform training in team and communication skills in all professions.
Subject(s)
Emergencies/psychology , Emergency Medical Services/statistics & numerical data , Emergency Service, Hospital/statistics & numerical data , Patient Care Team/statistics & numerical data , Adult , Communication , Cooperative Behavior , Female , Germany , Humans , Leadership , Male , Patient Safety/statistics & numerical dataABSTRACT
Emergency departments (EDs) are experiencing a worsening crisis of overcrowding, especially during the coronavirus pandemic. Persons experiencing psychiatric emergencies must be evaluated medically and screened for risks of harm to self or others before they can be cleared for transfer to inpatient units or discharged. Severe shortages of inpatient psychiatric beds can lead to hours or even days of costly boarding in the ED. The purpose of this article is to examine the potential role of psychiatric-mental health nurse practitioners in psychiatric ED care, from initial intake and medical clearance, screening for suicide risk, de-escalation, stabilization, and discharge. [Journal of Psychosocial Nursing and Mental Health Services, 59(3), 7-12.].
Subject(s)
Emergencies/psychology , Emergency Service, Hospital , Mental Health Services , Nurse Practitioners , Psychiatric Nursing , Female , Humans , Male , Mental Disorders/therapy , Nurse's Role , Patient DischargeABSTRACT
On March 11th, 2020, the outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic. Governments took drastic measures in an effort to reduce transmission rates and virus-associated morbidity. This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting during the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the COVID-19 pandemic with an increase in repeat visits within 1 month (30.2 vs. 20.4%, pBA = 0.001). Fewer patients with affective disorders utilized the PED (15.2 vs. 22.2%, pBA = 0.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4 vs. 26.8%, pBA = 0.004), while patients with schizophrenia more commonly had persecutory delusions (68.7 vs. 43.5%, pBA = 0.023) and visual hallucinations (18.6 vs. 3.3%, pBA = 0.011). Presentation rate of patients with neurotic, stress-related, and somatoform disorders increased. These patients were more likely to be male (48.6 vs. 28.9%, pBA = 0.060) and without previous psychiatric treatment (55.7 vs. 36.8%, pBA = 0.089). Patients with personality/behavioral disorders were more often inhabitants of psychiatric residencies (43.5 vs. 10.8%, pBA = 0.008). 20.1% of patients stated an association between psychological well-being and COVID-19. Most often patients suffered from the consequences pertaining to social measures or changes within the medical care system. By understanding how patients react to such a crisis situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.
Subject(s)
COVID-19 , Emergencies/psychology , Mental Disorders/therapy , Pandemics , Psychiatry/statistics & numerical data , Adult , Aged , Cost of Illness , Female , Germany , Humans , Male , Mental Disorders/classification , Middle Aged , Mood Disorders/epidemiology , Mood Disorders/therapy , Neurotic Disorders/epidemiology , Neurotic Disorders/psychology , Schizophrenia/epidemiology , Schizophrenic Psychology , Sex Factors , Somatoform Disorders/epidemiology , Somatoform Disorders/psychology , Substance-Related Disorders/epidemiology , Suicidal IdeationABSTRACT
Objective: On-call work is becoming increasingly common in response to service demands. This study had two aims; 1) describe the demographic profile of on-call workers in Australia, and 2) establish the impacts of on-call work on workers' sleep. Methods: A cross-sectional study was conducted using an online questionnaire completed by Australian on-call workers (n = 228) from various professions. The questionnaire included items on i) demographic and work characteristics, ii) rumination about on-call factors, iii) sleep quantity and quality. Analyses were conducted using mixed effects ordinal regression and multivariable logistic regression. Results: Workers slept <7 hours per night when on-call (80%), and reported sleep was impacted on-call even when no-calls were received (56%). On-call workers rated interruptions to family/leisure time (70%), missing a call (69%), preplanning in case of a call (69%), and not able to make plans (67%) as the main factors they ruminated about. Female on-call workers were more likely to think about the likelihood of being called, report frequent thoughts about what they would need to do if called, and think about interruptions to family/leisure time as a result of a call. Younger workers were more likely to think about the likelihood of being called compared to older adults, however middle-aged workers were less likely to plan for a call compared to younger workers. Conclusions: This study is the first to describe Australia's on-call population, including factors that specifically impact sleep. Future studies should implement tailored education and support strategies to address the unique challenges facing on-call workers.
Subject(s)
Emergencies/psychology , Sleep Wake Disorders/psychology , Work Schedule Tolerance/psychology , Workload/psychology , Adaptation, Psychological , Aged , Australia , Circadian Rhythm , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Sleep/physiology , Sleep Wake Disorders/epidemiology , Surveys and Questionnaires , Work-Life Balance/statistics & numerical dataABSTRACT
Informed consent is necessary for all medical, surgical and obstetric interventions. Whilst informed consent can be obtained for elective procedures, it is much more challenging to obtain for emergency interventions. It can be difficult for women to understand the need for emergency intervention when pregnancy has been low risk. This can lead to problems with psychological trauma from the delivery being foremost in their minds in the postnatal period and in future pregnancies. The Montgomery ruling of 2015 encouraged informing women about risks and benefits of interventions and letting the women take responsibility for their own decision-making. Here, a patient-focused survey collected information on pregnant women's knowledge and wishes regarding emergency interventions. The responses were analysed in relation to local and Scottish national delivery data. We have initiated a novel programme to ensure all of our pregnant women are empowered to give informed consent for emergency interventions.IMPACT STATEMENTWhat is already known on this subject? There has been very little published on this subject to date and what has been published has involved focus groups or very small numbers of women.What do the results of this study add? This study adds significantly to our understanding of current Scottish and Highland regional delivery statistics to help foster realistic delivery expectations in our pregnant women. This study is the first to report on pregnant women's understanding of the possibility of requiring emergency intervention in labour and the relevant risks. It also highlights the fact that women prefer to get their information from community midwives, friends and family rather than their obstetricians or GPs. This study is also the first to report women's actual preferences and comments with regard to information provision, labour and delivery experiences and their wishes for the future.What are the implications of these findings for clinical practice and/or further research? The findings from this study have allowed us to develop and implement a novel means of obtaining informed consent in emergency obstetrics and the success of this programme will be reported following future analysis of patient experiences.
Subject(s)
Emergencies/psychology , Emergency Service, Hospital/standards , Informed Consent/psychology , Obstetrics/standards , Pregnant Women/psychology , Adult , Female , Health Knowledge, Attitudes, Practice , Humans , Obstetrics/methods , Parturition/psychology , Pregnancy , Scotland , Surveys and QuestionnairesABSTRACT
The purpose of this retrospective case series was to describe adolescent psychiatric emergencies precipitated by the coronavirus disease 2019 (COVID-19) pandemic. This study used a sample of adolescents admitted to a safety net psychiatric hospital in Los Angeles, California, between March and May 2020. Medical records and involuntary psychiatric holds were reviewed to determine if the events precipitating the psychiatric crisis were related to the pandemic (eligible N = 14). COVID-19-precipitated admissions were 24% of total admissions from March 15 to May 31, 2020; however, total admissions during this time period were reduced from the same time period in prior years. Most hospitalizations were precipitated by shelter-in-place stressors for adolescents with a psychiatric history, but for 28.6% of the sample, this was their first mental health encounter. The COVID-19 pandemic and corresponding shelter-in-place orders may precipitate psychiatric emergencies among adolescents with and without existing mental health disorders. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 17-21.].
Subject(s)
COVID-19/psychology , Emergencies/psychology , Mental Disorders/therapy , Pandemics , Adolescent , COVID-19/epidemiology , California/epidemiology , Humans , Retrospective Studies , SARS-CoV-2ABSTRACT
Synchronization is a special case of self-organization in which one can observe close mimicry in behavior of the system components. Synchrony in body movements, autonomic arousal, and EEG activity among human individuals has attracted considerable attention for their possible roles in social interaction. This article is specifically concerned with autonomic synchrony and finding the best model for the dyadic relationships, with regard to both theoretical and empirical accuracy, that could be extrapolated to synchrony levels for groups and teams of three or more people. The four models that are compared in this study have different theoretical origins: the two-variable linear regression function, a three-parameter nonlinear regression function, the logistic map function stated in polynomial form, and the logistic map function stated as an exponential regression structure. The data for this study were electrodermal responses collected from a team of four people engaged in an emergency response simulation that produced 12 dyadic time series. Results shows strong levels of fit between the data and all four models, although there were significant differences among them. Further research directions point toward finding conditions that favor one model over another and exploring other possible nonlinear structures.