COVID-19 Outbreak: Burnout and Posttraumatic Stress Disorder, a Harmful Chronology for Health Caregivers in Emergency Departments and Intensive Care Units

Pujo, Jean Marc; Fitriani, Dewi Yunia; Adi, Nuri Purwito; Portecop, Patrick; Résière, Dabor; Mansyur, Muchtaruddin; Kallel, Hatem

doi:10.1017/dmp.2022.24

Cited by 3 publications

(5 citation statements)

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“…They include severe trauma management, snake bite envenoming and stress at work in the emergency setting. 18,19…”

Section: Prospectsmentioning

confidence: 99%

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First French and Indonesian university medical cooperation for promoting emergency medicine

Pujo,

Lapostolle,

Fitriani

et al. 2024

Emerg Medicine Australasia

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Indonesia and French Guiana share many geographic and medical concerns regarding access to care. The organisational needs in emergency management, particularly in the prehospital phase, are similar. Whereas emergency medicine (EM) is an academic and entire speciality in France, it is still under construction in Indonesia. In the framework of the French and Indonesian academic cooperation, the Medical school in Jakarta University and the French Guiana University in Cayenne signed a Memorandum of Understanding encompassing education programmes, joint research work and students' and health professionals' exchanges in EM. This partnership represented the first medical cooperation programme between the two countries. The first student class was launched in August 2022 and involved 50 Indonesian doctors who graduated in August 2023. The implementation and success of this Franco‐Indonesian cooperation were supported by political and academic partners from the two sides. Given the first student class's success, we aim to continue this programme, in line with Indonesia and World Health Organization's plan to establish a multi‐country training hub for health emergency operational readiness and Emergency Medical Teams.

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“…They include severe trauma management, snake bite envenoming and stress at work in the emergency setting. 18,19…”

Section: Prospectsmentioning

confidence: 99%

“…Many topics were identified as priority issues for research partnerships. They include severe trauma management, snake bite envenoming and stress at work in the emergency setting 18,19 …”

Section: Prospectsmentioning

confidence: 99%

First French and Indonesian university medical cooperation for promoting emergency medicine

Pujo,

Lapostolle,

Fitriani

et al. 2024

Emerg Medicine Australasia

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Section: Introductionmentioning

confidence: 99%

“…Work-related stress is a significant concern in the healthcare sector due to its negative impact on workers’ health and performance ( Koenen et al, 2017 ; Pujo et al, 2022 ). It represents a physical and emotional response when the job demands exceed the capabilities or resources of the person ( Pujo et al, 2021 , 2022 ). The weight of medical consequences calls for continuous stress monitoring at work to pinpoint its sources, prevent burnout, and adopt coping strategies to eliminate or reduce it until it reaches an acceptable level ( Yang et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

The effects of prolonged stress exposure on the brain of rats and insights to understand the impact of work-related stress on caregivers

Pujo,

Fitriani,

Ben Saad

et al. 2023

Front. Behav. Neurosci.

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IntroductionStress exposure is a significant concern in the healthcare sector. This animal model study aims to reproduce caregivers’ working conditions and determine their impact on the brain.MethodTwenty-four healthy male rats of the Wistar strain were divided into four groups. Three groups were submitted each to one stressor for 21 days, while the fourth group was used as a control. Stressors were food and water deprivation (FW), permanent illumination (PI), and forced swimming (FS). At the end of the experiment, rats were euthanized, and stress biomarkers, biological parameters, and DNA damage were measured.ResultsProoxidant biomarker rates increased in the different groups (+50 to +75%) compared to the control (p < 0.0001). Urinary corticosterone rates increased in all stressed animals, mainly in the PI group, with changes of up to +50% compared to the control group. Acetylcholinesterase levels decreased to −50% (p < 0.0001 for the three exposed groups). Total ATPase, (Na+/K+)-ATPase, and Mg2+-ATPase activities decreased in all stressed groups. The percentage of brain cell congestion and apoptosis was 3% for the FW group (p < 0.0001), 2% for the PI group (p < 0.0001), and 4% for the FS group (p < 0.0001) compared to the control (0.8%). DNA damage was observed in all exposed groups. Finally, we noticed behavioral changes and a depression-like syndrome in all stressed rats.ConclusionStressful conditions such as the working environment of caregivers can trigger several pathophysiological processes leading to oxidative, neurochemical, and hypothalamic–pituitary–adrenal disorders. These changes can progress to cell damage and apoptosis in the brain and trigger psychological and physical disorders.

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“…As a result, evidence is mounting that a significant psychological toll is incurred by frontline physicians [22], [23], who experience high stress, anxiety, depression, compassion fatigue and burnout sustained from working with COVID-19 patients [24], [25]. Of particular concern is the traumatic nature of COVID-19 associated stressors, which raise the likelihood of post-traumatic stress symptoms (PTSS) incurred by frontline physicians [26].…”

Section: Introductionmentioning

confidence: 99%

A Statistical Learning Approach to Evaluate Factors Associated With Post-Traumatic Stress Symptoms in Physicians: Insights From the COVID-19 Pandemic

Mukherjee

Rintamaki²,

Shucard

et al. 2022

IEEE Access

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Physicians facing the COVID-19 pandemic are likely to experience acute and chronic, and often unpredictable, occupational stressors that can incur post-traumatic stress symptoms (PTSS), prevention of which is of utmost importance to enhance healthcare workforce efficiency. Unlike previous studies, in this paper we developed a generalized data-driven framework to generate insights into the complex, nonlinear associations of cognitive/occupational factors with physicians' PTSS-risk. Data were collected from practicing physicians in the 18 states with the largest COVID-19 cases by deploying a cross-sectional, anonymous, web-based survey, following the second COVID-19 peak in the US. Analyses revealed that physicians directly treating COVID-19 patients (frontline) were at higher occupational risk of PTSS than those who didn't (secondline). We implemented a suite of eight statistical learning algorithms to evaluate the associations between cognitive/occupational factors and PTSS in frontline physicians. We found that random forest outperformed all other models, in particular the traditionally-used logistic regression by 6.4% (F1-score) and 9.6% (accuracy) in goodness-of-fit performance, and 4.8% (F1-score) and 4.6% (accuracy) in predictive performance, indicating existence of complex interactions and nonlinearity in associations between the cognitive/occupational factors and PTSS-risk. Our results show that depression, burnout, negative coping, fears of contracting/transmitting COVID-19, perceived stigma, and insufficient resources to treat COVID-19 patients are positively associated with PTSS-risk, while higher resilience and support from employer/friends/family/significant others are negatively associated with PTSS-risk. Insights obtained from this study will help to bring new attention to frontline physicians, allowing for more informed prioritization of their care during future pandemics/epidemics. INDEX TERMSPost-traumatic stress symptoms (PTSS); depression and burnout; COVID-related damaging factors; resilience and social support; nonlinear relationships; predictive analytics.

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COVID-19 Outbreak: Burnout and Posttraumatic Stress Disorder, a Harmful Chronology for Health Caregivers in Emergency Departments and Intensive Care Units

Cited by 3 publications

References 11 publications

First French and Indonesian university medical cooperation for promoting emergency medicine

First French and Indonesian university medical cooperation for promoting emergency medicine

The effects of prolonged stress exposure on the brain of rats and insights to understand the impact of work-related stress on caregivers

A Statistical Learning Approach to Evaluate Factors Associated With Post-Traumatic Stress Symptoms in Physicians: Insights From the COVID-19 Pandemic

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