Balloon dilatation of salivary duct stenosis is a simple, safe, and clinically effective method of relieving obstructive symptoms of parotid duct stenosis.
Introduction: Healthcare professionals (HCPs) appear to be at increased risk for negative psychological outcomes [e.g. depression, anxiety, post-traumatic stress disorder (PTSD), moral distress] and associated impacts on functioning throughout the COVID-19 pandemic. HCPs working on designated COVID-19 units may be further impacted than their colleagues not on these units given added demands of patient care and risk of contracting COVID-19. Little is known, however, about the mental health and functioning of specific professional groups beyond nurses and physicians, including respiratory therapists (RTs), over the course of the pandemic. Accordingly, the purpose of the present study was to characterize the mental health and functioning of Canadian RTs and compare profiles between RTs working on and off designated COVID-19 units. Methods: Canadian RTs completed an online survey between February and June 2021, including demographic information (e.g. age, sex, gender,) and measures of depression, anxiety, stress, PTSD, moral distress and functional impairment. Descriptive statistics, correlation analyses and between-groups comparisons were conducted to characterize RTs and compare profiles between those on and off COVID-19 units. Results: Two hundred and eighteen ( N = 218) RTs participated in this study. The estimated response rate was relatively low (6.2%) Approximately half of the sample endorsed clinically relevant symptoms of depression (52%), anxiety (51%) and stress (54%) and one in three (33%) screened positively for potential PTSD. All symptoms correlated positively with functional impairment ( p 's < .05). RTs working on COVID-19 units reported significantly greater patient-related moral distress compared to those not on these units ( p < .05). Conclusion: Moral distress and symptoms of depression, anxiety, stress and PTSD were prevalent among Canadian RTs and were associated with functional impacts. These results must be interpreted with caution given a low response rate, yet raise concern regarding the long-term impacts of pandemic service among RTs.
Background: Healthcare providers (HCPs) may be at elevated risk for moral injury due to increased exposure to potentially morally injurious events (PMIEs) throughout the COVID-19 pandemic. Identifying PMIEs experienced during the COVID-19 pandemic is a critical first step for understanding moral injury in HCPs. Accordingly, the purpose of the present study was to gain a deeper understanding of the work-related PMIEs experienced by HCPs in Canada during the pandemic. Methods: Canadian HCPs completed an online survey between February and December 2021 about mental health and functioning, including demographics and the Moral Injury Outcome Scale (MIOS). We conducted a qualitative thematic analysis of PMIEs described extemporaneously by HCPs in the open-text field of the MIOS. Results: One-hundred and twenty-four (N = 124) HCPs were included in analysis. Eight PMIE-related themes were identified, comprising patients dying alone; provision of futile care; professional opinion being ignored; witnessing patient harm; bullying, violence and divided opinions; resources and personal protective equipment; increased workload and decreased staffing; and conflicting values. Conclusions: Understanding broad categories of PMIES experienced by Canadian HCPs during the COVID-19 pandemic provides an opportunity to enhance cultural competency surrounding their experiences which will aid the development of targeted prevention and intervention approaches.
LAY SUMMARY In 2015, the Canadian Armed Forces (CAF) implemented Operation HONOUR to eliminate sexual misconduct (SM) in the military. Sexual assault, inappropriate sexual behaviours, sexual harassment, and gender discrimination are all types of SM. Experiencing SM can result in depression, substance abuse, physical health problems, and even posttraumatic stress disorder (PTSD). Despite Operation HONOUR, SM still happens in the CAF. At this time, many groups are working together to address SM and to support those who have experienced SM. Canadian-based researchers, policymakers, military members, Veterans, and clinicians are collaborating to identify new approaches to training, culture change, research, and treatment relating to SM in the CAF. The end goal of working together is to minimize SM in the CAF and ensure the health and safety of all CAF members and Veterans.
Throughout the COVID-19 pandemic, healthcare workers (HCWs) have been exposed to highly stressful situations, including increased workloads and exposure to mortality, thus posing a risk for adverse psychological outcomes, including acute stress, moral injury, and depression or anxiety symptoms. Although several reports have sought to identify the types of coping strategies used by HCWs over the course of the pandemic (e.g., physical activity, religion/spirituality, meditation, and alcohol), it remains unclear which factors may influence HCWs’ choice of these coping strategies. Accordingly, using a qualitative approach, the purpose of the present study was to gain a deeper understanding of the factors influencing HCWs’ choice of coping strategies during the COVID-19 pandemic in Canada. Fifty-one HCWs participated in virtual, semi-structured interviews between February and June 2021. Interview transcripts were analysed through an inductive thematic approach, yielding two primary themes. First, HCWs described an ongoing shift in their approach to coping depending on their mental “bandwidth”, ranging from “quick fix” to more “intentional effort” strategies to engage in proactive strategies to improve mental health. Second, many HCWs identified various barriers to desired coping strategies during the pandemic, including the preponderance of pandemic- and other circumstantial-related barriers. The findings from this study offer a unique understanding of the factors influencing HCWs’ choice of coping strategies under novel and increased stress. This knowledge will be central to developing appropriate forms of support and resources to equip HCWs throughout and after the pandemic period, and in mitigating the potential adverse mental health impacts of this period of prolonged stress and potential trauma.
Introduction Paramedics, firefighters, police officers and other public safety personnel (PSP) as well as Canadian Armed Forces (CAF) members are frequently exposed to stressors and demanding work environments. Although their specific work-related tasks may vary, a commonality between these occupations is the significant likelihood of repeated exposure to potentially psychologically traumatic events (PPTE) over the course of their careers. Due in part to these repeated exposures, CAF members and PSP are at an elevated risk of mental health concerns including posttraumatic stress disorder. The purpose of this study was to obtain a more in-depth understanding of the trauma- and non-trauma-related experiences of active or retired PSP and CAF members that may be implicated in mental health issues and resultant treatment and recovery. Methods Study participants were recruited during inpatient treatment at a private mental health and addictions inpatient hospital in Canada. We conducted and audiotaped semistructured focus groups and transcribed the discussions. Interpretive phenomenological analysis and thematic coding generated a coding scheme from which to identify concepts and linkages in the data. Results Analysis generated four primary themes: interpersonal relationships, personal identity, mental health toll and potential moral injury. A variety of subthemes were identified, including family dynamics, inability to trust, feelings of professional/personal betrayal, stigma within the CAF/PSP culture, increased negative emotions about self/others, and a reliance on comradery within the service. Conclusion The information gathered is critical to understanding the perspectives of PSP and military members as the career stressors and related exposure to PPTE of these occupations are unique.
Introduction LLes ambulanciers paramédicaux, les pompiers, les policiers et autres membres du personnel de la sécurité publique (PSP) ainsi que les membres des Forces armées canadiennes (FAC) sont fréquemment exposés à des facteurs de stress et à des environnements de travail exigeants. Même si leurs tâches professionnelles varient, il existe un point commun entre ces métiers : la forte probabilité d’une exposition répétée à des événements potentiellement traumatisants sur le plan psychologique en cours de carrière. En partie à cause de ces expositions répétées, les membres des FAC et du PSP courent un risque accru de problèmes de santé mentale, notamment de trouble de stress post-traumatique. Cette étude visait à obtenir une meilleure compréhension des expériences, qu’elles soient liées à des traumatismes ou non, qui sont susceptibles d’avoir une incidence sur les problèmes de santé mentale ainsi que sur le traitement et le rétablissementn subséquents de membres actifs ou retraités des FAC et des services de sécurité publique. Méthodologie Le recrutement des participants s’est fait parmi les patients séjournant dans un hôpital privé offrant des services sur place de traitement en santé mentale et dépendances. Nous avons mené des séances de discussion semi-dirigées en groupe, qui ont été enregistrées sur bande sonore puis transcrites. Une analyse phénoménologique interprétative et une analyse thématique ont permis d’établir un schéma de codage à partir duquel nous avons identifié les concepts et les associations qui ressortaient des données. Résultats L’analyse a mis en évidence quatre grands thèmes : relations interpersonnelles, identité personnelle, répercussions sur la santé mentale et blessure morale potentielle. Plusieurs sous-thèmes se sont dégagés, en particulier les dynamiques familiales, l’incapacité à faire confiance, des sentiments de trahison professionnelle ou personnelle, la stigmatisation dans la culture des FAC/du PSP, le renforcement des émotions négatives envers soi ou les autres et l’importance accordée à la camaraderie entre collègues. Conclusion L’information recueillie est essentielle pour comprendre les points de vue du PSP et des militaires, car leurs métiers comportent des facteurs de stress spécifiques qui entraînent l’exposition à des événements potentiellement traumatisants sur le plan psychologique.
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