Nurses may be at a higher risk of experiencing work-related traumatic stress response during the COVID-19 pandemic compared to other clinicians. This study aimed to investigate the correlations between work-related trauma symptoms and demographic factors, psychosocial hazards and stress response in a census sample of nurses working in COVID-19 settings in Cyprus. In this nationwide descriptive and cross-sectional study, data were collected between April and May 2020 using a questionnaire that included sociodemographic, educational and employment and work-related variables, as well as a modified version of the Secondary Traumatic Stress Scale (STSS) for the assessment of work-related trauma symptoms during the pandemic. Overall, 233 nurses participated (with a response rate of 61.3%) and 25.7% of them reported clinical work-related trauma symptoms (STSS-M > 55; actual scale range: 17–85). The mean value for emotional exhaustion was 7.3 (SD: 2.29; visual scale range: 1–10), while the value for distress that was caused by being avoided due to work in COVID-19 units was 6.98 (SD: 2.69; visual scale range: 1–10). Positive associations were noted between trauma symptoms and both emotional exhaustion and distress from being avoided by others due to work in a COVID-19 setting and a negative association was also found between trauma symptoms and satisfaction from organizational support variables (all p < 0.002). Working in COVID-19 settings during the pandemic is a stressful experience that has been linked to psychologically traumatic symptoms Thus, supportive measures are proposed for healthcare personnel, even in countries with low COVID-19 burden.

Background Addressing the enhancement of ill health self-management skills in adults diagnosed with bipolar disorder may be considered an important intervention for health care systems worldwide. Objective This protocol describes the study “Management of my Bipolarity” (MoB), which aims to develop an educational intervention for adults with bipolar disorder and assess its effectiveness. The objectives include (a) a literature review on bipolar disorder educational interventions; (b) a qualitative exploration of the educational needs of people with bipolar disorder; (c) development of an educational intervention based on objectives (a) and (b) (ie, the MoB educational intervention); and (d) exploration of the effectiveness of the intervention regarding participants’ knowledge of their mental health condition and enhancement of their ill health self-management skills. The MoB educational intervention will consist of an in-person and a web-based intervention in the form of a digital platform. Methods The proposed interventional study is a combination of a qualitative and a quantitative design (mixed methods study). A focus group and content analysis will be implemented for the qualitative assessment of the educational needs of adults with bipolar disorder. The intervention will be developed based on the qualitative data of the study and relevant literature. The effectiveness of the acquired knowledge and self-management skills will be assessed according to (a) substance use behavior, (b) health locus of control, (c) impulse control, (d) adherence to pharmacotherapy, (e) relapse prevention, (f) improvement of quality of life, and (g) bipolar disorder knowledge level via structured instruments in the quantitative part of the study using descriptive and inferential statistics (SPSS version 24.0). Results A total of 13 patients with bipolar disorder have been interviewed (8 women, 5 men) to identify educational needs to be covered through the intervention. Moreover, a literature review on bipolar disorder educational interventions has been completed. These data have been incorporated in the design of the MoB in-person intervention and the digital platform. The digital platform is live, and the development of the MoB in-person intervention was completed at the end of 2020. The recruitment of the participants for the intervention (40 patients) and the control group (40 patients) began during the first semester of 2021. Moreover, by tracking the platform for 1.5 years, we have recorded that 2180 users have visited the platform with an average session duration of almost 2 minutes. Mobile and tablet devices are being used by 70% of the visitors. Conclusions Since new parameters regarding educational interventions will be explored, these findings are expected to provide evidence that participation in structured educational interventions offers patients the opportunity to improve adherence to pharmacotherapy and increase their quality of life. Trial Registration ClinicalTrials.gov NCT04643210; https://clinicaltrials.gov/ct2/show/NCT04643210 International Registered Report Identifier (IRRID) DERR1-10.2196/25168

ObjectiveThe aim of the present article is to present the operating protocol of this helpline, as well as preliminary results of its evaluation.BackgroundThe “We Are Together” telephone support helpline (TSH) was developed for the empowerment of healthcare professionals in view of the psychological distress associated with the Covid-19 pandemic.MethodsBased on a scoping literature review the steps for the development of the TSH included: (a) identification of the objectives of the TSH, (b) description of the basic concepts and the structure of the telephone call, (c) development of the operating tools of the TSH, (d) definition of criteria for the enrollment of mental health professionals, (e) development of an educational program for those staffing the TSH, (f) design of the monitoring and evaluation methods of the TSH. Preliminary evaluation of the helpline was based on descriptive statistics (volume and length of calls, demographic and vocational data of service users, cause of call, number of recalls).ResultsDuring the first month of the helpline operation, only a limited number of calls was received. Only 20% of the service users were healthcare professionals, specifically emergency and critical care nurses, while the rest came from various backgrounds, including healthcare students, private sector employed citizens, unemployed, people with mental health issues, and the elderly. The majority of users were female.ConclusionAdditional measures to monitor and evaluate the effectiveness of the TSH regarding the psychological and mental health needs of its users are necessary.

BACKGROUND Interventions addressing enhancement of ill health self-management skills in adults diagnosed with a bipolar disorder may be considered as important elements of healthcare systems worldwide. OBJECTIVE This protocol describes the study “Management of my Bipolarity” which aims to develop an educational intervention for adults with a bipolar disorder and assess its effectiveness. Objectives include: a) a literature review on bipolar disorders educational programs, b) qualitative exploration of the educational needs of people with a bipolar disorder, c) development of an educational program based on a and b objectives [MoB educational intervention (ΜοΒ ΕΙ)], d) exploration of the effectiveness of the MoB ΕΙ regarding participants’ knowledge on their mental health condition and enhancement of ill health self-management skills. METHODS The effectiveness of the acquired knowledge and self-management skills will be assessed according to the degree of a) cognitive functioning, b) impulse control, c) adherence to pharmacotherapy, d) relapse prevention, d) improvement of quality of life. The proposed study is a combination of a qualitative and a quantitative, interventional design (mixed methods study). A focus group and content analysis will be implemented for the qualitative assessment of the educational needs of adults with a bipolar disorder. The MoB EI will be developed according to the qualitative data and relevant literature, aiming to include combination of face to face (F2F) and technology-based interventions via design of a Digital platform. The effectiveness of the MoB EI regarding the acquired knowledge and self-management skill will be assessed via structured instruments in the quantitative part of the study using descriptive and inferential statistics (SPSS version 24.0). RESULTS A total of 13 patients with a bipolar disorder have been interviewed (8 females, 5 males) to identify educational needs to be covered from an educational program. Moreover, a literature review on bipolar disorders educational programs has been completed. These data have been incorporated to the design of the MoB F2F EI and the digital platform. The digital platform is live, while the development of MoB F2F EI is still ongoing; expected to be completed by the end of 2020. The recruitment of the participants of the interventional group (40 patients) and the control (40 patients) is expected to begin by the first semester of 2021. Moreover, by tracking the platform for one and a half year we have recorded that 2180 users have visited the platform with an average session duration of almost 2 minutes. 70% of the visitors are using mobile and tablet devices. CONCLUSIONS Since new parameters regarding educational interventions will be explored, the findings are expected to provide evidence if participation in structured education programs gives patients the opportunity to improve adherence to pharmacotherapy and increase their quality of life, including important parameters, such as cognitive functioning, impulse control and relapse prevention. CLINICALTRIAL Trial registration: This protocol has been approved by the Cyprus National Committee of Bioethics [ΕΕΒΚ/ΕΠ/2018/27]; and it has been registered at the Research Committee Review board of the Ministry of Health of the Republic of Cyprus [5.34.01.7.6Ε/0490/2018].

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