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Wojnar-Gruszka K, Miernik M, Cichoń J, Liberacka-Lenart D, Płaszewska-Żywko L, Potocka M. Prevalence of the symptoms of post-traumatic stress disorder (PTSD) and burnout syndrome (BOS) among intensive care unit (ICU) healthcare workers during the COVID-19 pandemic. PSYCHOL HEALTH MED 2025; 30:770-781. [PMID: 39841903 DOI: 10.1080/13548506.2025.2455468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/12/2025] [Indexed: 01/24/2025]
Abstract
Pandemic COronaVIrus Disease-19 (COVID-19) was a traumatic event that had a significant impact on the mental health of healthcare workers (HCWs), especially intensive care units (ICUs). Months of exposure and the threat of death can lead to post-traumatic stress disorder (PTSD), and high physical and emotional strain can lead to burnout syndrome (BOS). The purpose of this study was to assess the prevalence of PTSD and BOS among ICU HCWs during the COVID-19 pandemic. A case-control study was conducted in 2022 using a diagnostic survey method with 148 hCWs from two intensive care units: a temporary intensive care unit (tICU, n = 93) and a general intensive care unit (gICU, n = 55) in Cracow, Poland. The Impact of Events Scale (IES-R), Oldenburg Burnout Inventory (OLBI) and a proprietary questionnaire were used. The results obtained indicate that 46.62% (69) of HCWs had pronounced PTSD symptoms. In the tICU HCWs, 47.31% (44) had severe symptoms of PTSD, and in the gICU HCWs, 45.45% (25) were affected. HCWs in the tICU reported the highest score in the Hyperarousal domain (x = 1.52; SD = 0.87), while HCWs from the gICU reported higher scores in the Avoidance domain (xx = 1.45 SD = 0.81). HCWs presented moderate levels of job BOS in the domains of exhaustion (50.68%; 75) and lack of commitment (64.86%; 96). It was shown that lack of commitment to work was significantly more frequent in the tICU group than in the gICU group (p = 0.022). It was shown that the greater the level of exhaustion or withdrawal, the greater the severity of each PTSD symptom. Activity responsibility and fatigue were found to be the most stressful in the workplace. PTSD symptoms co-occurred with BOS. It is necessary to provide employees with targeted psychological support in dealing with the post-pandemic emotional crisis and support the retention of nurses in the profession.
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Affiliation(s)
- Katarzyna Wojnar-Gruszka
- Department of Specialised Nursing, Faculty of Health Sciences, Jagiellonian University - Medical College, Cracow, Poland
| | - Magdalena Miernik
- Department of Anesthesiology and Intensive Care, District Hospital in Bochnia, Bochnia, Poland
| | - Jakub Cichoń
- Department of Specialised Nursing, Faculty of Health Sciences, Jagiellonian University - Medical College, Cracow, Poland
| | - Donata Liberacka-Lenart
- Clinic of Interdisciplinary Intensive Care, Jagiellonian University - Medical College, Cracow, Poland
| | - Lucyna Płaszewska-Żywko
- Department of Specialised Nursing, Faculty of Health Sciences, Jagiellonian University - Medical College, Cracow, Poland
| | - Marcelina Potocka
- Department of Specialised Nursing, Faculty of Health Sciences, Jagiellonian University - Medical College, Cracow, Poland
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Fournier A, Deltour V, Lheureux F, Poujol AL, Ecarnot F, Binquet C, Quenot JP, Laurent A. Association between burnout and PTSD, and perceived stress in the workplace among healthcare workers in the intensive care unit: a PsyCOVID-ICU substudy. PSYCHOL HEALTH MED 2025; 30:752-769. [PMID: 39927681 DOI: 10.1080/13548506.2025.2454038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 01/08/2025] [Indexed: 02/11/2025]
Abstract
The COVID-19 pandemic exposed intensive care unit (ICU) healthcare workers (HCWs) to acute stress (e.g. unpredictability, fear, helplessness) and chronic stress (e.g. prolonged crisis with recurring waves). While the psychological impact has been documented, few studies explore the overlap of these stressors. One year after the pandemic's first peak, we aimed to assess the psychotraumatic impact and burnout among ICU HCW and to examine the relationship between these disorders, and perceived workplace stressors. This study was conducted in 77 ICUs in France between June and July 2021. The online questionnaire included measures of perceived stress, burnout, and symptoms of post-traumatic stress disorder (PTSD). Descriptive analyses investigating the co-occurrence of PTSD/burnout symptoms were conducted and multinomial logistic regression was used to predict membership in these groupings from current perceived stress and a range of relevant demographic variables. Among 1108 hCW included, 318 (28.7%) exhibited only burnout, 34 (3.07%) exhibited only PTSD, and 182 (16.42%) exhibited both conditions simultaneously. These categories of professionals, particularly those with concurrent PTSD and burnout, perceived higher work-related stress than those without burnout and PTSD. These results can be used to provide personalized support for the specific psychological disorders present (burnout or PTSD), with a view to providing HCW with a work environment that is more conducive to their psychological recovery.Clinical trial registrationNCT04944394.
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Affiliation(s)
- Alicia Fournier
- Psychology Laboratory, Dynamiques Relationnelles Et Processus Identitaires (Psy-DREPI), University of Bourgogne Europe, Dijon, France
| | - Victoire Deltour
- Psychology Laboratory, Dynamiques Relationnelles Et Processus Identitaires (Psy-DREPI), University of Bourgogne Europe, Dijon, France
| | - Florent Lheureux
- Psychology Laboratory, University of Burgundy Franche-Comté, Besançon, France
| | - Anne-Laure Poujol
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care, Sorbonne University, Paris, France
- Équipe VCR, École de Psychologues Praticiens, Université catholique de Paris, Paris, EA, France
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Besançon, Besançon, France
- EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Christine Binquet
- Inserm, CIC1432, module Epidémiologie Clinique, Dijon, France
- CHU Dijon-Bourgogne, Centre d'Investigation Clinique-Epidémiologie Clinique/Essais Cliniques, CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Dijon, France
| | - Jean-Pierre Quenot
- CHU Dijon-Bourgogne, Service de Médecine Intensive-Réanimation, Dijon, France
- Equipe Lipness, centre de recherche INSERM, Université de Bourgogne Franche-Comté, UMR1231 Lipides Nutrition Cancer, Lipness, Dijon, France
- FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France
- Espace de Réflexion Éthique Bourgogne Franche-Comté (EREBFC), Dijon, France
| | - Alexandra Laurent
- Psychology Laboratory, Dynamiques Relationnelles Et Processus Identitaires (Psy-DREPI), University of Bourgogne Europe, Dijon, France
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France
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Cavaillon JM, Chaudry IH. Facing stress and inflammation: From the cell to the planet. World J Exp Med 2024; 14:96422. [PMID: 39713080 PMCID: PMC11551703 DOI: 10.5493/wjem.v14.i4.96422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 08/27/2024] [Accepted: 09/19/2024] [Indexed: 10/31/2024] Open
Abstract
As identified in 1936 by Hans Selye, stress is shaping diseases through the induction of inflammation. But inflammation display some yin yang properties. On one hand inflammation is merging with the innate immune response aimed to fight infectious or sterile insults, on the other hand inflammation favors chronic physical or psychological disorders. Nature has equipped the cells, the organs, and the individuals with mediators and mechanisms that allow them to deal with stress, and even a good stress (eustress) has been associated with homeostasis. Likewise, societies and the planet are exposed to stressful settings, but wars and global warming suggest that the regulatory mechanisms are poorly efficient. In this review we list some inducers of the physiological stress, psychologic stress, societal stress, and planetary stress, and mention some of the great number of parameters which affect and modulate the response to stress and render it different from an individual to another, from the cellular level to the societal one. The cell, the organ, the individual, the society, and the planet share many stressors of which the consequences are extremely interconnected ending in the domino effect and the butterfly effect.
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Affiliation(s)
| | - Irshad H Chaudry
- Department of Surgery, University of Alabama Birmingham, Birmingham, AL 35294, United States
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Wozniak H, Douflé G, Hamilton M, Santangelo E, Urner M, Parotto M, Herridge M, Dragoi L. Behind the Mask of ICU Healthcare Workers. Am J Respir Crit Care Med 2024; 209:1429-1430. [PMID: 38484214 PMCID: PMC11208967 DOI: 10.1164/rccm.202402-0350vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/13/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Hannah Wozniak
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Ghislaine Douflé
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; and
| | - Mika Hamilton
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; and
| | | | - Martin Urner
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; and
| | - Matteo Parotto
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; and
| | | | - Laura Dragoi
- Interdepartmental Division of Critical Care Medicine and
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Abdelbaky AM, Eldelpshany MS. Intensive Care Unit (ICU)-Related Post-traumatic Stress Disorder: A Literature Review. Cureus 2024; 16:e57049. [PMID: 38681363 PMCID: PMC11046361 DOI: 10.7759/cureus.57049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
An intensive care unit (ICU) is a challenging environment characterized by frequent incidences of stressors and traumatic situations. Therefore, both patients and caregivers are at high risk of developing psychological disorders such as post-traumatic stress disorder (PTSD), anxiety, and depression. ICU-related PTSD is a significant concern that remains under-recognized. This literature review examines the current state of knowledge regarding ICU-related PTSD, including its prevalence, risk factors, clinical manifestations, and potential interventions. Key findings suggest that a considerable proportion of ICU survivors develop PTSD symptoms, which can significantly impact their quality of life and recovery. The most common predictors investigated for PTSD in ICU survivors are age, gender, pre-illness psychopathy, length of stay in the ICU, delirium, and sedative agents. The treatment and prevention strategies of ICU-related PTSD include psychological therapies and pharmacological and non-pharmacological treatments. Psychological interventions, including cognitive-behavioral therapy and pharmacotherapy, have shown promise in mitigating PTSD symptoms in ICU survivors. However, further research is needed to better understand the mechanisms underlying ICU-related PTSD and to develop targeted interventions to prevent and manage this debilitating condition.
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Mejia CR, Serna-Alarcón V, Vilela-Estrada MA, Armada J, Ubillus M, Beraún-Barrantes J, Álvarez-Risco A, Del-Aguila-Arcentales S, Davies NM, Yáñez JA. Prevalence of post-traumatic stress disorder risk post-COVID-19 in 12 countries in Latin America: a cross-sectional survey. Front Public Health 2024; 11:1302694. [PMID: 38264243 PMCID: PMC10804613 DOI: 10.3389/fpubh.2023.1302694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/06/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Latin America was the region most affected by COVID-19 in the second quarter of 2020, and consequently, the impact on mental health requires evaluation. The aim of this study was to assess the risk of post-traumatic stress disorder (PTSD) caused by bereavement due to COVID-19 in 12 countries in Latin America. Methods The current study was an analytical cross-sectional study. Validated tests were applied for PTSD, depression, anxiety, and stress (DASS-21), questions about the respondent's condition or their environment, and demographic questions, as well as the length of the mourning period of suffering. Results The outcomes demonstrated that the PTSD risk increased for women (p < 0.001), when a friend or acquaintance had COVID-19 (p = 0.002), when a close relative died from COVID-19 (p = 0.010), having severe depression (p <0.001), severe anxiety (p <0.001), severe stress (p <0.001), residing in Chile (p <0.001), Paraguay (p <0.001), Bolivia (p <0.001), Costa Rica (p <0.001) or El Salvador (p = 0.005). On the other hand, there was less risk of PTSD at an older age (p <0.001) or if respondents had a sentimental partner (p = 0.025). In the case of severe PTSD, there was a greater gender risk for women (p <0.001), a close relative dying from COVID-19 (p = 0.017), having severe depression (p <0.001), severe anxiety (p <0.001), severe stress (p <0.001), residing in Chile (p <0.001), Paraguay (p <0.001), Bolivia (p <0.001) and Costa Rica (p = 0.002). It was also observed that there was less risk of severe PTSD at an older age demographic (p <0.001). Discussion It can be concluded that the percentages of PTSD are high in its clinical presentation as severe, especially among Latin American women.
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Affiliation(s)
| | - Víctor Serna-Alarcón
- Universidad Privada Antenor Orrego, Piura, Peru
- Hospital Regional José Cayetano Heredia, EsSalud, Piura, Peru
| | - Martín A. Vilela-Estrada
- Universidad Privada Antenor Orrego, Piura, Peru
- Hospital Regional José Cayetano Heredia, EsSalud, Piura, Peru
| | | | | | | | | | | | - Neal M. Davies
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
- Asociación Médica de Investigación y Servicios en Salud, Lima, Peru
| | - Jaime A. Yáñez
- Universidad Peruana de Ciencias Aplicadas, Facultad de Educación, Carrera de Educación y Gestión del Aprendizaje, Lima, Peru
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