Factors influencing utilization and perception of health care: a qualitative study among traumatized Yazidi refugees in Germany

Abstract Background Ensuring adequate utilization of healthcare services for displaced populations is critical, yet there are well-documented treatment gaps. Yazidi women captured by the Islamic State (IS) were subjected to extreme trauma and violence. This study aims to understand perceptions of healthcare providers and utilization of these services among women who experienced extreme trauma. Methods This is a qualitative study with voluntary participation offered to approximately 400 women resettled through the Special Quota Program. An empirical approach was used to collect data and a grounded theory approach was used for content analysis. Participants ranked their interactions with providers on a Likert scale. Posttraumatic stress disorder (PTSD) symptoms were assessed using the impact of event scale-revised questionnaire. Results A total of 116 Yazidi women participated in this study. The women experienced an average of 6.8 months of captivity by IS and 93% met criteria for probable PTSD. Eighty-three percent of the women interacted with a physician; 80% found this interaction helpful. Sixty-nine percent interacted with psychologists; 61% found this interaction helpful. Six themes emerged: “reminders of trauma” and “hopelessness” in relation to the traumatic experience; “immediate relief” and “healing through pharmaceutical treatment” in relation to provider interventions, and “support” and “cultural differences” in relation to interactions with providers. Conclusions There exist major barriers to care for Yazidi women who experienced extreme trauma, particularly in regards to psychiatric care. Perceptions of healthcare providers and perceived effectiveness of therapy are critical factors that must be taken into consideration to improve healthcare utilization and outcomes.

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Effect of Terrorist Attack of December 16, 2014 on Academic Performance of School Children of Peshawar

Peshawar Journal of Psychology and Behavioral Sciences (PJPBS) ◽

10.32879/pjpbs.2017.3.2.223-233 ◽

2018 ◽

Vol 3 (2) ◽

pp. 223-233

Author(s):

Fatima Syed ◽

Madiha Asghar ◽

Gulshan Tara

Keyword(s):

Academic Performance ◽

Public School ◽

Terrorist Attack ◽

Study Participant ◽

Sampling Technique ◽

Traumatic Experience ◽

Impact Of Event Scale ◽

Event Scale ◽

The Impact ◽

Model School

The purpose of study was to determine the effect of traumatic events of December 16, 2014 on level of trauma of the children of Peshawar and the effect of traumatic experience their academics performance. Total sample consisted of two hundred (N=200) students with age range of 14-16 years (M=14.59, SD=1.128). Data was collected from the students of Army Public School and College System. Warsak road Peshawar and other three Schools on Warsak road included, Peshawar Public School, Peshawar Model School for Girls and Warsak Model School. Random sampling technique was used to recruit the study participant. Demographic information sheet, the Impact of Event Scale- Revised, Self-constructed questionnaire for measuring the Academic Performance of the students before and after traumatic experience of the students. Result showed that the terrorist attack effect the mental health of the students, students reported significant effect on their academic performance.

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EMDR intervention after a disaster: The Morandi Bridge collapse

Emergency Care Journal ◽

10.4081/ecj.2019.8634 ◽

2019 ◽

Vol 15 (3) ◽

Author(s):

Isabel Fernandez ◽

Chiara Callerame

Keyword(s):

Traumatic Event ◽

Poor Quality ◽

World Health ◽

Traumatic Experience ◽

Post Traumatic Stress ◽

Impact Of Event Scale ◽

Event Scale ◽

Pre Treatment ◽

Health Organization ◽

The Impact

Survivors involved in natural or man-made disasters can develop a range of psychological problems including Post-Traumatic Stress Disorder (PTSD), depression, other forms of psychological distress, and a poor quality of life. Therefore, the principal focus of early psychological interventions, according to World Health Organization, is to provide a rapid and effective therapeutical approach like EMDR therapy. The EMDR approach enables the assimilation and integration of the various aspects of a traumatic experience at a somatic, sensorial, cognitive, behavioral and emotional level. In this article will be presented data of 47 patients collected after the partial collapse of Morandi bridge, in Genoa, in August 2018. Survivors were treated applying the Recent Traumatic Episode Protocol (R-TEP); in order to evaluate the effect of the traumatic event and to monitor the intervention outcome, the Impact of Event Scale- Revised (IES-R) was administered to each person pre and after EMDR treatment. Results show that regardless the number of sessions and the time elapsed after the disaster in which they were performed, EMDR significantly reduced participants’ IES-R scores from pre-treatment to posttreatment. Clinical implications and limits of the study will be discussed.

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A randomized controlled trial of individual psychological debriefing for victims of violent crime

Psychological Medicine ◽

10.1017/s0033291799008624 ◽

1999 ◽

Vol 29 (4) ◽

pp. 793-799 ◽

Cited By ~ 115

Author(s):

S. ROSE ◽

C. R. BREWIN ◽

B. ANDREWS ◽

M. KIRK

Keyword(s):

Violent Crime ◽

Controlled Trial ◽

Traumatic Experience ◽

Symptom Scale ◽

Impact Of Event Scale ◽

Psychological Reactions ◽

Event Scale ◽

Psychological Debriefing ◽

Post Traumatic ◽

The Impact

Background. It has been suggested that giving people the opportunity talk about a traumatic experience may prevent the development of later disorder. We tested the efficacy of two brief interventions, education and psychological debriefing, designed to prevent adverse psychological reactions to criminal victimization.Methods. Individuals who had been the victims of a violent crime within the past month were written to and invited to take part in a study of their attitudes to crime and punishment: 2161 were contacted and 243 replied, of whom 157 were eligible and were randomly assigned either to an education condition, to a psychological debriefing plus education condition, or to an assessment only condition. Education involved providing information about normal post-traumatic reactions. Debriefing involved in-depth probing about events, thoughts and feelings experienced during the crime. Subjects were recruited from police and hospital sources and interviewed in their own homes: 138 were followed up at 6 months, and 92 at 11 months.Results. Outcome was assessed using a DSM-III-R diagnosis of PTSD, the Post-traumatic Symptom Scale, the Impact of Event Scale and the Beck Depression Inventory. All groups improved over time but there were no between-group differences.Conclusions. No evidence was found to support the efficacy of brief one-session interventions for preventing post-traumatic symptoms in individual victims of violent crime.

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Mental Health of the General Population during the 2019 Coronavirus Disease (COVID-19) Pandemic: A Tale of Two Developing Countries

Psychiatry International ◽

10.3390/psychiatryint2010006 ◽

2021 ◽

Vol 2 (1) ◽

pp. 71-84

Author(s):

Cuiyan Wang ◽

Mohammad A. Fardin ◽

Mahmoud Shirazi ◽

Riyu Pan ◽

Xiaoyang Wan ◽

...

Keyword(s):

Mental Health ◽

Developing Countries ◽

Health Information ◽

Psychological Impact ◽

Healthcare Services ◽

Anxiety And Depression ◽

Post Traumatic Stress ◽

Impact Of Event Scale ◽

Event Scale ◽

The Impact

Background: This study aimed to compare the severity of psychological impact, anxiety and depression between people from two developing countries, Iran and China, and to correlate mental health parameters with variables relating to the COVID-19 pandemic. Although China and Iran are developing countries based on the World Bank’s criteria, these two countries are different in access to resources and health care systems. We hypothesized that Iranians would show higher levels of depression, anxiety and stress as compared to Chinese. Methods: This study collected information related to the COVID-19 pandemic including physical health, precautionary measures and knowledge about the pandemic. We also used validated questionnaires such as the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21) to assess the mental health status. Results: There were a total of 1411 respondents (550 from Iran; 861 from China). The mean IES-R scores of respondents from both countries were above the cut-off for post-traumatic stress disorder (PTSD) symptoms. Iranians had significantly higher levels of anxiety and depression (p < 0.01). Significantly more Iranians believed COVID-19 was transmitted via contact, practised hand hygiene, were unsatisfied with health information and expressed less confidence in their doctors, but were less likely to wear a facemask (p < 0.001). Significantly more Iranians received health information related to COVID-19 via television while Chinese preferred the Internet (p < 0.001). Conclusions: This cross-country study found that Iranians had significantly higher levels of anxiety and depression as compared to Chinese. The difference in reported measures between respondents from Iran and China were due to differences in access to healthcare services and governments’ responses to the pandemic.

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Investigating the effect of a nap following experimental trauma on analogue PTSD symptoms

Scientific Reports ◽

10.1038/s41598-021-83838-1 ◽

2021 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Ines Wilhelm ◽

Yasmine Azza ◽

Karin Brennwald ◽

Yamina Ehrt-Schäfer ◽

Erich Seifritz ◽

...

Keyword(s):

Rem Sleep ◽

Critical Role ◽

Traumatic Experience ◽

Ptsd Symptoms ◽

Post Traumatic Stress ◽

Impact Of Event Scale ◽

Event Scale ◽

Intrusive Memories ◽

Experimental Trauma ◽

The Impact

AbstractCognitive models assume that the incomplete integration of a traumatic experience into the autobiographical memory results in typical symptoms associated with post-traumatic stress disorder (PTSD) such as intrusive re-experiencing. Sleep supports the integration of new experiences into existing memory networks through memory consolidation. In fifty-six females, we investigated whether a 90-min daytime nap (n = 33) compared to a wake period (n = 23) after being exposed to an experimental trauma (i.e. a trauma film) prevents PTSD analogue symptoms. Intrusive memories were recorded for seven days using a diary, overall PTSD symptoms were assessed using the Impact of Event Scale (IES-R) and affective response to trauma cues were measured one week after experimental trauma. The two groups did not differ in any of the analogue PTSD symptoms. However, participants obtaining rapid eye movement (REM) sleep in the nap experienced less distressing intrusive memories. Moreover, the duration of REM sleep and slow wave activity was negatively correlated with analogue PTSD symptoms. Our findings suggest that even a short sleep period after experimental trauma can play a protective role in trauma memory formation but only if the nap contains REM sleep. Our data provide additional evidence for a critical role of REM sleep in PTSD development.

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The Centrality of Events Scale for Italian adolescents: Integrating traumatic experience into one’s identity and its relation to posttraumatic stress disorder symptomatology

Europe’s Journal of Psychology ◽

10.5964/ejop.v14i2.1465 ◽

2018 ◽

Vol 14 (2) ◽

pp. 359-372 ◽

Cited By ~ 2

Author(s):

Chiara Ionio ◽

Eleonora Mascheroni ◽

Paola Di Blasio

Keyword(s):

Life Experience ◽

Traumatic Experience ◽

Stressful Event ◽

Convenience Sample ◽

Impact Of Event Scale ◽

Event Scale ◽

Traumatic Memories ◽

Italian Context ◽

The Impact ◽

Italian Adolescents

Adolescents could develop areas of vulnerability, especially if they have had to deal with highly stressful and traumatic life events. Stressful experiences can work as traumatic memories that become central to one’s life and core topics for one’s identity and for the attribution of meaning to life experience. The present work evaluates (a) the internal structures of the 20-item Centrality of Event Scale in the Italian context and (b) the impact of stressful and traumatic experience during adolescence. The present work includes a convenience sample of 872 Italian adolescents -528 males, 344 females- aged between 11 and 21 years (M = 15.85; SD = 2.09). We performed a confirmatory factor analysis that confirmed a three-factor solution. Moreover, the perception of stressful event as central in the participants’ lives was significantly correlated with the presence of PTSD symptomatology, as measured by the Impact of Event Scale Revised. We found that participants with PTSD symptoms had significantly higher CES scores. These data show the validity of the CES with adolescent samples, emphasizing the sensitivity of this instrument in detecting the impact of negative life experiences even in a sample of adolescents.

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Healthcare Providers on the Frontline: A Quantitative Investigation of the Stress and Recent Onset Psychological Impact of Delivering Health Care Services During COVID-19 in Kashmir

Indian Journal of Psychological Medicine ◽

10.1177/0253717620933985 ◽

2020 ◽

Vol 42 (4) ◽

pp. 359-367

Author(s):

Aaliya Khanam ◽

Shabir Ahmad Dar ◽

Zaid Ahmad Wani ◽

Naveed Nazir Shah ◽

Inaamul Haq ◽

...

Keyword(s):

Health Care Services ◽

Psychological Impact ◽

Healthcare Providers ◽

Impact Of Event Scale ◽

Event Scale ◽

Recent Onset ◽

Care Services ◽

Increased Risk ◽

The Impact ◽

Patient Department

Background: Frontline healthcare workers (FHCWs) are at an increased risk of contracting COVID-19. We aimed to assess the stress and psychological impact of the COVID-19 pandemic among FHCWs. Methods: This was an exploratory hospital-based study. A semistructured e-questionnaire was developed and shared through emails, WhatsApp groups, Facebook, and Twitter. The study instruments used were stress questionnaire and the impact of event scale—revised. Results: We received 133 valid responses. A total of 81 (61.4%) of the respondents were single, 74 (55.6) were male, 70 (52.6%) were between 20 and 29 years of age, and 91 (68.4%) were from urban background. A total of 83 (62.4%) of respondents were doctors and 28 (21.1%) were registered nurses. A total of 36 (27.1%) were posted in emergency and 34 (25.6%) were in the in-patient department. Feeling sad and pessimistic, feeling of being avoided by others, the burden of change in the quality of work, and worrying whether the family will be cared for in their absence were significantly more in nurses as compared to the doctors. Stress due to burden in an increase in the quantity of work was seen more in FHCWs working in the swab collection center as compared to those working in the in-patient department, emergency, or theaters. Severe psychological impact was seen in 81 (60.9%) of FHCWs. The psychological impact was significantly more in males and in those who were married. It was also significantly related to the place of posting. Conclusion: More than half of the FHCWs had a severe psychological impact owing to COVID-19. The psychological impact was more in males and those who were married, and it was related to the place of posting of the FHCWs. Nurses had significantly higher stress as compared to doctors.

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Childbirth and Posttraumatic Stress Responses

European Journal of Psychological Assessment ◽

10.1027/1015-5759.22.4.259 ◽

2006 ◽

Vol 22 (4) ◽

pp. 259-267 ◽

Cited By ~ 40

Author(s):

Eelco Olde ◽

Rolf J. Kleber ◽

Onno van der Hart ◽

Victor J.M. Pop

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Responses ◽

Rating Scales ◽

Rating Scale ◽

Stress Disorder ◽

Traumatic Experience ◽

Event Scale ◽

Self Rating ◽

The Impact

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.

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