scholarly journals Mental health assessment of healthcare workers in the Emergency Department of a low middle-income country during COVID 19 pandemic

2021 ◽  
Author(s):  
Shahan Waheed ◽  
Nirdosh Kumar ◽  
Bushra Qureshi ◽  
Ahmed Rahim
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Healthcare Workers ◽  
Mental Illnesses ◽  
University Hospital ◽  
Mental Wellbeing ◽  
Categorical Variables ◽  
Anxiety And Depression ◽  
P Value ◽  
And Training

Abstract Introduction: Emergency department healthcare workers of Pakistan during COVID 19 pandemic are facing an acute rise of mental illnesses. In the present study, the authors aim to assess the frequency of anxiety and depression among healthcare workers in the emergency department. Methods: A cross-sectional online survey was conducted in the emergency department between July to August 2020 at Aga Khan University Hospital Karachi, Pakistan. The Hospital Anxiety and Depression (HAD) scale was used for mental illness assessment among emergency physicians and nurses. Descriptive analysis of grading as per Likert scale is done through frequencies, means and standard deviations. Categorical variables were expressed as frequency (%). Mann-Whitney U test was used to compare scores of various groups and sub-groups and Chi-square test was used to assess the association of depression and anxiety categories among the groups. Results: In the emergency department, 127 healthcare professionals (physicians and nurses) were included in this survey. Median depression score was 8 (IQR 6–10) with 21% (27) fall under depression and 39% (50) to borderline depression. Median anxiety score was 9 (IQR 7–12) with 33% (42) had abnormal, 38% (48) had borderline anxiety. Healthcare workers working for > 45 hours per week have odds of 3.62 [1.374–9.549] of developing depression compared to anxiety with a p-value of 0.009. Similarly, nurses and medical officers develop depression with odds of 2.18 [1.016–4.686] p-value 0.045 and 5.18 [0.197–1.02] p-value 0.002, respectively. Conclusion: In our study, we determined that healthcare workers working in the Emergency Department during COVID-19 pandemic suffered high levels of anxiety and depression, which is a matter of concern. Therefore, comprehensive support and training of emergency department healthcare providers are paramount to promote physical and mental wellbeing specifically through adequate provision and training on the use of personal protective equipment, strict infection control practices, shorter shift length, and provision of mental health and support services.

scholarly journals Risk perception, mental health impacts and coping strategies during COVID-19 pandemic among Filipino healthcare workers

2021 ◽  
Author(s):  
Roy Rillera Marzo ◽  
Emilio Quilatan Villanueva III ◽  
Udita Chandra ◽  
Mila Nu Nu Htay ◽  
Rajeev Shrestha ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Perception ◽  
Marital Status ◽  
Healthcare Workers ◽  
The Philippines ◽  
Anxiety Symptoms ◽  
Mental Illnesses ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Status Occupation

Background: COVID-19 pandemic has caused an extraordinary situation, especially for the healthcare workers (HCWs), leading to increased psychological stress. The aim of the study was to estimate the prevalence of different grades of anxiety and depression across different centers in the Philippines and identify demographic factors associated with them. Design and Method: A cross-sectional, web-based, multi-center study was conducted among HCWs of Philippines from April 20- May 20, 2020. The study instruments used were the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Risk perception scores were analyzed using Mann-Whitney and Kruskal-Wallis test. Logistic regression was done to identify factors significantly associated with symptoms of anxiety and depression determined. Results: A total of 516 HCWs were included in the study. Most of them have anxiety symptoms (70.74%), but only half of them have symptoms of depression (50.97%). In addition, gender, age, marital status, living status, occupation, work premises, and availability of mental health services were significantly associated with the participants’ anxiety symptoms; In contrast, gender, marital status, occupation, and work premises were significantly associated with depression symptoms. Conclusion: This study reiterates the fact and demonstrates that COVID-19 has disrupted the mental well-being of HCWs in the Philippines. Majority of HCW was psychologically affected by COVID-19. Therefore, there is a dire need to address mental illness amongst HCWs and frame guidelines based on proven algorithms to overcome these mental illnesses.

scholarly journals Preventing SARS-CoV-2 transmission in the emergency department by implementing a separate pathway for patients with respiratory conditions

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fulwah Alqahtani ◽  
Marzouqah Alanazi ◽  
Wajdan Alassaf ◽  
Fadilah Sfouq Aleanizy ◽  
Muna Aljahany ◽  
...  
Keyword(s):  
Emergency Department ◽  
Longitudinal Study ◽  
Healthcare Workers ◽  
Respiratory Symptoms ◽  
Control Measures ◽  
University Hospital ◽  
Respiratory Pathway ◽  
Infection Control Measures ◽  
Separate Pathway ◽  
Respiratory Conditions

Abstract Objectives This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

scholarly journals Burden of predominant psychological reactions among the healthcare workers and general during COVID-19 pandemic phase: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Bhaskar Thakur ◽  
Mona Pathak
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Healthcare Workers ◽  
Global Mental Health ◽  
Meta Analysis ◽  
Random Effect ◽  
Anxiety And Depression ◽  
Psychological Reactions ◽  
Frontline Healthcare Workers ◽  
Anxiety Depression

ABSTRACTAimPresent systematic review and meta-analysis examined the burden of psychological reactions predominantly anxiety, depression, stress and insomnia during novel COVID-19 pandemic phase among the frontline healthcare, non-frontline healthcare and general.MethodologyPubMed, EMBASE and SCOPUS were searched for studies between Jan 1, 2020 to May 25, 2020. Brief protocol of the systematic review was registered with the PROSPERO database, (CRD42020186229).Any study that reported the burden of at least one of psychological reactions including anxiety or depression or stress or insomnia was eligible. Heterogeneity was assessed using I2 statistic and results were synthesized using random effect meta-analysis.ResultsOut of 52eligible studies, 43 reported anxiety, 43 reported depression, 20 reported stress and 11 reported insomnia. Overall prevalence for anxiety, depression, stress and insomnia were 26.6%, 26.2%,26.2% and 34.4% respectively. Anxiety and depression were found highest among the COVID-19 patients (43.3% and 51.75 respectively). Apart from COVID-19 patients, prevalence of anxiety, depression, stress and insomnia were found highest among the frontline healthcare (27.2%, 32.1%,55.6% and 34.4% respectively) as compared to general healthcare workers (26.9%, 15.7%, 7.0% and 34.0% respectively) and general population (25.9%, 25.9%,25.4% and 29.4% respectively).ConclusionAnxiety and depression were found highest among the COVID-19 patients. Apart from COVID-19 patients, the anxiety, depression, stress and insomnia were more prevalent among frontline healthcare workers compared to general. Such increased prevalence is prompting towards the global mental health emergency. Therefore a call of urgent attention and pan-region effective mental-health intervention are required to mitigate these psychological reactions.

scholarly journals Rate and causes of discharge against medical advice from a university hospital emergency department in Iran: an ethical perspective

2020 ◽  
Author(s):  
Sanaz Rouhbakhsh Halvaei ◽  
Hojat Sheikh Motahar Vahedi ◽  
Ayat Ahmadi ◽  
Maryam Sadat Mousavi ◽  
Alireza Parsapoor ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Staff ◽  
Medical Advice ◽  
University Hospital ◽  
P Value ◽  
Emergency Ward ◽  
Ethical Perspective ◽  
Against Medical Advice ◽  
Discharge Against Medical Advice ◽  
Clinical Records

Discharge against medical advice (DAMA) is a common problem in the health-care system. It imposes risks to both patients and medical staff and could be the subject of ethical deliberation. This cross-sectional study was conducted in 2017 on 400 patients who were discharged against medical advice from the emergency ward of Shariati Hospital, Tehran, Iran. Patients’ information was collected using clinical records and telephone calls. The collected data were analyzed using STATA software. DAMA rate was 12% in the emergency department of Shariati Hospital. Male gender was found to be a risk factor for DAMA (OR: 1.90; CI (95%): 1.44 - 2.52; P < 0.0001). In addition, younger patients were more likely to leave hospital against medical advice (p-value: 0.04). The more common reasons for DAMA were feeling better, long delay in diagnostic and therapeutic procedures and the hectic ambience of the emergency ward. Patients’ self-discharge is a multi-dimensional phenomenon that is affected by patients’ characteristics, medical conditions and hospital circumstances. It raises some ethical concerns, mainly due to a conflict between patients’ autonomy and beneficence. It is helpful for the medical staff to create an effective relationship with patients who are at higher risk of DAMA, in order to increase their compliance and prevent the consequences of leaving hospital against medical advice.

First the Pandemic then the Tsunami: COVID-19 and Its Impact on Mental Health

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Keng Chuan SOH ◽  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Systematic Reviews ◽  
Healthcare Workers ◽  
Mental Health Problems ◽  
Large Population ◽  
Well Being ◽  
Health Impact ◽  
Mental Wellbeing ◽  
Behavioural Patterns

Introduction: COVID-19 has undeniably and profoundly impacted everyday lives of the general public. One particular emphasis is the mental wellbeing of populations. This review serves to examine the mental health impact of the current pandemic. Methods: A review of the literature on PubMed was conducted, drawing from systematic reviews and large population studies about mental health consequences of the COVID-19 pandemic. The content was synthesized with the writer’s experience of daily life across different perspectives. Certain demographic sub-groups were examined, such as those under home quarantine or isolation, those who had contracted COVID-19, those with pre-existing psychiatric disorders, as well as healthcare workers and medical students. Results: Psychological well-being was adversely affected by the pandemic, although there is some controversy about the magnitude of this impact which is likely in relation to the timeline of the pandemic’s progression. Behavioural patterns such as spending habits during lockdowns might provide an early indication of mental health problems. Those who had contracted COVID-19 were found to have heightened levels of posttraumatic stress symptoms and depressive symptoms. Healthcare workers and medical students have faced comparable levels of anxiety, depressed mood and insomnia. The final results of some of the systematic reviews are still pending. Conclusion: The COVID-19 pandemic has profoundly impacted everyday life. If not already thecase, there is likely to be an anticipated tsunami of mental health concerns. This wouldmake a strong case for the anticipatory need of increased resource allocation to allowmental health services to meet this demand.

scholarly journals 42 Training Forgiveness – A Novel Approach to Reducing Physician Burnout

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 198-199 ◽  
Author(s):  
Lidia Firulescu ◽  
Ross W. May ◽  
Frank D. Fincham ◽  
Emelina A. Arocha ◽  
Marcos A. Sanchez-Gonzalez
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Well Being ◽  
Anxiety And Depression ◽  
P Value ◽  
Depression And Anxiety ◽  
Physician Burnout ◽  
Study Objective ◽  
Work Related ◽  
Mental And Physical Health

AbstractStudy ObjectivePsychological risk factors that lead to impaired work performance, negatively impacting mental and physical health, have emerged as a concern across clinical settings. Although depression and anxiety are linked to poor physician mental health, physician burnout characterized by work related stress due to chronic exhaustion from clinical work, cynicism toward meaning of the medical profession, and feelings of inadequacy toward work related accomplishments, may be an even stronger indicator of well-being. Literature suggests that work satisfaction among physicians is rapidly deteriorating owing to high rates of burn out and poor mental health. Although the relationship between work burnout (WB) and negative affectivity has been well documented, the association with positive affect, such as trait forgiveness (TF) has been overlooked. On that note, research shows that lifetime stress severity and lower levels of forgiveness predict worse mental and physical health. Since TF has been linked strongly with healthy workplace relationships, positive occupational outcomes and general well-being, its association with WB remains to be investigated. Therefore, the aim of the present study was to explore the link between TF and WB among physicians. We hypothesized that TF would be associated with reduced levels of burnout.MethodA total of 62 (F=23) medical residents at a Teaching Hospital consented for the study. Residents were administered surveys on WB (Maslach BurnoutInventory), workplace bullying, personal bullying (PB), interpersonal rejection sensitivity (IRS), perceived stress scale (PSS), TF, anxiety, and depression, all of which were anonymously submitted via electronically. Hierarchical multiple regression (HMR) models were used to determine the associations between WB, work environment social factors and TF. A p-value of <0.05 was considered significant.ResultsThe mean age 33.1±SD 4.2 years. HMR analysis using WB as main outcome contained 6 predictors: Model 1 contained depression and anxiety, Model 2 added PB, Model 3 added IRS and PSS, Model 4 added TF. Anxiety and TF were the only significant predictors (p= >0.05) accounting for 10.4% and 17.5% of the variance in WB scores, respectively.ConclusionsThe novel finding of the present study is that TF was associated with low levels of burnout. Additionally, WB was found to be linked to anxiety and depression which is in line with previous research. These data suggest that TF could be a potential resolution to the deleterious influence of burnout. Further exploration is needed in order to understand the psychology of forgiveness as a potential adjuvant and/or therapeutic intervention for physicians’ burnout. These results suggest that strategies including forgiveness training aimed at decreasing WB while increasing job satisfaction among physicians warrant further exploration.Funding Acknowledgements: no funding

What is the Threshold of Teachers' Recognition and Report of Concerns About Anxiety and Depression in Students? An Exploratory Study With Teachers of Adolescents in Regional Australia

2011 ◽  
Vol 21 (2) ◽  
pp. 126-141 ◽  
Author(s):  
Michelle Trudgen ◽  
Sharon Lawn
Keyword(s):  
Mental Health ◽  
Professional Learning ◽  
Mental Health Problems ◽  
Teaching Experience ◽  
Later Life ◽  
Health Problems ◽  
Mental Wellbeing ◽  
Anxiety And Depression ◽  
Mental Health Training ◽  
School Students

AbstractIntroduction:Anxiety and depression in adolescence is prevalent but often unrecognised and untreated. This can lead to serious disorders in later life. This study explored how teachers recognise anxiety and depression in secondary school students and act on their concerns.Method:Twenty teachers from four secondary colleges in regional Victoria, Australia were interviewed regarding their experiences. In-depth interviews were analysed using descriptive thematic analysis in order to understand how teachers respond to this issue.Results:Teachers' recognition of mental health problems in students and the threshold for reporting their concerns was subjective and not based on any formal knowledge of how to identify anxiety or depression risk factors in students. Years of teaching experience was not associated with increased knowledge of mental health problems in students. Time pressures and lack of resources in student wellbeing teams were barriers to teachers reporting their concerns about students.Conclusion:Education bodies and teaching universities responsible for training teachers and providing ongoing professional learning need to ensure that mental health training is part of every teacher's core skill set, so that teachers can confidently promote mental wellbeing, identify emerging mental health problems, know how to facilitate access to more specialist intervention where required and contribute effectively to follow-up support.

scholarly journals Labour Market Attachment, Workplace Infection Control Procedures and Mental Health: A Cross-Sectional Survey of Canadian Non-healthcare Workers during the COVID-19 Pandemic

2020 ◽  
Author(s):  
Peter M Smith ◽  
John Oudyk ◽  
Guy Potter ◽  
Cameron Mustard
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Infection Control ◽  
Labour Market ◽  
Healthcare Workers ◽  
Internet Survey ◽  
Anxiety And Depression ◽  
Full Time ◽  
Increased Risk ◽  
Different Types

Abstract Background The COVID-19 pandemic has led to large proportions of the labour market moving to remote work, while others have become unemployed. Those still at their physical workplace likely face increased risk of infection, compared to other workers. The objective of this paper is to understand the relationship between working arrangements, infection control programs (ICP), and symptoms of anxiety and depression among Canadian workers, not specifically working in healthcare. Methods A convenience-based internet survey of Canadian non-healthcare workers was facilitated through various labour organizations between April 26 and June 6, 2020. A total of 5180 respondents started the survey, of which 3779 were assessed as employed in a full-time or part-time capacity on 2 March 2020 (prior to large-scale COVID-19 pandemic responses in Canada). Of this sample, 3305 (87.5%) had complete information on main exposures and outcomes. Anxiety symptoms were measured using the Generalised Anxiety Disorder screener (GAD-2), and depressive symptoms using the Patient Health Questionnaire screener (PHQ-2). For workers at their physical workplace (site-based workers) we asked questions about the adequacy and implementation of 11 different types of ICP, and the adequacy and supply of eight different types of personal protective equipment (PPE). Respondents were classified as either: working remotely; site-based workers with 100% of their ICP/PPE needs met; site-based workers with 50–99% of ICP/PPE needs met; site-based workers with 1–49% of ICP/PPE needs met; site-based workers with none of ICP/PPE needs met; or no longer employed. Regression analyses examined the association between working arrangements and ICP/PPE adequacy and having GAD-2 and PHQ-2 scores of three and higher (a common screening point in both scales). Models were adjusted for a range of demographic, occupation, workplace, and COVID-19-specific factors. Results A total of 42.3% (95% CI: 40.6–44.0%) of the sample had GAD-2 scores of 3 and higher, and 34.6% (95% CI: 32.–36.2%) had PHQ-2 scores of 3 and higher. In initial analyses, symptoms of anxiety and depression were lowest among those working remotely (35.4 and 27.5%), compared to site-based workers (43.5 and 34.7%) and those who had lost their jobs (44.1 and 35.9%). When adequacy of ICP and PPE was taken into account, the lowest prevalence of anxiety and depressive symptoms was observed among site-based workers with all of their ICP needs being met (29.8% prevalence for GAD-2 scores of 3 and higher, and 23.0% prevalence for PHQ-2 scores of 3 and higher), while the highest prevalence was observed among site-based workers with none of their ICP needs being met (52.3% for GAD-2 scores of 3 and higher, and 45.8% for PHQ-2 scores of 3 and higher). Conclusion Our results suggest that the adequate design and implementation of employer-based ICP have implications for the mental health of site-based workers. As economies re-open the ongoing assessment of ICP and associated mental health outcomes among the workforce is warranted.

scholarly journals Psychiatric liaison referrals: a thematic analysis during peak COVID-19

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S294-S294
Author(s):  
Kaj Svedberg ◽  
William Hancox ◽  
Hugh Grant-Peterkin
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Careful Consideration ◽  
University Hospital ◽  
Medical Attention ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Low Mood ◽  
Crisis Care

AimsWith the advent of the COVID-19 Pandemic the NHS long term Plan commitments of January 2019 to improve crisis care nationwide became all the more pressing. The aim of this study was to thematically investigate what mental health crisis presentations might be diverted from the Emergency department to external crisis hubs in order to reduce the COVID-19 contamination risks.MethodAll referrals made to the Homerton University Hospital (HUH) mental health liaison service were looked at between 1/3/20-11/6/20 (n = 846), coinciding with the first peak of the COVID-19 Pandemic.Referral data was anonymised and sorted independently into naturally emerging thematic classes by two junior liaison doctors.Cases that did not clearly fit any of the 14 themes generated were further looked into to determine outcome of referral and discussed to try and match to an appropriate class.Result14 frequent themes for mental health crisis referrals were identified. The distribution of these ranged from most common (suicidality) to neurocognitive presentation and identified shifts in themes over the course of the pandemic peak such as increases of low mood, anxiety and intoxication requiring medical attention over the three month period.ConclusionAlthough themes for presentations may be identified in acute referrals to mental health liaison services it is problematic determining how these may be parsed safely to crisis hubs without risking overlooking cases that may require medical attention. The most common theme that was identified and remained throughout the first wave of the COVID-19 Pandemic was acute suicidal presentation. The remaining themes would require careful consideration around risk thresholds for what a service may wish to accept in devolving the emergency department liaison and balance these against future risks of repeat COVID-19 waves.

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