Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore Background: In response to the coronavirus disease 2019 (COVID-19) pandemic, Singapore raised its Disease Outbreak Response System Condition alert to “orange,” the second highest level. Between 19 February and 13 March 2020, confirmed cases rose from 84 to 200 (34.2 per 1 000 000 population), with an increase in patients in critical condition from 4 to 11 (5.5%) and no reported deaths in Singapore (1). Understanding the psychological impact of the COVID-19 outbreak among health care workers is crucial in guiding policies and interventions to maintain their psychological well-being. Objective: To examine the psychological distress, depression, anxiety, and stress experienced by health care workers in Singapore in the midst of the outbreak, and to compare these between medically and non–medically trained hospital personnel. Methods and Findings: From 19 February to 13 March 2020, health care workers from 2 major tertiary institutions in Singapore who were caring for patients with COVID-19 were invited to participate with a self-administered questionnaire. LETTERS

Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore

Background A wide range of evidence has shown that healthcare workers, currently on the frontlines in the fight against COVID-19, are not spared from the psychological and mental health-related consequences of the pandemic. Studies synthesizing the role of coping behaviours, psychological resilience, and social support in safeguarding the mental health of HCWs during the pandemic is largely unknown. Aim (s) To appraise and synthesize studies examining psychological resilience, coping behaviours, and social support among healthcare workers (HWCs) during the coronavirus pandemic. Design This is a systematic review with a narrative synthesis. Method Using articles from PubMed, CINAHL, SCOPUS, MEDLINE and PsychINFO, a total of 31 articles were included in the review. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta□Analyses statement guidelines. Results Healthcare workers were found to have moderate to high levels of psychological resilience and utilized both problem-centred coping (e.g., use of social support, praying) and emotion-centred coping (e.g., use of diversionary activities) to manage the stress-associated with the coronavirus pandemic. Coping behaviours, psychological resilience, and social support were associated with positive mental and psychological health outcomes. Conclusion Substantial evidence supports the effectiveness of coping behaviours, psychological resilience, and social support to preserve psychological and mental health among HCWs during the COVID-19 pandemic. Relevance to Practice In order to safeguard the mental health and well-being of HCWs during the pandemic, hospital and nursing administrators should focus on building coping skills, psychological resilience, and social support in HWCs through innovative and theory-based interventions, supportive leadership, and fostering a resilient work environment.

https://medrxiv.org/content/10.1101/2020.11.05.20226415v1.full.pdf

Psychological resilience, coping behaviours, and social support among healthcare workers during the COVID-19 pandemic: a systematic review of quantitative studies

AIM: To appraise and synthesize studies examining resilience, coping behaviours and social support among health care workers during the coronavirus pandemic. BACKGROUND: A wide range of evidence has shown that health care workers, currently on the frontlines in the fight against COVID-19, are not spared from the psychological and mental health-related consequences of the pandemic. Studies synthesizing the role of coping behaviours, resilience and social support in safeguarding the mental health of health care workers during the pandemic are largely unknown. EVALUATION: This is a systematic review with a narrative synthesis. A total of 31 articles were included in the review. KEY ISSUES: Health care workers utilized both problem-centred and emotion-centred coping to manage the stress associated with the coronavirus pandemic. Coping behaviours, resilience and social support were associated with positive mental and psychological health outcomes. CONCLUSION: Substantial evidence supports the effectiveness of coping behaviours, resilience and social support to preserve psychological and mental health among health care workers during the COVID-19 pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: In order to safeguard the mental health of health care workers during the pandemic, hospital and nursing administrators should implement proactive measures to sustain resilience in HCWs, build coping skills and implement creative ways to foster social support in health care workers through theory-based interventions, supportive leadership and fostering a resilient work environment.

Psychological resilience, coping behaviours and social support among health care workers during the COVID-19 pandemic: A systematic review of quantitative studies.

Prevention of post-traumatic stress symptoms (PTSS) in healthcare workers (HCWs) facing the current COVID-19 pandemic is a challenge worldwide as HCWs are likely to experience acute and chronic, often unpredictable, occupational stressors leading to PTSS. This review aims to analyze the literature to discover which topics have been focused on and what the latest developments are in managing the occupational risk of PTSS in HCWs during the current pandemic. For the purpose of this review, we searched for publications in MEDLINE/Pubmed using selected keywords. The articles were reviewed and categorized into one or more of the following categories based on their subject matter: risk assessment, risk management, occurrence rates. A total of 16 publications matched our inclusion criteria. The topics discussed were: "Risk Assessment", "Occurrence Rates", and "Risk Management". Young age, low work experience, female gender, heavy workload, working in unsafe settings, and lack of training and social support were found to be predictors of PTSS. This review's findings showed the need for urgent interventions aimed at protecting HCWs from the psychological impact of traumatic events related to the pandemic and leading to PTSS; healthcare policies need to consider preventive and management strategies toward PTSS, and the related psychic sequelae, in HCWs.

https://www.mdpi.com/1660-4601/18/2/601/pdf

Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic: A Systematic Review.

Coping with the coronavirus disease (COVID-19) is a significant risk factor for the psychological distress of health workers. Hence, this study explores the relationship between coping strategies used by healthcare and emergency workers in Italy to manage the stress factors related to the COVID-19 emergency, which may result in the risk of developing secondary trauma. We study differences between healthcare (n = 121) and emergency workers (n = 89) in terms of their coping strategies, emergency stress, and secondary trauma, as well as the relationships of these differences to demographic variables and other stress factors (Instructions and Equipment). For this purpose, we collected data from participants through the following questionnaires online: Secondary Traumatic Stress Scale - Italian Version, The Coping Self-Efficacy Scale - Short Form, an original questionnaire on stressors, and the Emergency Stress Questionnaire (to assess organizational-relational, physical, decisional inefficacy, emotional, cognitive, and COVID-19 stress). We performed a t-test, correlational analysis, and hierarchical regression. The analyses reveal that compared with the emergency worker group, the health worker group has greater levels of emergency stress and arousal and is more willing to use problem-focused coping. Healthcare workers involved in the treatment of COVID-19 are exposed to a large degree of stress and could experience secondary trauma; hence, it is essential to plan prevention strategies for future pandemic situations. Moreover, individual efficacy in stopping negative emotions and thoughts could be a protective strategy against stress and secondary trauma.

/pdf/coping-with-covid-19-emergency-stress-secondary-trauma-and-30hbrj6svq.pdf

Coping With COVID-19: Emergency Stress, Secondary Trauma and Self-Efficacy in Healthcare and Emergency Workers in Italy

Being a victim of abuse in childhood can lead to the development of trauma-related psychopathology, which could affect the testimony of the child victim. Post-traumatic stress disorder (PTSD) is a factor that can increase both the levels of suggestibility and the production of memory errors, such as confabulations, which can be identified in distortions and fabrications. No studies have analyzed the relationship between suggestibility, fabrications, distortions, and PTSD on samples of children and adolescents suspected of being sexually abused. This study aims to verify in a sample of 221 sexually abused children and adolescents the effect of PTSD, measured by Trauma Symptoms Checklist for Children, in increasing the levels of immediate and delayed suggestibility and the production of fabrications and distortions in immediate and delayed memory tasks, obtained by Gudjonsson Suggestibility Scale 2, controlling age and non-verbal intelligence. Our results show that PTSD increases the levels of immediate and delayed suggestibility, but it has no effect on memory recall in immediate recall tasks. Moreover, PTSD leads to a greater number of distorted and fabricated information inserted in delayed memory. Forensic implications of PTSD consequences on memory tasks and suggestibility levels of sexually abused children are discussed.

The Relationship between Suggestibility, Fabrication, Distortion, and Trauma in Suspected Sexually Abused Children

Exposure to traumatic events in childhood may lead to the development of important clinical manifestations such as post-traumatic stress disorder (PTSD), often associated with internal defences of a dissociative nature. The present study aims to verify if and how memory tasks and levels of suggestibility are affected by PTSD in children called to testify in cases of suspected sexual abuse. One hundred and fourteen participants (children and adolescents) were recruited, of which 65 developed PTSD following the reported abusive experience. A greater suggestive vulnerability was detected in children with PTSD than in those who had not developed post-traumatic symptoms. Furthermore, the study assessed the relationship between immediate and delayed suggestibility and other symptomatic manifestations associated with trauma, such as anxiety, depression, anger and dissociation.

Effects of post-traumatic stress disorder on interrogative suggestibility in minor witnesses of sexual abuse

The relative impact of different ‘resistant behavioural responses’ on interrogative suggestibility in children: The powerful contribution of ‘direct explanation’ replies to unanswerable questions

Interrogative suggestibility: the role of forensic context and posttraumatic stress in children and adolescents witnesses of suspected sexual abuse

Parental stress is a psycho-social dimension of the parent-child relationship and is influenced by the context in which the relationship is experienced. Separa-tion can affect the functionality/dysfunctionality of parenting skills and the level and quality of perceived stress. The main goal of the present study is to investiga-te the possible predictive effect of parental stress perceived during judicial sepa-ration on parental behaviors of risk and/or psychological prejudice. On a sample of 22 parental couples involved in psychological expert witness, the PSI (Paren-ting Stress Index; Abidin, 1986) was administered in order to analyze parental stress level that takes into account the representation that the parent has of his/her child and of the relationship with him/her. The results reported in the PSI will be analyzed in relation to the evaluation of parental skills conducted with the APS-I tool (Assessment of Parental Skills Interview; Camerini et al., 2007). The results show how high parental stress, especially when perceived in the relation-ship with the child (PCDI scale), tends to assume a predictive effect of risk of emotional abuse and/or emotional and psychological neglect. Parental stress can be an interesting key to understanding dynamics between parents and children and parenting skills, useful both from a clinical point of view and in expert wit-ness in court.

Tiziana Maiorano

Papers

The Relationship between Suggestibility, Fabrication, Distortion, and Trauma in Suspected Sexually Abused Children

Effects of post-traumatic stress disorder on interrogative suggestibility in minor witnesses of sexual abuse

The relative impact of different ‘resistant behavioural responses’ on interrogative suggestibility in children: The powerful contribution of ‘direct explanation’ replies to unanswerable questions

Interrogative suggestibility: the role of forensic context and posttraumatic stress in children and adolescents witnesses of suspected sexual abuse

Stress e competenze genitoriali nelle separazioni giudiziarie. Analisi dei fattori protettivi e di rischio nelle relazioni parentali