Response of US Psychiatric Programs to the COVID-19 Pandemic and the Impact on Trainees

Abstract Background: Medical training program and hospital response to the COVID-19 pandemic has varied greatly and has impacted trainee well-being. Which factors have specifically affected trainee wellness, however, has not yet been examined in depth. The aim of the study was to understand trainee perspectives on the individual psychiatry trainee programs’ hospitals’ objective COVID-19 preparedness management, and to gauge how program changes, and general pandemic-related concerns, have impacted trainee satisfaction and burnout.Methods: A cross-sectional survey study of psychiatric trainees was distributed electronically throughout the country via various psychiatry residency program listservs in April 2020. Statistical analyses were performed utilizing simple linear regression.Results: From 352 respondents, the most frequent program changes were “decreased number of rotations requiring in-person patient care” and “increased call hours or duties.” Of pandemic-related concerns surveyed, the two greatest were “spreading COVID-19 to family/friends” and “co-residents’ burnout and anxiety.” A relationship was found between trainee satisfaction with perceived COVID-19 departmental response and comfort level of residents/fellows in expressing concerns with attending clinicians and department leadership.Conclusions: Since the start of the COVID-19 pandemic, trainees have experienced a variety of changes to trainee program policies and guidelines. Overall, poor communication and trainee dissatisfaction with departmental response correlated with concern of infection and anxiety/burnout. Insights garnered from this study could provide scaffolding for the best practices to reduce trainee physician anxiety/burnout for the current and future pandemics of this variety and magnitude. Trial registration: Not applicable

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Exploring the global impact of the COVID-19 pandemic on medical education: an international cross-sectional study of medical learners

Canadian Medical Education Journal ◽

10.36834/cmej.71149 ◽

2021 ◽

Author(s):

Allison Brown ◽

Aliya Kassam ◽

Mike Paget ◽

Kenneth Blades ◽

Megan Mercia ◽

...

Keyword(s):

Medical Education ◽

Medical Training ◽

Well Being ◽

World Health ◽

Future Research ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The World ◽

Geographic Regions ◽

The Impact

Background: The evidence surrounding the impact of COVID-19 on medical learners remains anecdotal and highly speculative despite the anticipated impact and potential consequences of the current pandemic on medical training. The purpose of this study was to explore the extent that COVID-19 initially impacted medical learners around the world and examine global trends and patterns across geographic regions and levels of training. Methods: A cross-sectional survey of medical learners was conducted between March 25–June 14, 2020, shortly after the World Health Organization declared COVID-19 a pandemic. Results: 6492 learners completed the survey from 140 countries. Most medical schools removed learners from the clinical environment and adopted online learning, but students reported concerns about the quality of their learning, training progression, and milestone fulfillment. Residents reported they could be better utilized and expressed concerns about their career timeline. Trainees generally felt under-utilized and wanted to be engaged clinically in meaningful ways; however, some felt that contributing to healthcare during a pandemic was beyond the scope of a learner. Significant differences were detected between levels of training and geographic regions for satisfaction with organizational responses as well as the impact of COVID-19 learner wellness and state-trait anxiety. Conclusions: The disruption to the status quo of medical education is perceived by learners across all levels and geographic regions to have negatively affected their training and well-being, particularly amongst postgraduate trainees. These results provide initial empirical insights into the areas that warrant future research as well as consideration for current and future policy planning.

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Exploring the global impact of the COVID-19 pandemic on medical education: an international cross-sectional study of medical learners

10.1101/2020.09.01.20186304 ◽

2020 ◽

Author(s):

Allison Brown ◽

Aliya Kassam ◽

Mike Paget ◽

Kenneth Blades ◽

Megan Mercia ◽

...

Keyword(s):

Medical Training ◽

Well Being ◽

Cross Sectional Study ◽

World Health ◽

Future Research ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The World ◽

Geographic Regions ◽

The Impact

To broadly explore the extent that COVID-19 has initially impacted medical learners around the world and examine global trends and patterns across geographic regions and levels of training, a cross-sectional survey of medical learners was conducted between March 25-June 14th, 2020, shortly after the World Health Organization declared concurrent COVID-19 a pandemic. 6492 medical learners completed the survey from 140 countries, Students were concerned about the quality of their learning, training progression, and milestone fulfillment. Most trainees felt under-utilized and wanted to be engaged clinically in meaningful ways; however, some trainees felt that contributing to healthcare during a pandemic was beyond the scope of a medical learner. Statistically significant differences were detected between levels of training and geographic regions for satisfaction with organizational responses, the impact of COVID-19 on wellness, and state-trait anxiety. Overall, the initial disruption to medical training has been perceived by learners across all levels and geographic regions to have negatively affected their training and well-being, particularly amongst postgraduate trainees. These results provide initial insights into the areas that warrant future research as well as consideration for current and future policy planning, such as the policies for clinical utilization of medical learners during public health emergencies.

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Psychological Impacts of COVID-19 During the First Nationwide Lockdown in Vietnam: Web-Based, Cross-Sectional Survey Study (Preprint)

10.2196/preprints.24776 ◽

2020 ◽

Author(s):

Khanh Ngoc Cong Duong ◽

Tien Nguyen Le Bao ◽

Phuong Thi Lan Nguyen ◽

Thanh Vo Van ◽

Toi Phung Lam ◽

...

Keyword(s):

Psychological Distress ◽

General Population ◽

Psychological Health ◽

Online Survey ◽

Survey Study ◽

Limited Information ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Event Scale ◽

The Impact

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged <18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL

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The impact of COVID‐19 on work, training and well‐being experiences of nursing associates in England: A cross‐sectional survey

Nursing Open ◽

10.1002/nop2.928 ◽

2021 ◽

Author(s):

Rachel King ◽

Tony Ryan ◽

Michaela Senek ◽

Emily Wood ◽

Bethany Taylor ◽

...

Keyword(s):

Well Being ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Work Training ◽

The Impact

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Development of the Psychological Insight Questionnaire among a sample of people who have consumed psilocybin or LSD

Journal of Psychopharmacology ◽

10.1177/0269881120967878 ◽

2021 ◽

pp. 026988112096787

Author(s):

Alan K Davis ◽

Frederick S Barrett ◽

Sara So ◽

Natalie Gukasyan ◽

Thomas C Swift ◽

...

Keyword(s):

Life Satisfaction ◽

Longitudinal Research ◽

Psychological Flexibility ◽

Well Being ◽

Survey Study ◽

Strongly Correlated ◽

Strong Correlations ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Therapeutic Outcomes

Background: Several measures have been developed to examine acute psychedelic effects (e.g. mystical-type and challenging experiences), but no measure assesses acute psychologically insightful experiences that may occur during psychedelic experiences. Aim: The purpose of this study was to develop and examine the psychometric properties of the Psychological Insight Questionnaire. Method: A cross-sectional survey study among psilocybin and LSD users. Respondents ( n=1661; Mage=22.9, standard deviation=8.5; Caucasian/White=83%; non-Hispanic=91%; men=72%; United States resident=66%) completed an Internet-based survey. Results: The Psychological Insight Questionnaire consists of 23 items with two subscales: (a) Avoidance and Maladaptive Patterns Insights and (b) Goals and Adaptive Patterns Insights. Construct validity of the Psychological Insight Questionnaire was supported by strong correlations of the Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores with the insight subscale of the Session Impacts Scale, and weak-to-moderate correlations with the Mystical Experiences and Challenging Experiences Questionnaires. Furthermore, Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores were moderately-to-strongly correlated with retrospectively reported increases in psychological flexibility, and well-being/life satisfaction that were attributed to a memorable psychedelic experience. Lastly, incremental validity was established showing that the Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights subscale) scores predict unique variance in changes in psychological flexibility, and Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores predict changes in well-being and life satisfaction, beyond measures of acute mystical-type and challenging effects. Conclusions: The Psychological Insight Questionnaire has the potential to extend the understanding of the acute and enduring effects of psychedelics. Further longitudinal research is necessary to determine the long-term predictive validity of the Psychological Insight Questionnaire and to examine the role of psychological insight in predicting therapeutic outcomes.

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Doctors’ perception of support and the processes involved in complaints investigations and how these relate to welfare and defensive practice: a cross-sectional survey of the UK physicians

BMJ Open ◽

10.1136/bmjopen-2017-017856 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017856 ◽

Cited By ~ 7

Author(s):

Tom Bourne ◽

Bavo De Cock ◽

Laure Wynants ◽

Mike Peters ◽

Chantal Van Audenhove ◽

...

Keyword(s):

Online Survey ◽

Well Being ◽

Adverse Outcomes ◽

Perceived Support ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Final Sample ◽

Perception Of Support ◽

The Uk

ObjectiveHow adverse outcomes and complaints are managed may significantly impact on physician well-being and practice. We aimed to investigate how depression, anxiety and defensive medical practice are associated with doctors actual and perceived support, behaviour of colleagues and process issues regarding how complaints investigations are carried out.DesignA survey study. Respondents were classified into three groups: no complaint, recent/current complaint (within 6 months) or past complaint. Each group completed specific surveys.SettingBritish Medical Association (BMA) members were invited to complete an online survey.Participants95 636 members of the BMA were asked to participate. 7926 (8.3%) completed the survey, of whom 1780 (22.5%) had no complaint, 3889 (49.1%) had a past complaint and 2257 (28.5%) had a recent/current complaint. We excluded those with no complaints leaving 6144 in the final sample.Primary outcomes measuresWe measured anxiety and depression using the Generalised Anxiety Disorder Scale 7 and Physical Health Questionnaire 9. Defensive practice was assessed using a new measure for avoidance and hedging.ResultsMost felt supported by colleagues (61%), only 31% felt supported by management. Not following process (56%), protracted timescales (78%), vexatious complaints (49%), feeling bullied (39%) or victimised for whistleblowing (20%), and using complaints to undermine (31%) were reported. Perceived support by management (relative risk (RR) depression: 0.77, 95% CI 0.71 to 0.83; RR anxiety: 0.80, 95% CI 0.74 to 0.87), speaking to colleagues (RR depression: 0.64, 95% CI 0.48 to 0.84 and RR anxiety: 0.69, 95% CI 0.51 to 0.94, respectively), fair/accurate documentation (RR depression: 0.80, 95% CI 0.75 to 0.86; RR anxiety: 0.81, 95% CI 0.75 to 0.87), and being informed about rights (RR depression 0.96 (0.89 to 1.03) and anxiety 0.94 (0.87 to 1.02), correlated positively with well-being and reduced defensive practice. Doctors worried most about professional humiliation following a complaint investigation (80%).ConclusionPoor process, prolonged timescales and vexatious use of complaints systems are associated with decreased psychological welfare and increased defensive practice. In contrast, perceived support from colleagues and management is associated with a reduction in these effects.

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The Psychological Impact of COVID-19 on Healthcare Providers in Obstetrics: A Cross-Sectional Survey Study

Frontiers in Psychology ◽

10.3389/fpsyg.2021.632999 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lidia Del Piccolo ◽

Valeria Donisi ◽

Ricciarda Raffaelli ◽

Simone Garzon ◽

Cinzia Perlini ◽

...

Keyword(s):

Psychological Distress ◽

General Health Questionnaire ◽

Healthcare Providers ◽

Organizational Level ◽

Survey Study ◽

University Hospitals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Gynecology And Obstetrics ◽

The Individual

Objective: To assess the psychological distress of healthcare providers (HCPs) working in the field of obstetrics during the coronavirus disease 2019 (COVID-19) pandemic and to identify factors associated with psychological distress at the individual, interpersonal, and organizational level.Design: Cross-sectional survey study.Setting: Four University hospitals in Italy.Participants: HCPs working in obstetrics, including gynecologists, residents in gynecology and obstetrics, and midwives.Methods: The 104-item survey Impatto PSIcologico COVID-19 in Ostetricia (IPSICO) was created by a multidisciplinary expert panel and administered to HCPs in obstetrics in May 2020 via a web-based platform.Main Outcome Measures: Psychological distress assessed by the General Health Questionnaire-12 (GHQ-12) included in the IPSICO survey.Results: The response rate to the IPSICO survey was 88.2% (503/570), and that for GHQ-12 was 84.4% (481/570). Just over half (51.1%; 246/481) of the GHQ-12 respondents reported a clinically significant level of psychological distress (GHQ-12 ≥3). Psychological distress was associated with either individual (i.e., female gender, stressful experience related to COVID-19, exhaustion, and the use of dysfunctional coping strategies), interpersonal (i.e., lower family support, limitations in interactions with colleagues), and organizational (i.e., reduced perception of protection by personal protective equipment, perceived delays on updates and gaps in information on the pandemic) factors in dealing with the pandemic.Conclusions: Results confirm the need for monitoring and assessing the psychological distress for HCPs in obstetrics. Interventions at the individual, interpersonal, and organizational level may relieve the psychological distress during the COVID-19 pandemic and foster resilience skills in facing emotional distress.

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The Relation Between Official WhatsApp-Distributed COVID-19 News Exposure and Psychological Symptoms: Cross-Sectional Survey Study (Preprint)

10.2196/preprints.22142 ◽

2020 ◽

Author(s):

Jean C J Liu ◽

Eddie M W Tong

Keyword(s):

Protective Factor ◽

Psychological Symptoms ◽

Well Being ◽

Primary Outcome Measure ◽

World Health ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Global Pandemic ◽

Health Organization

BACKGROUND In a global pandemic, digital technology offers innovative methods to disseminate public health messages. As an example, the messenger app WhatsApp was adopted by both the World Health Organization and government agencies to provide updates on the coronavirus disease (COVID-19). During a time when rumors and excessive news threaten psychological well-being, these services allow for rapid transmission of information and may boost resilience. OBJECTIVE In this study, we sought to accomplish the following: (1) assess well-being during the pandemic; (2) replicate prior findings linking exposure to COVID-19 news with psychological distress; and (3) examine whether subscription to an official WhatsApp channel can mitigate this risk. METHODS Across 8 weeks of the COVID-19 outbreak (March 7 to April 21, 2020), we conducted a survey of 1145 adults in Singapore. As the primary outcome measure, participants completed the Depression, Anxiety, and Stress Scale (DASS-21). As predictor variables, participants also answered questions pertaining to the following: (1) their exposure to COVID-19 news; (2) their use of the Singapore government’s WhatsApp channel; and (3) their demographics. RESULTS Within the sample, 7.9% of participants had severe or extremely severe symptoms on at least one DASS-21 subscale. Depression scores were associated with increased time spent receiving COVID-19 updates, whereas use of the official WhatsApp channel emerged as a protective factor (b=–0.07, t[863]=–2.04, P=.04). Similarly, increased anxiety scores were associated with increased exposure to both updates and rumors, but this risk was mitigated by trust in the government’s WhatsApp messages (b=–0.05, t[863]=–2.13, P=.03). Finally, although stress symptoms increased with the amount of time spent receiving updates, these symptoms were not significantly related to WhatsApp use. CONCLUSIONS Our findings suggest that messenger apps may be an effective medium for disseminating pandemic-related information, allowing official agencies to reach a broad sector of the population rapidly. In turn, this use may promote public well-being amid an “infodemic.” CLINICALTRIAL ClinicalTrials.gov NCT04305574; https://clinicaltrials.gov/ct2/show/NCT04305574

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The Role of Helplessness in the Appraisal of Illness Uncertainty in Women With Fibromyalgia

Nursing Science Quarterly ◽

10.1177/0894318420943151 ◽

2020 ◽

Vol 33 (4) ◽

pp. 346-352

Author(s):

Melody D. Reibel ◽

Marianne H. Hutti

Keyword(s):

Survey Design ◽

Well Being ◽

Subjective Well Being ◽

Regression Analyses ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Illness Uncertainty ◽

High Level ◽

The Impact

Fibromyalgia is a chronic pain disorder characterized by uncertainty in etiology, symptomatology, diagnosis, treatment, and outcome. The high level of illness uncertainty that results from fibromyalgia is a risk factor for maladjustment to illness. A cross-sectional survey design was used to examine the relationships among illness uncertainty, helplessness, and subjective well-being in 138 women with fibromyalgia. Multiple regression analyses were conducted to examine a predictive model for mediation. We found illness uncertainty is negatively associated with subjective well-being and that helplessness strongly influences the impact of illness uncertainty on subjective well-being in women with fibromyalgia.

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Mobile Health Program to Reduce Psychological Treatment Gap in Mental Healthcare in Alberta Through Daily Supportive Text Messages – Cross-sectional Survey Evaluating Text4Mood

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1970 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S139-S139 ◽

Cited By ~ 1

Author(s):

V. Agyapong ◽

K. Mrklas ◽

M. Juhás ◽

J. Omeje ◽

A. Ohinmaa ◽

...

Keyword(s):

Response Rate ◽

Psychological Treatment ◽

Mental Healthcare ◽

Well Being ◽

Text Messages ◽

Mental Wellbeing ◽

Treatment Gap ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Impact

BackgroundTo complement the oversubscribed counselling services in Alberta, the Text4Mood program which delivers daily supportive text messages to subscribers was launched on the 18th of January, 2016. This report presents an evaluation of self-reports of the impact of the program on the mental wellbeing of subscribers.MethodsAn online link to a survey questionnaire was created by an expert group and delivered via text messages to mobile phones of all 4111 active subscribers of the Text4Mood program as of April 11, 2016.ResultsOverall, 894 subscribers answered the survey (overall response rate 21.7%). The response rate for individual questions varied and is reported alongside the results. Most respondents were female (83%, n = 668), Caucasian (83%, n = 679), and diagnosed with a psychiatric disorder (38%, n = 307), including Depression (25.4%, n = 227) and Anxiety (20%, n = 177). Overall, 52% (n = 461) signed up for Text4Mood to help elevate their mood and 24.5% (n = 219) signed up to help them worry less. Most respondents felt the text messages made them more hopeful about managing issues in their lives (81.7%, n = 588), feel in charge of managing depression and anxiety (76.7%, n = 552), and feel connected to a support system (75.2%, n = 542). The majority of respondents felt Text4Mood improved their overall mental well-being (83.1%, n = 598).ConclusionSupportive text messages are a feasible and acceptable way of delivering adjunctive psychological interventions. Given that text messages are affordable, readily available, and can be delivered to thousands of people simultaneously, they present an opportunity to help close the psychological treatment gap for mental health patients.

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