scholarly journals The physician’s Achilles heel—surviving an adverse event

2019 ◽  
Vol 26 (6) ◽  
Author(s):  
I. Stukalin ◽  
B. C. Lethebe ◽  
W. Temple
Keyword(s):  
Health Care ◽  
Adverse Event ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Institutional Support ◽  
Post Traumatic Stress ◽  
Event Scale ◽  
Self Blame ◽  
Brief Cope ◽  
Post Traumatic

Background Of hospitalized patients in Canada, 7.5% experience an adverse event (ae). Physicians whose patients experience aes often become second victims of the incident. The present study is the first to evaluate how physicians in Canada cope with aes occurring in their patients.Methods Survey participants included oncologists, surgeons, and trainees at the Foothills Medical Centre, Calgary, AB. The surveys were administered through REDCap (Research Electronic Data Capture, version 9.0: REDCap Consortium, Vanderbilt University, Nashville, TN, U.S.A.). The Brief cope (Coping Orientation to Problems Experienced) Inventory, the ies-r (Impact of Event Scale–Revised), the Causal Dimension Scale, and the Institutional Punitive Response scale were used to evaluate coping strategies, prevalence of post-traumatic stress, and institutional culture with respect to aes.Results Of 51 responses used for the analysis, 30 (58.8%) came from surgeons and 21 (41.2%) came from medical specialists. On the ies-r, 54.9% of respondents scored 24 or higher, which has been correlated with clinically concerning post-traumatic stress. Individuals with a score of 24 or higher were more likely to report self-blame (p = 0.00026) and venting (p = 0.042). Physicians who perceive institutional support to be poor reported significant post-traumatic stress (p = 0.023). On multivariable logistic regression modelling, self-blame was associated with an ies-r score of 24 or higher (p = 0.0031). No significant differences in ies-r scores of 24 or higher were observed between surgeons and non-surgeons (p = 0.15). The implications of aes for physicians, patients, and the health care system are enormous. More than 50% of our respondents showed emotional pathology related to an ae. Higher levels of self-blame, venting, and perception of inadequate institutional support were factors predicting increased post-traumatic stress after a patient ae.Conclusions Our study identifies a desperate need to establish effective institutional supports to help health care professionals recognize and deal with the emotional toll resulting from aes.

scholarly journals Vicarious trauma and secondary traumatic stress in health care professionals

2017 ◽  
Vol 86 (2) ◽  
pp. 42-43 ◽  
Author(s):  
Nicole A Guitar ◽  
Monica L Molinaro
Keyword(s):  
Health Care ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Secondary Traumatic Stress ◽  
Vicarious Trauma ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Post Traumatic Stress ◽  
Post Traumatic

Three-quarters of Canadians are exposed to a traumatic event sufficient to cause psychological trauma in their lifetime. In fact, post-traumatic stress disorder is a global health issue with a prevalence as high as 37%. Health care professionals trained to provide mental health treatment for these individuals are at risk of developing vicarious trauma and secondary traumatic stress, both of which result in adverse symptoms for the health care provider that often mimic post-traumatic stress disorder (PTSD). Vicarious trauma develops over time as the clinician is continually exposed to their clients’ traumatic experiences, while clinicians experiencing secondary traumatic stress begin to experience the symptoms of PTSD due to secondary exposure of the traumatic event. Both vicarious trauma and secondary traumatic stress cause mental, physical, and emotional issues for health care professionals that include burnout and decreased self-worth. Health care systems and administration should aim to develop training and professional education for health care providers. This review will emphasize what factors lead to the development of vicarious trauma and secondary traumatic stress, and what aids or supports can be implemented to treat the symptoms. The implications for policy development and training will be discussed.

scholarly journals Coping Styles Associated with Post-Traumatic Stress and Depression Symptoms Following Childbirth in Croatian Women

2018 ◽  
Vol 27 (3) ◽  
pp. 543-559 ◽  
Author(s):  
Sandra Nakić Radoš ◽  
Erin Burn ◽  
Susan Ayers ◽  
Alexandra Sawyer
Keyword(s):  
Traumatic Stress ◽  
Edinburgh Postnatal Depression Scale ◽  
Coping Styles ◽  
Depression Scale ◽  
Depression Symptoms ◽  
Post Traumatic Stress ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Brief Cope ◽  
Post Traumatic

Porođaj je normativni čin u životu žene i uglavnom se smatra pozitivnim događajem. Međutim, svaka treća žena doživi porođaj kao tjelesnu prijetnju za sebe i/ili za svoje novorođenče te 3 % žena nakon porođaja razvije posttraumatski stresni poremećaj (PTSP). Dosadašnja istraživanja upućuju na to da su slabe strategije suočavanja povezane s PTSP-om nakon porođaja, međutim, ta su se istraživanja uglavnom koristila jednodimenzionalnim mjerama strategija suočavanja. Drugim riječima, tek valja ispitati koje specifične dimenzije suočavanja pridonose PTSP-u nakon porođaja. Ciljevi su ovog istraživanja ispitati simptome PTSP-a nakon porođaja te kako su različiti stilovi suočavanja povezani sa simptomima PTSP-a i depresije kod žena u Hrvatskoj. Žene (N = 160) koje su rodile unatrag dvije godine ispunile su online upitnik koji mjeri simptome PTSP-a (Impact of Event Scale – IES), poslijeporođajnu depresiju (Edinburgh Postnatal Depression Scale – EPDS) te stilove suočavanja (Brief Cope). U ovom je uzorku 1.9 % ispitanica izvijestilo o ozbiljnim simptomima PTSP-a nakon porođaja, a 21.9 % ih je izvijestilo o depresivnim simptomima. Većina je žena (66.7 %) sa simptomima PTSP-a izvijestila i o depresivnim simptomima. S druge strane, 28.6 % žena s depresivnim simptomima također je izvijestilo i o simptomima PTSP-a, što upućuje na viši komorbiditet PTSP-a i depresije nego obrnuto. Od izbjegavajućih su stilova suočavanja poricanje i samookrivljavanje pozitivno korelirali sa simptomima PTSP-a i depresije, dok je odustajanje pozitivno koreliralo samo sa simptomima PTSP-a, a odvraćanje pažnje sa simptomima depresije. Također, niže razine planiranja i više razine emocionalne podrške bile su povezane s višom razinom depresivnosti. Međutim, nakon kontroliranja poslijeporođajnih psihopatoloških simptoma stilovi suočavanja nisu bili značajni prediktori simptoma PTPS-a, ali je samookrivljavanje bilo značajni prediktor depresivnih simptoma. Žene u Hrvatskoj izvještavaju o psihopatološkim simptomima nakon porođaja te su oni povezani sa stilovima suočavanja. Izbjegavajući stil suočavanja, samookrivljavanje, posebno je povezan s depresivnim simptomima. Buduća bi istraživanja trebala ispitati prediktore PTSP-a kod hrvatskih žena u reprezentativnijim uzorcima u trudnoći te s praćenjem nakon porođaja. Također, probir za poslijeporođajne psihopatološke simptome trebao bi se provoditi i za simptome depresije i za simptome PTSP-a.

Post-traumatic stress symptomatology among health care professionals in Croatia.

1999 ◽  
Vol 69 (4) ◽  
pp. 529-535 ◽  
Author(s):  
Jodi Shields ◽  
Kristi Erdal ◽  
Jarmila Skrinjaric ◽  
Gordan Majic
Keyword(s):  
Health Care ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Post Traumatic Stress ◽  
Post Traumatic

Adult separation anxiety in patients with complicated grief: relationship with post traumatic stress versus mood spectrum symptomatology

2011 ◽  
Vol 26 (S2) ◽  
pp. 142-142
Author(s):  
C. Carmassi ◽  
C. Socci ◽  
M. Corsi ◽  
I. Pergentini ◽  
E. Massimetti ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Traumatic Stress ◽  
Separation Anxiety ◽  
Complicated Grief ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Event Scale ◽  
Control Subjects ◽  
Post Traumatic ◽  
The Impact

IntroductionAround 9–20% of bereaved individuals experience symptoms of complicated grief (CG) associated with significant distress and impairment. Increasing research has been focused on identifying the distinctive set of psychiatric symptoms that characterize this condition with respect to major depression, corroborating the need to include this syndrome in the forthcoming DSM-V as a distinctive diagnosis. Vulnerability to CG has been rooted in attachment disturbances and authors reported that symptoms of separation anxiety in childhood should be considered as predictors of CG onset in adulthood.ObjectivesTo date no study explored symptoms of adult separation anxiety among patients with CG with respect to healthy control subjects (HC).AimsTo explore adult separation anxiety and mood spectrum symptoms in patients with CG with respect to HC.Methods53 patients with CG and 50 control subjects were recruited, Department of Psychiatry, University of Pisa. Assessments: SCID-I/P, the Inventory of Complicated Grief (ICG), the Adult Separation Anxiety Questionnaire (ASA-27), the Work and Social Adjustment Scale (WSAS), the Impact of Event Scale (IES) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version.ResultsPatients with CG reported significantly higher scores on the MOODS-SR, ASA_27, IES and WSAS with respect to controls. The scores on the ASA_27 were more strongly associated with IES scores with respect to other scales.ConclusionsOur results suggest a correlation between adult separation anxiety and CG onset after the loss of a loved one in adulthood, with a possible correlation to a post-traumatic stress symptomatology. Further studies are needed.

Effects of Support Groups on Post Traumatic Stress Responses in Women Experiencing Stillbirth

2007 ◽  
Vol 55 (1) ◽  
pp. 71-90 ◽  
Author(s):  
Joanne Cacciatore
Keyword(s):  
Support Groups ◽  
Support Group ◽  
Stress Responses ◽  
Traumatic Stress ◽  
Post Traumatic Stress ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Quantitative Results ◽  
Post Traumatic ◽  
The Impact

This research study explores the effects of support groups on traumatic stress responses of women experiencing stillbirth. Women ( N = 47) responded to a mixed method questionnaire. Quantitative results utilizing the Impact of Event Scale Revised demonstrate that women who attend support group, when controlling for time, had fewer post traumatic stress symptoms than did the women who did not attend support group. Qualitative results elucidate the role of support groups in managing grief, suggesting that connectivity with other like women may be a useful strategy in reducing problematic psychological outcomes.

scholarly journals Early cognitive–behavioural therapy for post-traumatic stress symptoms after physical injury

2004 ◽  
Vol 184 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Jonathan I. Bisson ◽  
Jonathan P. Shepherd ◽  
Deborah Joy ◽  
Rachel Probert ◽  
Robert G. Newcombe
Keyword(s):  
Psychological Distress ◽  
Traumatic Stress ◽  
Behavioural Intervention ◽  
Psychological Interventions ◽  
Physical Injury ◽  
Post Traumatic Stress ◽  
Event Scale ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Intervention ◽  
Post Traumatic

BackgroundEarly single-session psychological interventions, including psychological debriefing following trauma, have not been shown to reduce psychological distress. Longer early psychological interventions have shown some promise.AimsTo examine the efficacy of a four-session cognitive–behavioural intervention following physical injury.MethodA total of 152 patients attending an accident and emergency department displaying psychological distress following physical injury were randomised 1–3 weeks post-injury to a four-session cognitive–behavioural intervention that started 5–10 weeks after the injury or to no intervention and then followed up for 13 months.ResultsAt 13 months, the total Impact of Event Scale score was significantly more reduced in the intervention group (adjusted mean difference=8.4, 95% CI 2.4–14.36). Other differences were not statistically significant.ConclusionsAbrief cognitive–behavioural intervention reduces symptoms of post-traumatic stress disorder in individuals with physical injury who display initial distress.

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