Moral distress in frontline healthcare workers in the initial epicenter of the COVID‐19 pandemic in the United States: Relationship to PTSD symptoms, burnout, and psychosocial functioning

Abstract Objectives: Protecting frontline healthcare workers with personal protective equipment (PPE) is critical during the COVID pandemic. Through an online survey, we demonstrated variable adherence to the Center for Disease Control and Prevention’s (CDC) PPE guidelines among health care personnel (HCP). Methods: CDC guidelines for optimal and acceptable PPE usage in common situations faced by frontline healthcare workers were referenced to create a short online survey. The survey was distributed to national, statewide, and local professional organizations across the United States and to HCP using a snowball sampling technique. Responses were collected between June 15 and July 17, 2020. Results: 2245 responses were received from doctors, nurses, midwives, paramedics, and medical technicians in 44 states. Eight states with n>20 (Arizona, California, Colorado, Louisiana, Oregon, South Carolina, Texas, and Washington) and a total of 436 responses are included in the quantitative analysis. Adherence to CDC guidelines was observed to be highest in the scenario of patient contact when COVID was not suspected (86.47%) and lowest when carrying out aerosol generating procedures (AGPs) (42.47%). Conclusions: Further research is urgently needed to identify the reasons underlying variability between professions and regions to pinpoint strategies for maximizing adherence and improving the safety of HCPs.

Download Full-text

Occupational exposures to influenza among healthcare workers in the United States

Journal of Occupational and Environmental Hygiene ◽

10.1080/15459624.2015.1096363 ◽

2016 ◽

Vol 13 (3) ◽

pp. 213-222 ◽

Cited By ~ 12

Author(s):

Rachael M. Jones ◽

Yulin Xia

Keyword(s):

United States ◽

Healthcare Workers ◽

Occupational Exposures ◽

The United States

Download Full-text

A Comparison of Mental Health Outcomes in the United States and Italy at Different Levels of Cumulative COVID-19 Prevalence

10.31234/osf.io/c8y3q ◽

2021 ◽

Author(s):

Anthony D Mancini ◽

Gabriele Prati

Keyword(s):

Mental Health ◽

United States ◽

New York ◽

San Francisco ◽

The United States ◽

Ptsd Symptoms ◽

General Distress ◽

High Prevalence ◽

Low Prevalence ◽

Different Levels

How does the prevalence of COVID-19 impact people’s mental health? In a preregistered study (N = 857), we sought to answer this question by comparing demographically matched samples in four regions in the United States and Italy with different levels of cumulative COVID-19 prevalence. No main effect of prevalence emerged. Rather, prevalence region had opposite effects, depending on the country. New York City participants (high prevalence) reported more general distress, PTSD symptoms, and COVID-19 worry than San Francisco (low prevalence). Conversely, Campania participants (low prevalence) reported more general distress, PTSD symptoms, and COVID-19 worry than Lombardy (high prevalence). Consistent with these patterns, COVID-19 worry was more strongly linked with general distress and PTSD symptoms in New York than San Francisco, whereas COVID-19 worry was more strongly linked with PTSD in Campania than Lombardy. In exploratory analyses, media exposure predicted and mapped on to geographic variation in mental health outcomes.

Download Full-text

La construcción social del sueño americano en la frontera entre México y Estados Unidos. Formación y proyectos migratorios de los estudiantes de enfermería

Revista Trace ◽

10.22134/trace.61.2012.437 ◽

2018 ◽

pp. 62

Author(s):

Patrick Pérez

Keyword(s):

United States ◽

Working Conditions ◽

Healthcare Workers ◽

Home Country ◽

The United States ◽

Topical Issue ◽

The Real ◽

Conditions De Travail ◽

Personnel De Santé ◽

The Individual

En México, el “sueño americano” no deja de ser reciente, las expectativas del personal de cuidado de la salud en materia de movilidad dependen de la iniciativa individual. Los factores que determinan tanto la migración, como la admisión de los candidatos, son numerosos y difíciles de objetivar, debido a que se encuentran sedimentados por la historia y las complejas relaciones con Estados Unidos, que simbolizan la promesa de un “horizonte de movilidad abierto”, con referencia al cual se desprecian profundamente las condiciones de trabajo en el país de origen. Sin embargo, las condiciones reales de trabajo en Estados Unidos no son tan idílicas como los estudiantes gustan creerlo.Abstract: In Mexico, the “American dream” is still a topical issue. The expectations of the healthcare workers in terms of mobility depends on the individual initiative. The factors which determine migration, as well as the admission of candidates are numerous and uneasy to specify, given that they are frozen by history and complex relations with the United States, which symbolizes the promise of an “open mobility horizon”, in reference to the disregard of working conditions in their home country. However, the real working conditions in the United-States are not as idyllic as the students want to believe.Résumé : Au Mexique, le « rêve américain » n’en finit pas d’être d’actualité. Les perspectives du personnel de santé en matière de mobilité dépendent de l’initiative individuelle. Les facteurs déterminants de la migration, ainsi que de l’admission des candidats sont nombreux et difficiles à spécifier, puisqu’ils sont figés par l’histoire et les relations complexes avec les États-Unis, lesquels symbolisent la promesse d’un « horizon de mobilité ouvert », et font référence au mépris des conditions de travail dans le pays d’origine. Cependant, les conditions réelles de travail aux États-Unis ne sont pas aussi idylliques que les étudiants veulent le croire.

Download Full-text

PTSD Symptoms Experienced and Coping Tactics Used by Crime Scene Investigators in the United States

Journal of Forensic Sciences ◽

10.1111/1556-4029.14044 ◽

2019 ◽

Vol 64 (5) ◽

pp. 1444-1450 ◽

Cited By ~ 3

Author(s):

Joseph A. Rosansky ◽

Jeffery Cook ◽

Harold Rosenberg ◽

Jon E. Sprague

Keyword(s):

United States ◽

Crime Scene ◽

The United States ◽

Ptsd Symptoms ◽

Crime Scene Investigators ◽

And Coping ◽

Coping Tactics

Download Full-text

The incidence and management of workplace violence among medical professionals in the United States: A methodological pilot study

Journal of Hospital Administration ◽

10.5430/jha.v8n1p56 ◽

2019 ◽

Vol 8 (1) ◽

pp. 56

Author(s):

Ashleigh Chinelo Oguagha ◽

Jing Chen

Keyword(s):

United States ◽

Workplace Violence ◽

Healthcare Workers ◽

Online Survey ◽

Health Sector ◽

Medical Personnel ◽

The United States ◽

Medical Professionals ◽

Psychological Violence ◽

Physical And Psychological Violence

This study aimed to investigate workplace violence (WPV) experienced by medical professionals in the United States as well as individual and managerial actions following violent episodes and further, predict estimators of WPV. A modified version of the Workplace Violence in the Health Sector: Country Case Studies Research Instruments Survey Questionnaire was used to assess the incidence and management of workplace violence experienced by healthcare workers. Medical personnel from two social aggregation websites were recruited to participate in an online survey. 226 valid questionnaires were received. 48.5\% and 76.1\% of respondents, respectively, experienced physical and psychological violence in the past year. Risk factors for violence included occupation, patient population, ethnicity, and higher levels of anxiety regarding violence in hospitals. Overall, 17.7\% of reported incidents were investigated, 52.4\% of cases saw no consequences meted out to perpetrators and 51.7\% of victims suffered from negative emotions or aftereffects following a violent episode. Only 30.1\% of victims formally reported their experience with violence. The prevalence of violence was high and medical professionals were negatively affected by violence; however, formal reporting of episodes was low and measures combating violence were inadequate. Harsher penalties for perpetrators of violence are needed and hospitals need to implement guidelines that track the management of violence.

Download Full-text

“Effective Disembodiment:” Female Patienthood and Reproductive Health in Elisa Albert’s After Birth and Pamela Erens’s Eleven Hours

Contemporary Women s Writing ◽

10.1093/cww/vpz005 ◽

2019 ◽

Vol 13 (1) ◽

pp. 34-52

Author(s):

Haleigh R Williams

Keyword(s):

United States ◽

Reproductive Health ◽

Female Patient ◽

Clinical Setting ◽

Healthcare Workers ◽

The United States ◽

Pregnancy And Childbirth ◽

Fictional Narratives ◽

The Status ◽

Shed Light

Abstract Historically, female patienthood has been defined by an expectation of passivity and the concession of bodily autonomy. After Birth by Elisa Albert (2015) and Eleven Hours by Pamela Erens (2016) shed light on the status of the modern female patient through the lens of her treatment throughout the process of childbirth in a clinical setting. The increasing medicalization of pregnancy and childbirth in the United States has added a compelling layer to the existing tension between women and the institution of medicine. Positioning these texts in conversation with the treatment of women at the hands of healthcare workers allows us to contextualize the fictional narratives, which themselves offer a dialectal framework to facilitate our understanding of female patienthood.

Download Full-text

Ancestors, Computers, and Other Mixed Messages: Ambiguity and Euthanasia in Japan

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180101001086 ◽

2001 ◽

Vol 10 (1) ◽

pp. 62-71 ◽

Cited By ~ 3

Author(s):

SUSAN ORPETT LONG

Keyword(s):

United States ◽

Healthcare Workers ◽

Assisted Suicide ◽

The United States ◽

Cultural Norms ◽

Ordinary People ◽

Physician Assisted Suicide ◽

Policy Makers ◽

Societal Level ◽

Mixed Messages

Ethical questions about end-of-life treatment present themselves at two levels. In clinical situations, patients, families, and healthcare workers sift through ambivalent feelings and conflicting values as they try to resolve questions in particular circumstances. In a very different way, at the societal level, policy makers, lawyers, and bioethicists attempt to determine the best policies and laws to regulate practices about which there are a variety of deeply held beliefs. In the United States we have tried a number of ways to resolve the societal-level issues. We have ignored them, argued to try to convince others of our beliefs, voted to let the majority determine what is right or wrong, and turned to the courts to decide, as in the cases of Karen Ann Quinlan, Nancy Cruzan, and Jack Kervorkian. Yet none of these approaches has yet left us with comfortable, unambiguous cultural norms about issues such as euthanasia and physician-assisted suicide, which are readily assumed by “ordinary people” as they face individual and interpersonal dilemmas.

Download Full-text

Re-Engineering Healthcare

Mechanical Engineering ◽

10.1115/1.2007-nov-1 ◽

2007 ◽

Vol 129 (11) ◽

pp. 22-27 ◽

Cited By ~ 1

Author(s):

Ahmed Noor

Keyword(s):

United States ◽

Healthcare System ◽

Healthcare Workers ◽

Medical Technology ◽

Rapid Change ◽

Medical Knowledge ◽

The United States ◽

Rapid Changes ◽

Pervasive Access ◽

Delivery Of Health Services

This article reviews a system that is in need of repair in the United States, and engineers are uniquely equipped to help fix it. Although the expenditure per capita on healthcare in the United States is higher than in any other country, the current US healthcare system cannot be sustained, and major improvements are needed. Lives unnecessarily lost each year in the United States due to medical errors are estimated to be as high as 98,000 and injuries over a million. The healthcare system is currently facing many problems and challenges, including rapid changes in medical technology and practice, severe shortages in skilled healthcare workers, and an aging population with increased incidence of disease and disability. The cyber infrastructure will facilitate technology-based, distributed delivery of health services, as well as training and lifelong learning for healthcare workers. It can evolve into an electronic care continuum with pervasive access to global, accurate, and timely medical knowledge for individuals about their health needs in an era of rapid change and expanding knowledge.

Download Full-text