Volunteering experience during emergencies: Comparative analysis of a military operation and a pandemic.

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.

Prazer e sofrimento no trabalho de enfermagem em urgência e emergência / El placer y el sufrimiento en el trabajo de enfermería en urgencia y emergência / Pleasure and suffering in urgent and emergency nursing work

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.

Psychiatric liaison service referral patterns during the UK COVID-19 pandemic: An observational study

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 1–39) compared with the same period in 2019. We calculated changes in the proportion of ED attendees (all-cause) referred to liaison psychiatry. Results. From 2019–2020, 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.

Towards an integrated model for supervision for mental health and psychosocial support in humanitarian emergencies: A qualitative study.

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.

Public Perspectives on Decisions About Emergency Care Seeking for Care Unrelated to COVID-19 During the COVID-19 Pandemic.

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.

Design and psychometric evaluation of schools' resilience tool in Emergencies and disasters: A mixed-method.

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.

Communication of preclinical emergency teams in critical situations: A nationwide study.

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.

Psychiatric Emergencies and the Potential Role of Psychiatric-Mental Health Nurse Practitioners.

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.].

Peripandemic psychiatric emergencies: impact of the COVID-19 pandemic on patients according to diagnostic subgroup.

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.

What Factors Influence the Sleep of On-call Workers?

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.

Informed consent in obstetrics - a survey of pregnant women to set a new standard for consent in emergency obstetric interventions.

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.

Adolescent Psychiatric Emergencies Precipitated by the COVID-19 Pandemic.

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.].

A Comparison of Four Dyadic Synchronization Models.

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.

The Impact of COVID-19 and Public Health Emergencies on Consumer Purchase of Scarce Products in China.

Objectives: During public health emergencies, people often scramble to buy scarce goods, which may lead to panic behavior and cause serious negative impacts on public health management. Due to the absence of relevant research, the internal logic of this phenomenon is not clear. This study explored whether and why public health emergencies such as the COVID-19 pandemic stimulate consumers' preference for scarce products. Methods: Applying the questionnaire survey method, two online surveys were conducted on the Credamo data platform in China. The first survey was launched in February and collected psychological and behavioral data from 1,548 participants. Considering the likelihood of population relocation due to the pandemic, a follow-up survey was conducted in August with 463 participants who had participated in the first survey and had not relocated to other cities between February and August. The hypotheses were tested with these data through stepwise regression analysis, bootstrapping, and robustness testing. Results: Pandemic severity was found to positively affect scarce consumption behavior and the effect was found to be situational; this indicates that the impact of the pandemic on scarce consumption was only significant during the pandemic. Further, it was found that materialism plays a mediating role in the relationship between pandemic severity and scarce consumption. Finally, the need to belong was found to play a moderating role between pandemic severity and materialism. Conclusion: This study findings imply that the scarce consumption behavior during public health emergencies can be reduced by decreasing materialism and increasing the need to belong. These findings may aid government leaders in managing public health emergencies.

Public attitudes toward allocating scarce resources in the COVID-19 pandemic.

The general public is subject to triage policies that allocate scarce lifesaving resources during the COVID-19 pandemic, one of the worst public health emergencies in the past 100 years. However, public attitudes toward ethical principles underlying triage policies used during this pandemic are not well understood. Three experiments (preregistered; online samples; N = 1,868; U.S. residents) assessed attitudes toward ethical principles underlying triage policies. The experiments evaluated assessments of utilitarian, egalitarian, prioritizing the worst-off, and social usefulness principles in conditions arising during the COVID-19 pandemic, involving resource scarcity, resource reallocation, and bias in resource allocation toward at-risk groups, such as the elderly or people of color. We found that participants agreed with allocation motivated by utilitarian principles and prioritizing the worst-off during initial distribution of resources and disagreed with allocation motivated by egalitarian and social usefulness principles. At reallocation, participants agreed with giving priority to those patients who received the resources first. Lastly, support for utilitarian allocation varied when saving the greatest number of lives resulted in disadvantage for at-risk or historically marginalized groups. Specifically, participants expressed higher levels of agreement with policies that shifted away from maximizing benefits to one that assigned the same priority to members of different groups if this mitigated disadvantage for people of color. Understanding these attitudes can contribute to developing triage policies, increase trust in health systems, and assist physicians in achieving their goals of patient care during the COVID-19 pandemic.

What triggers online help-seeking retransmission during the COVID-19 period? Empirical evidence from Chinese social media.

The past nine months witnessed COVID-19's fast-spreading at the global level. Limited by medical resources shortage and uneven facilities distribution, online help-seeking becomes an essential approach to cope with public health emergencies for many ordinaries. This study explores the driving forces behind the retransmission of online help-seeking posts. We built an analytical framework that emphasized content characteristics, including information completeness, proximity, support seeking type, disease severity, and emotion of help-seeking messages. A quantitative content analysis was conducted with a probability sample consisting of 727 posts. The results illustrate the importance of individual information completeness, high proximity, instrumental support seeking. This study also demonstrates slight inconformity with the severity principle but stresses the power of anger in help-seeking messages dissemination. As one of the first online help-seeking diffusion analyses in the COVID-19 period, our research provides a reference for constructing compelling and effective help-seeking posts during a particular period. It also reveals further possibilities for harnessing social media's power to promote reciprocal and cooperative actions as a response to this deepening global concern.

[Accommodation facility for dependent elderly people, ensuring relational proximity after health emergencies]. / Ehpad, pour la proximité relationnelle après l'urgence sanitaire.

The health emergency linked to Covid-19 has been stressful for staff working in nursing home, and doubly painful for residents faced with the risk of infection and the reality of family separation. We explore in this article some psychological consequences resulting from their experience in the waning health crisis, hoping that the experience gained will allow greater efficiency in the event of a resumption of the pandemic.

Emergency consultations in obstetrics: identification of decisive, contributing and associated factors.

PURPOSE: Psychosocial and biological factors influence the perception of physical changes during pregnancy. Some pregnant women present to the obstetric emergency department (ED) with diverse symptoms not requiring urgent medical action. These visits result in over-consultation, tying up resources and inflating health care expenses. This study outlines factors associated with multiple ED visits during pregnancy, measures the prevalence of anxiety and depression, and explores the choice of maternity clinic for delivery aiming to elucidate options for care strategies. METHODS: This prospective, cross-sectional, questionnaire-based bicentric study was performed in the obstetric outpatient departments of two university hospitals in Germany and recruited pregnant women between 12/2016 and 11/2017. The questionnaire included socio-demographics, obstetric history, anxiety (GAD-7), depression (PHQ-9), and health status (WHO-5, SF-12). RESULTS: This analysis included 496 women and showed that women with numerous ED visits were significantly younger (p < 0.0001), less educated (p = 0.0002), and more likely to be unemployed and single. Different prevalences for anxiety and depression were detected correlating with the number of ED visits although each showing only low effect sizes (0.024 resp. 0.015). CONCLUSIONS: Pregnant women attending the ED more often might benefit from health education, psychosomatic interventions, and social support to overcome their depression and anxiety to avoid non-urgent ED consultations. Further prospective studies are needed to support these findings.