Moral Injury, Traumatic Stress, and Threats to Core Human Needs in Health-Care Workers: The COVID-19 Pandemic as a Dehumanizing Experience

The pandemic has threatened core human needs. The pandemic provides a context to study psychological injury as it relates to unmet basic human needs and traumatic stressors, including moral incongruence. We surveyed 1,122 health-care workers from across the United States between May 2020 and August 2020. Using a mixed-methods design, we examined moral injury and unmet basic human needs in relation to traumatic stress and suicidality. Nearly one third of respondents reported elevated symptoms of psychological trauma, and the prevalence of suicidal ideation among health-care workers in our sample was roughly 3 times higher than in the general population. Moral injury and loneliness predict greater symptoms of traumatic stress and suicidality. We conclude that dehumanization is a driving force behind the psychological injury resulting from moral incongruence in the context of the pandemic. The pandemic most frequently threatened basic human motivations at the foundational level of safety and security relative to other higher order needs.

Occupational injury among paramedics: a systematic review

IntroductionParamedics are frequently exposed to acute and/or chronic environmental, operational and patient-related factors that increase their risk of physical and psychological injury. However, there has been wide variation in reported paramedic injury rates. This systematic review aims to synthesise the evidence to examine the incidence and nature of occupational injury among paramedics.MethodsThis systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO 2020: CRD42020164556). A systematic search of four electronic databases was conducted for the years 2004–2019. Peer-reviewed studies examining the incidence and proportions of paramedic occupational injury within civilian emergency medical services (EMS) were included. Injury types, mechanisms, contributing factors and incidence of injury were synthesised narratively.ResultsTwelve studies met the inclusion criteria. The incidence of injury ranged from 29.7 to 345.6 injuries per 1000 workers per year. Sprains and strains were the most reported injury types, and the trunk and upper limbs were the main sites. Body motion was the most frequently reported mechanism of injury, accounting for 35%–55% of all injuries. Female paramedics had a proportionally higher rate of injury compared with male paramedics. Paramedics aged 25–34 years accounted for the majority of fatal (mean 34.0%) and non-fatal (mean 51.7%) injuries.ConclusionThis review highlights the increased risk of occupational injury among paramedics and provides further insight into their overall injury profile.

Fear of Nurses During COVID-19 Pandemic in Saudi Arabia: A Cross-Sectional Assessment

Objective: We aimed to assess the level of fear among nurses in Saudi Arabia during the COVID-19 outbreak.Methods: A cross-sectional survey-based study was conducted from June to August 2020. All nurses currently working in public and private hospitals in Saudi Arabia during the COVID-19 pandemic were invited to complete an online survey. We used the 7-item unidimensional Fear of COVID-19 Scale (FCV-19S) to assess the level of fear of COVID-19. Multiple regression analysis was used to identify predictors associated with fear of COVID-19.Results: A total of 969 nurses participated in this study. The participants were relatively young with a mean age of 35.5 ± 10.46 years. About two-thirds of the participants were women (65.9%), married (57.2%), and were non-Saudi nationals (67%). The total mean score for the FCV-19S was 19.7 SD 7.03 (range 7–35), which is near the mid-point, indicating a moderate level of fear of COVID-19. Out of the eight variables measured in the analysis, three variables emerged as a significant predictor (i.e., gender, marital status, and age). A higher level of fear (FCV-19S) was associated with being a woman, married, and older age (p ≤ 0.05).Conclusion: This study demonstrated the level of fear of COVID-19 among nurses in Saudi Arabia. Overall, nurses in Saudi reported moderate levels of fear of COVID-19. Assessing the level of fear of nurses who work during the COVID-19 pandemic should be a priority to health care administrators to prevent mental health difficulties or psychological injury.

Patients’ and Families’ Experiences Regarding Disclosure of Patient Safety Incidents

In South Korea, disclosure of patients’ safety incidents is not common in health care settings. Thus, this study identified patients’ and families’ experiences regarding disclosure of patient safety incidents. Data were collected through in-depth individual interviews from May 25, 2020, to June 23, 2020, and analyzed using Colaizzi’s phenomenological method. The participants consisted of 15 patients and their families who had experienced patient safety incidents in hospitals. It is essential to form a base of mutual understanding to enable disclosure and promote follow-up management systems that can ethically and responsibly handle patient safety incidents. Concrete protocols and policies need to be developed to protect patients and their families from physical/psychological injury and the stress experienced due to patient safety incidents. The patients and their families desired changes to improve protocols for proper disclosure, help health care professionals adopt an ethical and mature attitude, and develop professional health care policies regarding patients’ safety incidents.

Dilemas éticos en la práctica psicológica forense: Revisión sistemática y análisis bibliométrico

La función del psicólogo forense enfrenta múltiples dilemas éticos, presentando especiales desafíos para la formación y ejercicio profesional. Este estudio tiene como objetivo identificar los principales dilemas éticos con los que se enfrenta en la práctica el psicólogo forense expuestos por la literatura especializada de 2010 al 2019 desde una perspectiva internacional, además de realizar un análisis bibliométrico. Para ello, se llevó a cabo una revisión sistemática siguiendo las recomendaciones del estándar PRISMA. La búsqueda partió de una base de 7889 artículos, de la cual se extrajeron 197 para finalmente seleccionar 16 para este estudio. En ellos se identificaron 124 menciones de dilemas éticos que se sintetizaron en 77, los cuales fueron clasificados en seis categorías: objetividad, conflicto de intereses, obtención y uso de información, consentimiento, competencia profesional, e intervención. Del análisis bibliométrico, se destaca que la mitad de los documentos fueron elaborados en Estados Unidos de América y ninguno en Latinoamérica; el 87% en idioma inglés y el 12.5% en español. Sin embargo, la revista Anuario de Psicología Jurídica fue la que publicó un mayor número de dilemas. De los documentos analizados, el año en el que fueron publicados más artículos fue el 2014 y la revista que más publicaciones emitió fue Psychological Injury and Law. Se concluye que son reducidos los estudios en los que se aborda el tema de los dilemas éticos en la práctica de la psicología forense, y ninguno de ellos se ha publicado en México.

Pendampingan Pastoral Kepada Perempuan Korban KDRT dI HKBP

This research is intended to give attention to members of the congregation, especially women (wives) victims of Domestic Violence (Domestic Violence) in the HKBP church, especially HKBP Duren Sawit. Cases of domestic violence experienced by women as victims greatly affect their personal lives and relationships to others. Women victims of domestic violence suffer physical and psychological injury. This happens as a result of the violence and suffering experienced. Based on this the authors conducted research and provide assistance through pastoral assistance that is sustaining, reconciling and healing. Supporting is to strengthen women victims of domestic violence who are experiencing a crisis so that they do not dissolve in their sadness, disappointment and fear. Reconciling is helping women victims of domestic violence build and renew their relationships with God and others. Healing is overcoming the damage suffered by women domestic violence, returning to wholeness and leading it to a better direction. Sampling was carried out for five female congregation (wife) victims of domestic violence at the HKBP Duren Sawit church. Pastoral assistance from the Duren Sawit HKBP church to victims of domestic violence has never been done well and seriously. This makes the congregation of victims of domestic violence despair because of the violence and suffering they experienced, thus making it stay in a feeling of confusion and fear. As a result there are congregation victims of domestic violence who actually go outside the church, to seek protection in the hope of receiving strength and recovery. Crisis counseling is a form of service that the church can do to women victims of domestic violence, so that they can experience strengthening, reconciliation, and healing from the violence and suffering experienced.

The Effectiveness of De-Escalation Techniques as Compared to Physical Restraint/Seclusion on Inpatient Psychiatric Units: A Quantitative Systematic Review

BackgroundRestraint and seclusion were considered a form of treatment but consistently has led to physical and mental injuries to staff and patients. De-escalation has been viewed as a safer option. Understanding which intervention yields decreased injuries, aggression and violence will guide policy and inform practice.ObjectivesTo identify which intervention leads to decreased physical and psychological injury to patients and staff.MethodsThe frequency of physical injuries to patients and staff from aggressive patients; frequency of psychological injuries to patients and staff from violent, aggressive incidents; frequency of violence, agitation and aggression; competence of staff at managing aggression and violence were evaluated.ResultsFourteen studies were included in this review. There are many forms of de-escalation. Studies where techniques were taught to staff, the intervention was effective in decreasing injury in approximately half the studies. De-escalation techniques taught to patients decreased injury in 100% of the studies included in this review.ConclusionConsensus on which intervention works best could not be reached, nor is there overwhelming evidence for a particular type of de-escalation better suited for decreasing aggression and violence. Caution should be exercised when choosing a de-escalation technique for implementation in institutions due to lack of regulating agencies that inform practice and standards. In addition, the literature lacks best practices for de-escalation techniques backed by evidence. Restraint and seclusion should be used as a last resort due to inherent risk associated with the intervention.

A Realist Review of Violence Prevention Education in Healthcare

Violence from patients and visitors towards healthcare workers is an international concern affecting the safety and health of workers, quality of care, and healthcare system sustainability. Although the predominant intervention has been violence prevention (VP) education for healthcare workers, evaluating its effectiveness is challenging due to underreporting of violence and the inherent complexity of both violence and the health care environment. This review utilized a theory-driven, realist approach to synthesize and analyze a wide range of academic and grey literature to identify explanations of how and why VP education makes a difference in preventing violence and associated physical and psychological injury to workers. The review confirmed the importance of positioning VP education as part of a VP strategy, and consideration of the contexts that influence successful application of VP knowledge and skills. Synthesis and analysis of patterns of evidence across 64 documents resulted in 11 realist explanations of VP education effectiveness. Examples include education specific to clinical settings, unit-level modeling and mentoring support, and support of peers and supervisors during violent incidents. This review informs practical program and policy decisions to enhance VP education effectiveness in healthcare settings.