福祉関連職におけるMaslach Burnout Inventoryの因子構造の比較

The novel coronavirus disease 2019 (COVID-19) has become a pandemic affecting health and wellbeing globally. In addition to the physical health, economic, and social implications, the psychological impacts of this pandemic are increasingly being reported in the scientific literature. This narrative review reflected on scholarly articles on the epidemiology of mental health problems in COVID-19. The current literature suggests that people affected by COVID-19 may have a high burden of mental health problems, including depression, anxiety disorders, stress, panic attack, irrational anger, impulsivity, somatization disorder, sleep disorders, emotional disturbance, posttraumatic stress symptoms, and suicidal behavior. Moreover, several factors associated with mental health problems in COVID-19 are found, which include age, gender, marital status, education, occupation, income, place of living, close contact with people with COVID-19, comorbid physical and mental health problems, exposure to COVID-19 related news and social media, coping styles, stigma, psychosocial support, health communication, confidence in health services, personal protective measures, risk of contracting COVID-19, and perceived likelihood of survival. Furthermore, the epidemiological distribution of mental health problems and associated factors were heterogeneous among the general public, COVID-19 patients, and healthcare providers. The current evidence suggests that a psychiatric epidemic is cooccurring with the COVID-19 pandemic, which necessitates the attention of the global health community. Future epidemiological studies should emphasize on psychopathological variations and temporality of mental health problems in different populations. Nonetheless, multipronged interventions should be developed and adopted to address the existing psychosocial challenges and promote mental health amid the COVID-19 pandemic.

Epidemiology of mental health problems in COVID-19: a review.

The coronavirus pandemic (COVID-19) will undoubtedly have psychological impacts for healthcare workers, which could be sustained; frontline workers will be particularly at risk. Actions are needed to mitigate the impacts of COVID-19 on mental health by protecting and promoting the psychological wellbeing of healthcare workers during and after the outbreak. We developed and evaluated a digital learning package using Agile methodology within the first three weeks of UK outbreak. This e-package includes evidence-based guidance, support and signposting relating to psychological wellbeing for all UK healthcare employees. A three-step rapid development process included public involvement activities (PPIs) (STEP 1), content and technical development with iterative peer review (STEP 2), and delivery and evaluation (STEP 3). The package outlines the actions that team leaders can take to provide psychologically safe spaces for staff, together with guidance on communication and reducing social stigma, peer and family support, signposting others through psychological first aid (PFA), self-care strategies (e.g., rest, work breaks, sleep, shift work, fatigue, healthy lifestyle behaviours), and managing emotions (e.g., moral injury, coping, guilt, grief, fear, anxiety, depression, preventing burnout and psychological trauma). The e-package includes advice from experts in mental wellbeing as well as those with direct pandemic experiences from the frontline, as well as signposting to public mental health guidance. Rapid delivery in STEP 3 was achieved via direct emails through professional networks and social media. Evaluation included assessment of fidelity and implementation qualities. Essential content was identified through PPIs (n = 97) and peer review (n = 10) in STEPS 1 and 2. The most important messages to convey were deemed to be normalisation of psychological responses during a crisis, and encouragement of self-care and help-seeking behaviour. Within 7 days of completion, the package had been accessed 17,633 times, and healthcare providers had confirmed immediate adoption within their health and wellbeing provisions. Evaluation (STEP 3, n = 55) indicated high user satisfaction with content, usability and utility. Assessment of implementation qualities indicated that the package was perceived to be usable, practical, low cost and low burden. Our digital support package on 'psychological wellbeing for healthcare workers' is free to use, has been positively evaluated and was highly accessed within one week of release. It is available here: Supplementary Materials. This package was deemed to be appropriate, meaningful and useful for the needs of UK healthcare workers. We recommend provision of this e-package to healthcare workers alongside wider strategies to support their psychological wellbeing during and after the COVID-19 pandemic.

Mitigating the Psychological Impact of COVID-19 on Healthcare Workers: A Digital Learning Package.

The novel coronavirus 2019 (COVID-19) is widely spreading all over the world, causing mental health problems for most people. The medical staff is also under considerable psychological pressure. This study aimed to review all research carried out on the mental health status of health care workers (HCWs) to bring policymakers and managers’ attention. A literature search conducted through e-databases, including PubMed, EMBASE, Scopus, and Web of Science (WoS) from December 2019 up to April 12th 2020. All cross- sectional studies published in English which assessed the health workers’ psychological well-being during the SARS-CoV-2 pandemic included. Study quality was analyzed using NHLBI Study Quality assessment tools. One hundred relevant articles were identified through systematic search; of which eleven studies were eligible for this review. Their quality score was acceptable. The lowest reported prevalence of anxiety, depression, and stress among HCWs was 24.1%, 12.1%, and 29.8%, respectively. In addition, the highest reported values for the aforementioned parameters were 67.55%, 55.89%, and 62.99%, respectively. Nurses, female workers, front-line health care workers, younger medical staff, and workers in areas with higher infection rates reported more severe degrees of all psychological symptoms than other health care workers. Moreover, vicarious traumatization in non-front-line nurses and the general public was higher than that of the front-line nurses. During SARS-CoV-2 outbreak, the health care workers face aggravated psychological pressure and even mental illness. It would be recommended to the policymakers and managers to adopt the supportive, encouragement & motivational, protective, and training & educational interventions, especially through information and communication platform.

/pdf/the-mental-health-of-healthcare-workers-in-the-covid-19-57o8heati4.pdf

The mental health of healthcare workers in the COVID-19 pandemic: A systematic review.

COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being.

Physician burnout is a universal dilemma that is seen in healthcare professionals, particularly physicians, and is characterized by emotional exhaustion, depersonalization, and a feeling of low personal accomplishment. In this review, we discuss the contributing factors leading to physician burnout and its consequences for the physician’s health, patient outcomes, and the healthcare system. Physicians face daily challenges in providing care to their patients, and burnout may be from increased stress levels in overworked physicians. Additionally, the healthcare system mandates physicians to keep a meticulous record of their physician-patient encounters along with clerical responsibilities. Physicians are not well-trained in managing clerical duties, and this might shift their focus from solely caring for their patients. This can be addressed by the systematic application of evidence-based interventions, including but not limited to group interventions, mindfulness training, assertiveness training, facilitated discussion groups, and promoting a healthy work environment.

https://www.mdpi.com/2076-328X/8/11/98/pdf

Factors Related to Physician Burnout and Its Consequences: A Review

Several indexes are used to classify physician burnout, with the Maslach Burnout Inventory currently being the most widely accepted. This index measures physician burnout based on emotional exhaustion, detachment from work, and lack of personal achievement. The overall percentage of physicians with burnout is estimated to be around 40%, but the proportion varies between specialties. Neurology currently has the second-highest rate of burnout and is projected to eventually take the top position. The purpose of this review is to provide a comprehensive overview focusing on the causes and ramifications of burnout and possible strategies for addressing the crisis. Several factors contribute to burnout among neurologist, including psychological trauma associated with patient care and a lack of respect compared to other specialties. Various interventions have been proposed for reducing burnout, and this article explores the feasibility of some of them. Burnout not only impacts the physician but also has adverse effects on the overall quality of patient care and places a strain on the health-care system. Burnout has only recently been recognized and accepted as a health crisis globally, and hence most of the proposed action plans have not been validated. More studies are needed to evaluate the long-term effects of such interventions.

https://www.thejcn.com/pdf/10.3988/jcn.2020.16.2.191

Recommended Strategies for Physician Burnout, a Well-Recognized Escalating Global Crisis Among Neurologists

Parkinson’s disease (PD) is the second most common neurodegenerative disorder of adult onset in the United States. It is a debilitating condition and presents with both motor and non-motor symptoms. Current treatment options are scarce and include replacement of dopamine deficiency with levodopa which targets only motor symptoms of the disorder, does not halt its progression, and is associated with side effects of its own, including dyskinesia. With medical marijuana gaining popularity and being legalized in the United States, we examined the pros and cons of marijuana in the treatment of Parkinson’s disease.

Pros and Cons of Marijuana in Treatment of Parkinson’s Disease

Pros and Cons of Marijuana in Treatment of Parkinson's Disease

Background: There is limited literature available showing the mental health burden among adolescents following cyberbullying. Objective: The aim was to evaluate the association between low mood and suicidality among cyberbullied adolescents. Method: A cross-sectional analysis of the data was performed among adolescents from the National Youth Risk Behavior Surveillance System. Responses from adolescents related to cyberbullying and suicidality were evaluated. Chi-square and mix-effect multivariable logistic regression analysis was performed to determine the association of cyberbullying with sadness/hopelessness and suicide consideration, plan, and attempts. Results: Of a total of 8274 adolescents, 14.8% of adolescents faced cyberbullying past year. There was a higher prevalence of cyberbullying in youths aged 15, 16, and 17 years (25%, 26%, 23%, respectively), which included more females than males (68% vs. 32%; p < 0.0001). Caucasians (53%) had the highest number of responses to being cyberbullied compared to Hispanics (24%) or African Americans (11%; p < 0.0001). There was an increased prevalence of cyberbullied youths, feelings of sadness/hopelessness (59.6% vs. 25.8%), higher numbers considering suicide (40.4% vs. 13.2%), suicide plan (33.2% vs. 10.8%), and multiple suicidal attempts in comparison to non-cyberbullied (p < 0.0001). On regression analysis, cyberbullied adolescents had a 155% higher chance of feeling sad and hopeless [aOR = 2.55; 95%CI = 2.39–2.72] and considered suicide [aOR = 1.52 (1.39–1.66)] and suicide plan [aOR = 1.24 (1.13–1.36)]. Conclusion: In our Study, cyberbullying was associated with negative mental health outcomes. Further research is warranted to examine the impact of cyberbullying among adolescents and guiding the policies to mitigate the consequences.

Mansi R Shah

Papers

Factors Related to Physician Burnout and Its Consequences: A Review

Recommended Strategies for Physician Burnout, a Well-Recognized Escalating Global Crisis Among Neurologists

Pros and Cons of Marijuana in Treatment of Parkinson’s Disease

Pros and Cons of Marijuana in Treatment of Parkinson's Disease

Mood and Suicidality among Cyberbullied Adolescents: A Cross-Sectional Study from Youth Risk Behavior Survey