Keywords
Categories
How to Cite
Abstract
Introduction: The outbreak of the COVID-19 pandemic put at risk the resilience of healthcare professionals by exposing them to high levels of stress. Our aim was to identify key elements for implementing the STEP programme, a psychological support service for healthcare professionals.
Methods: qualitative design. The study participants were hospital healthcare staff. Anonymous questionnaires and transcriptions of group interventions and focus groups were used to identify professionals’ preferences to receiving psychological support, needs, concerns, resilience (STEP1.0); constrained emotions and associated thoughts (STEP1.5); perception of self-efficacy on managing emotions (STEP2.0); and the professionals’ profile requiring individual therapy.
Results: Three hundred professionals participated in the study, 100.0% in STEP 1.0 , 27.3% in STEP 1.5, 2.7% in STEP 2.0, and 10.0% in individual interventions. Two hundred and three (67.7%) participants reflected in the survey that they would prefer access to a face-to-face psychological service during working hours. Three consecutive phases with specific needs and concerns were identified: The “cognitive” phase, at the beginning of the pandemic, when infection and self-efficacy were major concerns, the “ventilation” phase, when constrained emotions associated with several factors were expressed; and the “recovery” phase, when the clinical overload decreased and professionals were able to focus on emotion management training. Several personal characteristics associated with referral to individual therapy were identified.
Conclusions: The key characteristics of a psychological support service are proximity, face-to-face interaction during working shifts, and a chronological phase system adapted to different emerging needs.
References
Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 Pandemic. JAMA. 2020;323(21):2133-34. doi: 10.1001/jama.2020.5893.
Huang JZ, Han MF, Luo TD, Ren-Ak-Zhou XP. Mental health survey of medical staff in a tertiary infectious disease hospital for COVID-19. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 Mar 20;38(3):192-195. Chinese. doi: 10.3760/cma.j.cn121094-20200219-00063.
Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit. 2020;26:e923549. doi: 10.12659/MSM.923549.
Turner J, Kelly B. The concept of debriefing and its application to staff dealing with life-threatening illnesses such as cancer, AIDS and other conditions. In P. Raphael B, Wilson JP. Psychological debriefing: Theory, practice and evidence. Cambridge: Cambridge University; 2000. p. 254-71.
Bandura A, Cioffi D, Taylor CB, Brouillard ME. Perceived self-efficacy in coping with cognitive stressors and opioid activation. J Per Soc Psychol. 1988;55(3):479-88. doi: 10.1037//0022-3514.55.3.479.
Arnsten A, Mazure CM, Sinha R. Neural circuits responsible for conscious self-control are highly vulnerable to even mild stress. When they shut down, primal impulses go unchecked and mental paralysis sets in. Sci Am. 2012;306(4):48-53. doi: 10.1038/scientificamerican0412-48.
Farchi M, Levy TB, Gershon BB, Hirsch-Gornemann MB, Whiteson A, Gidron Y. The SIX Cs model for Immediate Cognitive Psychological First Aid: From Helplessness to Active Efficient Coping. Int J Emerg Ment Health . 2018;20(2):395. doi: 10.4172/1522-4821.1000395.
Regan A, Howard RA, Oyebode JR. Emotional exhaustion and defense mechanisms in intensive therapy unit nurses. J. Nerv. Ment. Dis. 2009;197(5):330-36. doi: 10.1097/NMD.0b013e3181a20807.
Campos RC. Projection and projective methods: a brief theoretical comment. SIS J Proj Psy & Ment Health. 2009;16(2):166-168. http://hdl.handle.net/10174/1832.
Lahad M. Masking the gas mask: Brief intervention using metaphor, imagery, movement and enactment. In A. Gersie, Dramatic approaches to brief therapy. London: Jessica Kingsley publisher; 1995. pp.139-145.
Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol. 2006;62(3):373-86. doi: 10.1002/jclp.20237.
Foa EB, Cahill SP, Boscarino JA, Hobfoll SE, Lahad M, McNally RJ, Solomon Z. Social, psychological, and psychiatric interventions following terrorist attacks: recommendations for practice and research. Neuropsychopharmacology. 2005;30: 1806-17. doi: 10.1038/sj.npp.1300815.
Weisaeth L. Briefing and debriefing: group psychological interventions in acute stressor situations. In P. Raphael, B., & Wilson, J.P, Psychological debriefing: Theory, practice and evidence. Cambridge: Cambridge University Press. 2000. pp. 43-57.
Diaz-Navarro C, Hadfield A, Pierce S. (2014). TALK for clinical debriefing©. [accessed 22 November 2023]. Available from: https://www.talkdebrief.org/startingtotalk.
Cullen A. Schwartz rounds®. Promoting compassionate care and healthy organisations. J Soc Work Pract. 2016;30(2):219-28. doi.org/10.1080/02650533.2016.1168386.
Mitchell JT, Everly GS. Critical Incident Stress Management and Critical Incident Stress Debriefings: evolutions, effects and outcomes. In P. Raphael B, Wilson JP, Psychological debriefing: Theory, practice and evidence. Cambridge: Cambridge University Press. 2000. pp 71-90.
Institut Assistència Sanitària. Memoria 2018. [accessed 22 November 2023]. Available from: https://es.calameo.com/read/005425181f32c3732255f
Institut Assistència Sanitària. Break bad news role playing. [Video file]. [updated 2020, April 30; accessed 22 November 2023]. Available from: https://youtu.be/cjlPQLHLpgE
Petzold MB, Plag J, Ströhle A. Dealing with psychological distress by healthcare professionals during the COVID-19 pandemia [German]. Nervenarzt. 2020.91:417-21. doi: 10.1007/s00115-020-00905-0.
Liu CY, Yang YZ, Zhang XM, Xu X, Dou QL, Zhang WW, Cheng ASK. (2020). The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiol Infect. 2020;148(e98):1–7. doi: 10.1017/S0950268820001107.
Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. BMJ. 2020;368:m1211. doi: 10.1136/bmj.m1211.
Maunder RG, Lancee WJ, Mae R, Vincent L, Peladeau N, Beduz MA, Hunter JJ, Leszcz M. (2010). Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training. BMC Health Serv Res. 2020;10:72-82. doi: 10.1186/1472-6963-10-72.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2024 Eva Frigola-Capell, Laura Fabregas, Marta Juanola, Mercè Soms, Marta Hernández, Roser Grau, Noelia Alarcón, Neus Colomer, Jordi Cid, Andrés Cuartero-Barbanoj, Jordi Garcia