PREVALENCE OF POST-TRAUMATIC STRESS DISORDER AND RELATED FACTORS IN 112 EMPLOYEES IN THE 11th MONTH OF THE PANDEMİC

Yıl 2024, Cilt: 9 Sayı: 1, 29 - 50, 01.07.2024

Özge Çelen Zeynep Şimşek

https://doi.org/10.54409/hod.1469745

Öz

Objectives: In this study, the prevalence of post-traumatic stress disorder and associated factors among 112 employees was determined in the 11th month of the COVID-19 pandemic, with the aim of preparing for pandemics expected to increase with climate change.
Material and Methods: In this cross-sectional study, 440 paramedics randomly selected, and "Socio-demographic Information Form", "Life Events Checklist" and "Post Traumatic Stress Disorder Control Form" were used for data collection.
Results: 49.5% of the participants were female and the mean age was 29.9±7.34. The prevalence of Post Traumatic Stress Disorder (PTSD) was 59.8%. Multiple regression analysis showed that approximately 25% of the total PTSD score was explained independently by general health situation and socio-demographic characteristics of paramedics, 27% by crisis management skills, long working hours, lack of equipment and traffic density, and 40% by difficult life events during their professional practice intervention such as gun injuries and being attacked by gunfire, sexual assault, brutal death and causing injury/death to another person from past traumatic experiences (p<0.05).
Conclusion: Based on these findings, in order to prevent/control of PTSD in paramedics; it is thought that it would be beneficial to integrate mental health monitoring system into the health and safety program and to apply regular supervision and psycho- social support interventions for high-risk groups in terms of controlling individual and occupational factors of paramedics and to include them in health services’ disaster preparedness plans.

Anahtar Kelimeler

Paramedics, Covid-19 Pandemia, Post Traumatic Stress Disorder, Traumatic Experiences, Individual and Occupational Factors

Destekleyen Kurum

Istanbul Bilgi University, Istanbul Provincial Directorate of Health

Teşekkür

Authors are thankful to Istanbul Health Directorate Emergency Health Services for providing the authority to conduct this research.

PANDEMİNİN 11. AYINDA 112 ÇALIŞANLARINDA TRAVMA SONRASI STRES BOZUKLUĞU GÖRÜLME SIKLIĞI VE İLİŞKİLİ FAKTÖRLER

Öz

Amaç: Bu çalışmada iklim değişikliğiyle birlikte artması beklenen pandemilere hazırlık amacıyla, COVID-19 pandemisinin 11. ayında 112 çalışanlarında travma sonrası stres bozukluğu prevalansı ve ilişkili faktörler saptanmıştır.
Gereç ve Yöntemler: Kesitsel tipteki bu araştırmaya rastgele örnekleme yöntemiyle seçilen 440 paramedik katıldı. Veri toplamada "Sosyodemografik Bilgi Formu", "Yaşam Olayları Kontrol Listesi" ve "Travma Sonrası Stres Bozukluğu Kontrol Listesi" kullanıldı.
Bulgular: Katılımcıların %49,5'i kadın ve yaş ortalaması 29,9±7,34 idi. Travma Sonrası Stres Bozukluğu (TSSB) yaygınlığı %59,8’dur. Çoklu regresyon analizi, toplam TSSB puanının yaklaşık %25'ini paramediklerin genel sağlık durumu ve sosyo-demografik özelliklerinin, %27'sini kriz yönetimi becerisi, uzun çalışma saatleri, ekipman eksikliği ve trafik yoğunluğunun, %40'ını ise travmatik yaşantılardan silah yaralanmalara, cinsel saldırıya, vahşice ölüme ve bir başkasının yaralanmasına/ ölümüne neden olan olaylara müdahale bağımsız olarak açıklamıştır (p<0.05).
Sonuç: Bulgulara dayanarak paramediklerde TSSB'nin önlenmesi amacıyla; bireysel ve mesleki faktörlerin kontrolüne yönelik çalışan sağlığı ve güvenliği programlarına ruh sağlığı izleminin entegre edilmesinin, risk altındaki gruplara düzenli süpervizyon verilmesinin ve psiko-sosyal destek müdahalelerinin uygulanmasının, belirtilen girişimlerin afete hazırlık planlarına dahil edilmesinin yararlı olacağı düşünülmektedir.

Anahtar Kelimeler

Paramedikler, Covid-19 Pandemisi, Travma Sonrası Stres Bozukluğu, Travmatik Yaşantılar, Kişi ve Ortam Faktörleri

Kaynakça

• Adams, R. E., Boscarino, J. A., & Figley, C. R. (2008). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 78(4), 466.
• Alexander, D. A., & Klein, S. (2001). Ambulance personnel and critical incidents: Impact of accident and emergency work on mental health and emotional well-being. British Journal of Psychiatry, 178(1), 76-81.
• Almutairi, I., Al-Rashdi, M., Almutairi, A. (2020). Prevalence and Predictors of Depression, Anxiety and Stress Symptoms in Paramedics at Saudi Red Crescent Authority. Saudi J Med Med Sci, 8 (2), 105-111. doi: 10.4103/sjmms.sjmms_227_18.
• Avcı, S., Yağcı, İ. (2021). Psychological Status of Emergency Department Personnel During the COVID-19 Pandemic Period. Bozok Medical Journal, 11 (1), 49-55. Doi:10.16919/bozoktip.778738.
• Barger, L. K., Cade, B. E., Ayas, N. T., Cronin, J. W., Rosner, B., Speizer, F. E., & Czeisler, C. A. (2009). Extended work shifts and the risk of motor vehicle crashes among interns. New England Journal of Medicine, 352(2), 125-134.
• Baykal, D., Tütüncü, S.K. (2021). The Perceived Stress of Paramedics and Paramedic Students on Their Stress Coping Behaviors During COVID. Genel Sağlık Bilimleri Dergisi, 3 (2), 90- 101. doi:10.51123/jgehes.2021.20.
• Baysak, E., Zengin Eroglu, M., Cisem, U., Kaya, B., Baysak, E. (2019). Evaluation of PostTraumatic Stress Disorder, Burnout and Coping Styles in Emergency and Intensive Care Unit Employees. Clinical Psychiatry, 22, 36-47. doi:10.5505/kpd.2018.557072010.
• Beaton, R. D., & Murphy, S. A. (1995). Working with people in crisis: Research implications. Journal of Mental Health Counseling, 17(3), 249-259.
• Benfante, A., Di Tella, M., Romeo, A, Castelli, L. (2020). Traumatic Stress in Healthcare Workers During COVID-19 Pandemic: A Review of the Immediate Impact. Front Psychol, 23 (1), 569935. doi:10.3389/fpsyg.2020.569935.
• Blanco, C., Xu, Y., Brady, K., Pérez-Fuentes, G., Okuda, M., & Wang, S. (2013). Comorbidity of posttraumatic stress disorder with alcohol dependence among US adults: Results from the National Epidemiological Survey on Alcohol and Related Conditions.
• Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000 Oct;68(5):748-66. doi: 10.1037//0022-006x.68.5.748.
• Bremner, J. D., Southwick, S. M., Johnson, D. R., Yehuda, R., & Charney, D. S. (1993). Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans. American Journal of Psychiatry, 150(2), 235-239.
• Bryant, R. A., Harvey, A. G., Guthrie, R. M., & Moulds, M. L. (2000). Acute psychophysiological arousal and posttraumatic stress disorder: A two-year prospective study. Journal of Traumatic Stress, 13(4), 659-664.
• Buneviciene I, Bunevicius R, Bagdonas S, Bunevicius A. The impact of pre-existing conditions and perceived health status on mental health during the COVID-19 pandemic. J Public Health (Oxf). 2022 Mar 7;44(1):e88-e95. doi: 10.1093/pubmed/fdab248.).
• Carmassi, C., Cerveri, G., Bertelloni, C.A., Marasco, M., Dell'Oste, V., Massimetti, E., ve ark. (2021). Mental Health of Frontline Help-seeking Healthcare Workers During the COVIDOutbreak in the First Affected Hospital in Lombardy, Italy. Psychiatry Res, 298, 113763. doi:10.1016/j.psychres.2021.113763.
• Carmassi, C., Foghi, C., Dell'Oste, V., Cordone, A., Bertelloni, C.A., Bui, E., ve ark. (2020). PTSD Symptoms in Healthcare Workers Facing the Three Coronavirus Outbreaks: What can We Expect After the COVID-19 Pandemic. Psychiatry Res, 292, 113312. doi: 10.1016/j.psychres.2020.113312.
• Chirico, F., Nucera, G., Magnavita, N. (2020). COVID-19: Protecting Healthcare Workers is a Priority. Infect Control Hosp Epidemiol, 41 (9), 1117. doi:10.1017/ice.
• Everly, G. S., & Mitchell, J. T. (1999). Critical incident stress management (CISM): A new era and standard of care in crisis intervention. Chevron Publishing Corporation.
• Everly, G. S., McCabe, O. L., Semon, N. L., Thompson, C. B., & Links, J. M. (2014). The development of a model of psychological first aid for non–mental health trained public health personnel: The Johns Hopkins RAPID-PFA. Journal of Public Health Management and Practice, 20(Suppl 5), S24-S29.
• Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1-20). Routledge.
• Fu SS, McFall M, Saxon AJ, Beckham JC, Carmody TP, Baker DG, Joseph AM. Post-traumatic stress disorder and smoking: a systematic review. Nicotine Tob Res. 2007 Nov;9(11):1071-84. doi: 10.1080/14622200701488418).
• Gallagher, S., McGilloway, S. (2009). Experience of Critical Incident Stress Among Ambulance Service Staff and Relationship to Psychological Symptoms. Int J Emerg Ment Health, 11 (4), 235-248. Gökçen, I., Karaman, Y., Yastıbaş, C. (2021). What is the Relationship of Depression, Anxiety and Post-traumatic Stress Symptoms with Sociodemographic and Vocational Variables in Healthcare Professionals Who Work in Covid-19 Pandemia? Van Medical Journal, 28 (2), 249- 257. doi:10.5505/vtd.2021.55453.
• Hapke, U., Schumann, A., Rumpf, H. J., John, U., & Meyer, C. (2005). Association of smoking and nicotine dependence with trauma and posttraumatic stress disorder in a general population sample.
• Hobfoll, S. E., Watson, P., Bell, C. C., Bryant, R. A., Brymer, M. J., Friedman, M. J., ... & Ursano, R. J. (2007). Five essential elements of immediate and mid–term mass trauma intervention: Empirical evidence. Psychiatry: Interpersonal and Biological Processes, 70(4), 283-315.
• Jonsson, A., Segesten, K. (2004). Guilt, Shame and Need for a Container: A Study of PostTraumatic Stress Among am Bulance Personnel. Accident and Emergency Nursing, 12, 215- 223. Kang, L., Ma, S., Chen, M., Yang, J., Wang, Y., Li, R., ve ark. (2020). Impact on Mental Health and Perceptions of Psychological Care Among Medical and Nursing Staff in Wuhan During the 2019 Novel Coronavirus Disease Outbreak: A Cross-Sectional Study. Brain Behav Immun, 87, 11-17. doi: 10.1016/j.bbi.2020.03.028.
• Karancı, AN., Aker, T., Işıklı, S., Erkan, BB., Gül, E., Yavuz, H. (2012). Türkiye’de Travmatik Yaşam Olayları ve Ruhsal Etkileri. Ankara: Matus Basımevi.
• Li, G., Miao, J., Wang, H., Xu, S., Sun, W., Fan, Y., ve ark. (2020). Psychological Impact on Women Health Workers Involved in COVID-19 Outbreak in Wuhan: A Cross-Sectional Study. J Neurol Neurosurg Psychiatry, 91 (8), 895-897. doi:10.1136/jnnp-2020-323134.
• Lund, C., Breen, A., Flisher, A. J., Kakuma, R., Corrigall, J., Joska, J. A., ... & Patel, V. (2010). Poverty and common mental disorders in low and middle income countries: A systematic review.
• Marczewski, K.P., Piegza, M., Gospodarczyk, A., Pudlo, R., Sosada, K. (2021). Emotional Problems and Sleep Disturbances in Paramedics in the Era of the Covid-19 Pandemic. Wiad Lek, 74 (7), 1754-1757.
• Marmar, C. R., McCaslin, S. E., Metzler, T. J., Best, S., Weiss, D. S., Fagan, J., ... & Neylan, T. (2006). Predictors of posttraumatic stress in police and other first responders. Annals of the New York Academy of Sciences, 1071(1), 1-18.
• McFarlane, A.C., Bryant, R.A. (2007). Post-traumatic Stress Disorder in Occupational Settings: Anticipating and Managing the Risk. Occup Med (Lond), 57 (6), 404-10. doi: 10.1093/occmed/kqm070.
• Miori S, Sanna A, Lassola S, Cicolini E, Zanella R, Magnoni S, De Rosa S, Bellani G, Umbrello M. Incidence, Risk Factors, and Consequences of Post-Traumatic Stress Disorder Symptoms in Survivors of COVID-19-Related ARDS. Int J Environ Res Public Health. 2023 Apr 13;20(8):5504. doi: 10.3390/ijerph20085504. PMID: 37107786; PMCID: PMC10138688.
• Mojica-Crespo, R., Morales-Crespo, M.M. (2020). Pandemic COVID-19, the New Health Emergency of International Concern: A Review. Semergen. 46, (1), 65-77. doi: 10.1016/j.semerg.2020.05.010.
• National Association of Social Workers (NASW) (2013) ‘Code of Ethics: Overview’, Available online at: http://www.socialworkers.org/pubs/code/default.asp, 29.07.2023.
• Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V.G., Papoutsi, E., Katsaounou, P. (2020). Prevalence of Depression, Anxiety, and Insomnia Among Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. Brain Behav Immun, 88, 901- 907. doi: 10.1016/j.bbi.2020.05.026.
• Regmi, P., Paneru, D.P., Oli, P., Baral, U., Poudel, D., Khadka Thapa, D. (2022). Ambulance Service in Kathmandu, Nepal: Service Delivery Constraints, Challenges, and Achievements During the COVID-19 Pandemic. Prehosp Disaster Med, 5, 1-8. doi:10.1017/S1049023X22002242.
• Reker, G. T., & Chamberlain, K. (Eds.). (2000). "Exploring Existential Meaning: Optimizing Human Development Across the Life Span." Thousand Oaks, CA: Sage Publications.
• Riedel, B., Horen, S.R., Reynolds, A., Hamidian Jahromi, A. (2021). Mental Health Disorders in Nurses During the COVID-19 Pandemic: Implications and Coping Strategies. Front Public Health, 9, 707358. doi:10.3389/fpubh.2021.707358.
• Sakusic A, Avdibegovic E, Zoricic Z, Pavlovic S, Gaspar V, Delic A. Relationship between anger, alcoholism and symptoms of posttraumatic stress disorders in war veterans. Med Arh. 2010;64(6):354-8.
• Sareen, J., Cox, B. J., Clara, I., & Asmundson, G. J. (2005). The relationship between anxiety disorders and physical disorders in the US National Comorbidity Survey.
• Schnurr, P. P., & Green, B. L. (2004). Understanding relationships among trauma, posttraumatic stress disorder, and health outcomes.
• Shi, L., Wang, L., Jia, X., Li, Z., Mu, H., Liu, X., ... & Fan, L. (2017). Prevalence and correlates of symptoms of post-traumatic stress disorder among Chinese healthcare workers exposed to physical violence: a cross-sectional study. BMJ open, 7(7), e016810.
• Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences, 1141(1), 105-130.
• Svensson, A., Fridlund, B. (2008). Experiences of and action towards worries among ambulance nurses in their professional life: A critical incident study. International Emergency Nursing. (16(1): 35-42.
• Suryavanshi, N., Kadam, A., Dhumal, G., Nimkar, S., Mave, V., Gupta, A., ve ark. (2020). Mental Health and Quality of Life Among Healthcare Professionals During the COVID-19 Pandemic in India. Brain Behav, 10 (11), e01837. doi: 10.1002/brb3.1837.
• Şahin, E., Cerit, C. (2019). A Research of Post-traumatic Stress and Depression Symptoms in Emergency Ambulance Staff: Districts of Mersin Case Study. Journal of Health Sciences of Kocaeli University, 5 (3), 156-160.
• Taylor, S. E., & Stanton, A. L. (2007). Coping resources, coping processes, and mental health. Tedeschi, R. G., & Calhoun, L. G. (2004). "Posttraumatic growth: Conceptual foundations and empirical evidence." Psychological Inquiry, 15(1), 1-18.
• Vindegaard, N., Benros, M.E. (2020). COVID-19 Pandemic and Mental Health Consequences: Systematic Review of the Current Evidence. Brain Behav Immun. 89, 531-542. doi: 10.1016/j.bbi.2020.05.048.
• Walton, M., Murray, E., Christian, M.D. (2020). Mental Health Care for Medical Staff and Affiliated Healthcare Workers During the COVID-19 Pandemic. Eur Heart J Acute Cardiovasc Care, 9 (3), 241-247. doi:10.1177/2048872620922795.
• Wang, J., Zhou, M. ve Liu, F. (2019). Reasons for Healthcare Workers Becoming Infected with Novel Coronavirus Disease 2019 (COVID-19) in China. J Hosp Infect. 105 (1), 100-101. doi: 10.1016/j.jhin.2020.03.002.
• Weathers, F.W., Blake, D.D., Schnurr, P.P., Kaloupek, D.G., Marx, B.P., Keane, T.M. (2013). The Life Events Checklist for DSM-5 (LEC-5). www.ptsd.va.gov, 10.12.2022.
• Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., Schnurr, P.P. (2013). The PTSD Checklist for DSM-5 (PCL-5). https://www.ptsd.va.gov/professional/assessment/adultsr/ptsdchecklist.asp, 10.12.2023. World Health Organization (2022). Mental Health at Work; Fact Sheets. WHO. https://www.who.int/news-room/fact-sheets/detail/mental-health-at-work, 28.09.2022.
• Yasal, D., & Günüşen, N. P. (2019). Acil Serviste Çalışan Hemşirelerin Travma Sonrası Stres Belirtilerini Etkileyen Faktörler ve Hemşirelerin Başetme Yollarının İncelenmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 12(1), 74-81.
• Yin, Q., Sun, Z., Liu, T., Ni, X., Deng, X., Jia, Y., ve ark. (2019). Posttraumatic Stress Symptoms of Health Care Workers During the Corona Virus Disease 2019. Clin Psychol Psychother, 27 (3), 384-395. doi: 10.1002/cpp.2477.