The COVID-19 pandemic highlighted the need for psychological support initiatives directed toward frontline healthcare workers, which can be rapidly and sustainably implemented during an infectious disease outbreak. The current case study presents a comprehensive model of psychological support that was implemented at an intensive care unit (ICU) during the first wave of the COVID-19 pandemic. The psychological support model aimed at promoting a resilient stress reaction among frontline staff by protecting physical, social, and psychological resources. The initiatives, targeting different groups of workers, included education and training, peer support, psychologist-supervised and unsupervised group sessions, on-boarding for transferred staff, manager support, and individual sessions for workers experiencing strong stress reactions. The results of the process evaluation of this rapid implementation suggest that peer support initiatives as well as daily group sessions were the most appreciated forms of psychological support. Psychologists involved in organizing and providing the support highlighted several aspects of a successful implementation of the support model: offering support during work hours (preferably after shift), positive attitude of line managers that framed support initiatives as a team effort, and involvement of experienced psychologists able to quickly adjust the content of the support according to the current needs. The study also identified two main problems of the current implementation: the lack of efficient planning due to the use of volunteer work and the need for more structural resources on the organizational level to ensure long-term sustainability of the support model and its implementation among all groups of healthcare staff. The current case study highlights the importance of establishing permanent structural resources and routines for psychological support integrated in clinical practice by healthcare organizations to improve both rapid and sustainable response to future crises.
In order to minimize the risk of infection during the Covid-19 pandemic, people are recommended to keep interpersonal distance (e.g., 1 m, 2 m, 6 feet), wash their hands frequently, limit social contacts and sometimes to wear a face mask. We investigated how people judge the protective effect of interpersonal distance against the Corona virus. The REM model, based on earlier empirical studies, describes how a person’s virus exposure decreases with the square of the distance to another person emitting a virus in a face to face situation. In a comparison with model predictions, most participants underestimated the protective effect of moving further away from another person. Correspondingly, most participants were not aware of how much their exposure would increase if they moved closer to the other person. Spectral analysis of judgments showed that a linear ratio model with the independent variable = (initial distance)/(distance to which a person moves) was the most frequently used judgment rule. It leads to insensitivity to change in exposure compared with the REM model. The present study indicated a need for information about the effects of keeping interpersonal distance and about the importance of virus carrying aerosols in environments with insufficient air ventilation. Longer conversations emitting aerosols in a closed environment may lead to ambient concentrations of aerosols in the air that no distance can compensate for. The results of the study are important for risk communications in countries where people do not wear a mask and when authorities consider removal of a recommendation or a requirement to wear a face mask.
The resource saving bias is a cognitive bias describing how resource savings from improvements of high-productivity units are overestimated compared to improvements of less productive units. Motivational reasoning describes how attitudes, here towards private/public health care, distort decisions based on numerical facts. Participants made a choice between two productivity increase options with the goal of saving doctor resources. The options described productivity increases in low-/high-productivity private/public emergency rooms. Jointly, the biases produced 78% incorrect decisions. The cognitive bias was stronger than the motivational bias. Verbal justifications of the decisions revealed elaborations of the problem beyond the information provided, biased integration of quantitative information, change of goal of decision, and motivational attitude biases. Most (83%) of the incorrect decisions were based on (incorrect) mathematical justifications illustrating the resource saving bias. Participants who had better scores on a cognitive test made poorer decisions. Women who gave qualitative justifications to a greater extent than men made more correct decision. After a first decision, participants were informed about the correct decision with a mathematical explanation. Only 6.3% of the participants corrected their decisions after information illustrating facts resistance. This could be explained by psychological sunk cost and coherence theories. Those who made the wrong choice remembered the facts of the problem better than those who made a correct choice.
Objectives: This study aimed to investigate if high levels of burnout symptoms during the first wave of the Covid-19 pandemic led to high burnout and depressive symptoms up to a year later, and if participation in psychological support initiatives was related to lower levels of burnout or depressive symptoms across the first year of the pandemic.Methods: A longitudinal case-control study followed 581 healthcare workers from two Swedish hospitals. Survey data were collected with a baseline in May 2020 and three follow-up assessments until September 2021. The case group were participants reporting high burnout symptoms at baseline. Logistic regression analyses were performed separately at three follow-ups with case/control group assignment as the main predictor and burnout and depression symptoms as outcomes, controlling for frontline work, changes in work tasks, and participation in psychological support. Results: One out of five healthcare workers reported high burnout symptoms at baseline. The case group was more likely to have high burnout and depression symptoms at all follow-ups. Participation in psychological support was not related to decreased burnout and depressive symptoms at any of the follow-ups.Conclusion: Burnout symptoms early in the pandemic predicted both high burnout and depressive symptoms later in the crisis. During a persistent crisis when job demands are high, healthcare organizations should be mindful of psychological reactions among staff and who they place in frontline work early in the crisis.
During a crisis there is limited time to plan support initiatives for healthcare workers and few resources available to secure that they engage with the initiatives. Within the context of the recent Covid-19 pandemic, this study aimed to investigate help-seeking behaviors among healthcare workers in relation to psychological support initiatives offered to them. Data from a Swedish longitudinal survey following healthcare workers from early (N = 681) to mid-pandemic (N = 396) were analyzed using latent class and transition analyses. We found three patterns of healthcare workers’ help-seeking behavior that applied to both time points: (1) engaging with different forms of group-based support, (2) not participating in any kind of offered support, and (3) only having been offered information-based support. The availability of support declined during mid-pandemic. Group support users were primarily nurses and frontline workers, with higher levels of burnout symptoms early pandemic. Our findings suggest that healthcare organizations should limit their implementation of psychological support during a crisis to a few key formats based on social support. Promoting participation from all staff groups may enhance inclusivity, effectiveness, and sustainability of the support.
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