Статті в журналах: "Paramedic Depression"

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Courtney, James A., Andrew J. P. Francis, and Susan J. Paxton. "Caring for the Carers: Fatigue, Sleep, and Mental Health in Australian Paramedic Shiftworkers." Australian and New Zealand Journal of Organisational Psychology 3 (April 1, 2010): 32–41. http://dx.doi.org/10.1375/ajop.3.1.32.

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AbstractThis study investigated fatigue, sleep quality, mental health and physical activity in paramedic shiftworkers. Although limited, previous studies have established high fatigue levels and poor health in this sector from shiftwork rostering and occupational demands. A modified version of the Standard Shiftwork Index was completed by 342 paramedics (243 male and 98 females). Single sample t tests found significantly higher levels of fatigue, depression, anxiety, and stress, and significantly poorer sleep quality than reference samples. Paramedics also reported less physical activity than community samples. Depression and sleep quality explained the greatest amount of variance in fatigue scores, followed by level of exercise. No differences were detected in levels of depression or fatigue on the basis of gender. The findings suggest that ambulance paramedic shiftworkers are at particular risk for increased levels of fatigue and depression (regardless of age or gender) and poor quality sleep. Organisational intervention was suggested.

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Holmes, Lisa. "Exploring the Preparedness of Student Paramedics for the Mental Health Challenges of the Paramedic Profession." Prehospital and Disaster Medicine 34, s1 (May 2019): s83. http://dx.doi.org/10.1017/s1049023x19001742.

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Introduction:The mental health challenges encountered by paramedics have received much attention in recent years. This attention has particularly focused on high rates of stress, depression, anxiety, and post-traumatic stress disorder. This heightened awareness of the high incidence of mental illness, which has at times tragically resulted in the suicide of serving and former paramedics, is stimulating the address of mental health within the paramedic profession. It is now time to call on paramedic educators to prepare student paramedics for the mental health challenges associated with a career in the emergency medical services.Aim:To explore the preparedness of student paramedics for the mental health challenges of the paramedic profession and identify the coping strategies used by veteran paramedics to successfully meet these challenges.Methods:Twenty semi-structured interviews with veteran paramedics from Australia and New Zealand were conducted.Results:Advice from veteran paramedics was comprised of three key themes: support, health, and the profession.Discussion:The findings of the study indicate that the preparation of student paramedics for the mental health challenges of the paramedic profession throughout the undergraduate curriculum could be advantageous. The advice offered by veteran paramedics can be included within undergraduate paramedic curricula and delivered by sharing the personal experiences of the veteran paramedics. These experiences are highly credible and sharing them offers an opportunity for veterans to contribute positively to the future of paramedicine. Guidelines for their inclusion in the undergraduate paramedic curriculum should be prepared to facilitate knowledge translation and to encourage the development of conscious coping strategies by student paramedics during their learning phase. Further research is needed to raise awareness in this area, with a specific focus on preparing paramedic students to cope with mental health challenges related to undergraduate degree programs, and how they feel about commencing their career as a paramedic.

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May, Tobias, Teresa Klas, Christina Arnold, Thomas Hofmann, Leona Maaß, Yvonne Treusch, and Luis Möckel. "Depressionen und damit assoziierte Faktoren bei Rettungskräften in Deutschland – Ergebnisse aus der EMS-Health-Studie für den Zeitraum 2020/2021." ASU Arbeitsmedizin Sozialmedizin Umweltmedizin 2024, no. 02 (January 30, 2024): 120–28. http://dx.doi.org/10.17147/asu-1-335668.

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Depression and associated factors among emergency medical services staff in Germany: results from the EMS Health Study for the period 2020/2021 Background: Depression is one of the most common psychological conditions and factors such as pain and psychosocial workload can increase the risk for depression. Since there is little data available for prehospital emergence medical services (EMS) staff in Germany, the aim of the study was to identify factors associated with depression. Methods: This analysis was a nationwide cross-sectional study with prehospital EMS staff in Germany. Factors associated with depression were identified using multivariable logistic regression analysis, calculating adjusted odds ratios (AOR) and associated 95 % confidence intervals (95 % CI). Results: A total of 2,313 EMS staff were included in the analysis. The 12-month prevalence of depression was 15.6 % in women and 12.2 % in men. Significantly associated with depression were qualifications (paramedic*s: AOR: 1.99 [95 % CI: 1.10; 3.58] p = 0.022; paramedic*s: AOR: 1.69 [95 % CI: 1.08; 2.61] p = 0.021; reference: paramedics) and actual working hours (increase per hour: AOR: 1.02 [95 % CI: 1.00; 1.03] p = 0.013). Furthermore, poorer health, severe pain, allergies, and being a former smoker were also associated with a significantly higher chance of depression. In contrast, employees living in a relationship showed a lower chance of suffering from depression. Conclusion: This analysis provides evidence for factors associated with depression in prehospital EMS staff in Germany. Keywords: mental health – rescue service – workload – rescue service personnel – paramedics

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Warren-James, Matthew, Julie Hanson, Belinda Flanagan, Mary Katsikitis, and Bill Lord. "OP08 Levels and sources of stress reported by first year paramedic students associated with their first ambulance placement." Emergency Medicine Journal 38, no. 9 (August 19, 2021): A4.2—A4. http://dx.doi.org/10.1136/emermed-2021-999.8.

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BackgroundWhilst there is evidence to suggest paramedics experience significant stress when working in the ambulance setting little is known about the experiences of first year paramedic students. This research aimed to: (i) identify whether levels of stress, anxiety and depression experienced by first year paramedic students changed after ambulance placement compared to a control group, and (ii) identify the main perceived and actual sources of stress around ambulance placement.MethodsA before-and-after quasi-experimental design was used to compare whether the experience of ambulance placement altered the levels of stress, anxiety and depression in an experimental group that attended an ambulance placement (n = 20) and the control group who did not (n = 10). Online surveys encompassing the Depression, Anxiety and Stress Scale (DASS-21) and qualitative questions about sources of stress were concurrently deployed to both the experimental and control groups before and after the ambulance placement. Participants were first year paramedic students working in Queensland Ambulance Service, Australia.ResultsThere was a significant reduction in levels of stress in participants after undertaking their first ambulance placement (Mdn = -4.00) when compared to a control group (Mdn = 0.00), U = 52.5, p = .035, n2 = 0.15. Responses to survey questions suggest anticipation about experiencing death and dying of patients was the most frequently reported stressor of student paramedics before undertaking ambulance placements, however insecurity about knowledge, competence and fear of failure was the most frequently experienced stressor reported after completing ambulance placements.ConclusionsThe findings from this study suggest that the fear of the unknown may be worse than the reality. Anticipatory stress is the foremost problem for first year paramedic students attending their first ambulance placement. Placement pre-briefing should focus on educational interventions to build knowledge and skills competency to reduce stress levels and fear of failure.

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Gurung, Laxmi, Narmada Devkota, Rocky Maharjan, Anju Rayamajhi, Radha Poudel, and Suryamani Ghimire. "State of Psychological Well-being and Self-Care Patterns Among Paramedic Trainees During the First Wave of COVID-19." Medical Journal of Shree Birendra Hospital 21, no. 1 (July 7, 2022): 137–44. http://dx.doi.org/10.3126/mjsbh.v21i1.37191.

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Introduction: Several studies suggest that health workers and medical students suffer from psychological problems during the pandemic. Paramedic trainees were doing duty at the hospital round the clock as other trainee health care workers during the first wave of COVID-19, but there was no published study regarding mental health issues of paramedic trainees till the date in Nepal. This study aims to assess their well-being to full fill the gap. Methods: This is a descriptive, cross-sectional study design carried out with 280 paramedics. The study period was September - October 2020. Depression, anxiety and stress scale – 21 (DASS 21) and self - care assessment worksheet was used to collect the data after getting permission from the concerned authors. Results: The point prevalence of psychological problems as defined by DASS-21 was 117 (45.3%). Specifically, DASS-21 sub-scales-defined caseness was: Depression 31 (12.0%), anxiety 55 (21.3%) and stress 31 (12.0%), where 218 (80%) of participants were not taking any self-help care-related training to enhance their coping skills to date. Chi-square (χ2) test found that there was a significant association between emotional self-care and severity of depression (P = 0.001), anxiety (P = 0.03) and stress (P = 0.04). Conclusions: A significant number of paramedic trainees suffered from depression, anxiety and stress during the first wave of the COVID-19 Pandemic. Therefore, psychological interventions like stress management, positive coping skills, and self-care training may be beneficial to help them cope with the situation.

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Bounds, Roger. "Factors Affecting Perceived Stress in Pre-hospital Emergency Medical Services." Californian Journal of Health Promotion 4, no. 2 (June 1, 2006): 113–31. http://dx.doi.org/10.32398/cjhp.v4i2.1937.

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This study investigated the factors related to the perception of stress in EMT’s and paramedics. 144 EMTs and paramedics from urban “third service” EMS providers in Texas completed a questionnaire that included several demographic questions, Speilberger’s (1995) state-trait personality inventory (STPI), Sarason’s (1983) social support questionnaire, and Schwarzer’s (2000) general perceived self-efficacy scale. Six of the eight SPTI measures served as a measure of perceived stress. They were state and trait anxiety, state and trait anger, and state and trait depression. Education was negatively correlated with state anxiety (r=-0.274, p=0.001), state anger (r=-0.217, p=0.009), state depression (r=-0.231, p=0.006), and trait anxiety (r=-0.2058, p=0.014). Since years of education was related to stress and somewhat related to self-efficacy (r=0.17, p=0.042) a partial correlation procedure (controlled for years of education) was performed for self-efficacy (GPSES) and the stress variables. Self-efficacy was negatively correlated with state anxiety (r=-0.312, p=0.0001), state anger (r=-0.194, p=0.021), state depression (r=-0.339, p=0.0001), trait anxiety (r=-0.436, p=0.0001), and trait depression (r=-0.3762, p=0.0001). An analysis of variance was conducted to compare the means of the perceived stress variables for three job function groups (attendant basic or intermediate, attendant paramedic, and in-charge paramedic). Higher perceived stress was reported by both the attendant basic-intermediates and the in-charge paramedics (p

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Davis, Nia K. "Driving Under the Influence Laws, Party Culture and College Students." Californian Journal of Health Promotion 4, no. 2 (June 1, 2006): 132–38. http://dx.doi.org/10.32398/cjhp.v4i2.1938.

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This study investigated the factors related to the perception of stress in EMT’s and paramedics. 144 EMTs and paramedics from urban “third service” EMS providers in Texas completed a questionnaire that included several demographic questions, Speilberger’s (1995) state-trait personality inventory (STPI), Sarason’s (1983) social support questionnaire, and Schwarzer’s (2000) general perceived self-efficacy scale. Six of the eight SPTI measures served as a measure of perceived stress. They were state and trait anxiety, state and trait anger, and state and trait depression. Education was negatively correlated with state anxiety (r=-0.274, p=0.001), state anger (r=-0.217, p=0.009), state depression (r=-0.231, p=0.006), and trait anxiety (r=-0.2058, p=0.014). Since years of education was related to stress and somewhat related to self-efficacy (r=0.17, p=0.042) a partial correlation procedure (controlled for years of education) was performed for self-efficacy (GPSES) and the stress variables. Self-efficacy was negatively correlated with state anxiety (r=-0.312, p=0.0001), state anger (r=-0.194, p=0.021), state depression (r=-0.339, p=0.0001), trait anxiety (r=-0.436, p=0.0001), and trait depression (r=-0.3762, p=0.0001). An analysis of variance was conducted to compare the means of the perceived stress variables for three job function groups (attendant basic or intermediate, attendant paramedic, and in-charge paramedic). Higher perceived stress was reported by both the attendant basic-intermediates and the in-charge paramedics (p

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Evans, M., A. Reynolds, B. Brown, S. Wanstall, M. Crowther, G. Rawson, A. Vakulin, et al. "P038 Sleep disorders, perceived control over sleep and depression in paramedic students." SLEEP Advances 3, Supplement_1 (October 1, 2022): A43. http://dx.doi.org/10.1093/sleepadvances/zpac029.111.

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Abstract Introduction University students are commonly affected by sleeping difficulties and poor mental health, and ~20% of this demographic live with a clinical sleep disorder. This is particularly concerning for students who will progress into careers which will introduce further sleep disturbance via shift work schedules. The aim of the current study was to explore the relationship between sleep disorders and depression in paramedic students, and determine whether perceived control over sleep moderates the relationship. Methods Data from fifty-three Flinders University Paramedic students was included, consisting of sleep disorder screening (obstructive sleep apnea, insomnia and restless legs syndrome), and mental health (Patient Health Questionnaire-9) questionnaires. PHQ-9 scores ranged from 0 to 27, with higher scores indicating more severe depression. Regression analysis adjusted for age and sex at birth were conducted using SPSS version 27. Results Meeting criteria for a sleep disorder (n=21, 38.2%) was associated with higher depression scores (mean+standard error) in paramedic students (for sleep disorders vs no sleep disorders, 11.4±0.9 v 4.3±0.8, F₁,₅₂=33.5, p <.001). High perceived control over sleep was associated with lower depression scores than low perceived control 5.3±0.9 vs 9.6±1.1, F₁,₅₂=9.0 p = .004) but no moderating effect was observed (p = 0.17). Discussion Sleep disorders and low perceived control over sleep are independently associated with higher depression scores. Investigation and management of factors contributing to low perceived control over sleep, together with early screening and management of sleep disorders are important priorities to support paramedic student sleep and mental health prior to commencing shift work.

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Wild, J., K. V. Smith, E. Thompson, F. Béar, M. J. J. Lommen, and A. Ehlers. "A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression." Psychological Medicine 46, no. 12 (June 28, 2016): 2571–82. http://dx.doi.org/10.1017/s0033291716000532.

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BackgroundIt is unclear which potentially modifiable risk factors best predict post-trauma psychiatric disorders. We aimed to identify pre-trauma risk factors for post-traumatic stress disorder (PTSD) or major depression (MD) that could be targeted with resilience interventions.MethodNewly recruited paramedics (n = 453) were assessed for history of mental disorders with structured clinical interviews within the first week of their paramedic training and completed self-report measures to assess hypothesized predictors. Participants were assessed every 4 months for 2 years to identify any episodes of PTSD and MD; 386 paramedics (85.2%) participated in the follow-up interviews.ResultsIn all, 32 participants (8.3%) developed an episode of PTSD and 41 (10.6%) an episode of MD during follow-up. In all but nine cases (2.3%), episodes had remitted by the next assessment 4 months later. At 2 years, those with episodes of PTSD or MD during follow-up reported more days off work, poorer sleep, poorer quality of life, greater burn-out; and greater weight-gain for those with PTSD. In line with theories of PTSD and depression, analyses controlling for psychiatric and trauma history identified several pre-trauma predictors (cognitive styles, coping styles and psychological traits). Logistic regressions showed that rumination about memories of stressful events at the start of training uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD.ConclusionsParticipants at risk of developing episodes of PTSD or depression could be identified within the first week of paramedic training. Cognitive predictors of episodes of PTSD and MD are promising targets for resilience interventions.

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Sega, Petrus Agustinus Seda, Anak Ayu Sri Wahyuni, Ni Ketut Sri Diniari, and I. Wayan Gede Artawan Eka Putra. "relationship between saliva 17 beta-estradiol levels with anxiety and depression in menopause paramedic at Prof I.G.N.G Ngoerah Hospital Denpasar." International journal of health & medical sciences 6, no. 3 (July 10, 2023): 130–39. http://dx.doi.org/10.21744/ijhms.v6n3.2159.

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Background: Hospital Services rely on Medical and Paramedics at the Hospital, Hospital Paramedic services, especially women, are greatly influenced by mood, in women it is especially influenced by hormonal balance, including menstruation and menopause. The drop in estrogen levels after menopause causes many physical and emotional changes. Estradiol is the largest estrogen. It is estimated that the number of women who have menopause will experience a very significant increase of estradiol. Methods: An analytic observational study with a cross-sectional study design on 85 menopausal paramedics at Prof I.G.N.G Ngoerah Hospital Denpasar using a Hospital Anxiety and Depression Scale (HADS) questionnaire and examined salivary levels of 17? estradiol and looked for its relationship with anxiety and depression. Results: Based on the low salivary 17? estradiol level of the sample aged above 50 years (76.5%). Outpatient (75%), underweight (100%), married status (74.4%), and sample >5 years (76.5%). It is also a significant result where the salivary 17? estradiol level is lower in the sample compared to anxiety and depression complaints, with the chi-square test (p-value = <0.001). Conclusion: There is a significant relationship between low salivary 17? estradiol levels and complaints of anxiety and depression in menopausal paramedics.

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Harris, R., S. Drummond, B. Meadley, S. Rajaratnam, B. Williams, K. Smith, K. Bowles, E. Nguyen, M. Dobbie, and A. Wolkow. "P052 Mental health predictors for shift work disorder in paramedics during their early career." SLEEP Advances 2, Supplement_1 (October 1, 2021): A38. http://dx.doi.org/10.1093/sleepadvances/zpab014.099.

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Abstract Introduction Shift work disorder (SWD) involves excessive sleepiness and/or insomnia and is associated with poor health outcomes in those affected. This study assessed the prevalence of and risk factors for SWD during the first six-months of paramedics’ careers. Furthermore, the study explored potential mediators in the relationship between mental health and SWD risk. Methods Recruit paramedics’ (n=101) SWD risk (SWD-Screening Questionnaire) was assessed at baseline (i.e., before shift work) and at six-months after engaging in shift work as a graduate paramedic. Logistic regression models assessed whether baseline depression (Patient Health Questionnaire-9) and baseline anxiety (Generalised Anxiety Disorder Questionnaire-7) predicted a high risk for SWD at six-months. Lavaan path analysis was used to assess whether shift and sleep variables, created from participants’ sleep and work diaries, mediated the relationship between mental health and SWD risk. Results After six-months of emergency work 21.5% of paramedics were high risk for SWD. Baseline depression predicted 1.28-times greater odds for SWD at six-months. Shift and sleep variables were not mediators in the relationship between baseline mental health and subsequent SWD risk. Baseline depression was independently associated with increased sleepiness levels following paramedics’ major sleep periods across all work conditions (nightshift, workdays, and non-workdays) at six-months. Depression levels before shift work also predicted a greater perceived workload on nightshifts. Conclusions Depression symptoms before starting shift work are a modifiable risk factor for SWD. Moreover, the first six-months of paramedics’ careers is a critical period for implementing preventative measures for SWD, including interventions to decrease depression symptoms.

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Yoo, Yang Gyeong, MiRa Yun, In-Soo Lee, Hyeyoung Kim, Sang Gyun Roh, and Boas Yu. "Effects of an On-Campus Meditation Course on Depression, Anxiety, Stress, and Sleep Quality among South Korean Paramedic Students." Perspectives in Psychiatric Care 2023 (May 11, 2023): 1–9. http://dx.doi.org/10.1155/2023/3003004.

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Background. Paramedic students frequently face various stressful and challenging situations as they work in emergency medical settings. Currently, research studies on utilizing meditation courses as a part of the curriculum to improve the mental health of paramedic students in Korea are lacking. Methods. For this quasiexperimental study, a nonequivalent group pretest and post-test research design was used. The study sample comprised 55 paramedic students from two similar-sized universities in different locations: 27 in the experimental group and 28 in the control group. The experimental group participated in an eight-week meditation course, while the control group did not receive any interventions during the same time period. Results. The results indicated that compared with the control group, the experimental group had significantly decreased anxiety ( p = 0.047 ) and stress levels ( p = 0.044 ) and improved sleep quality ( p = 0.041 ). The change in depression levels did not significantly differ between the groups ( p = 0.419 ). Conclusions. The inclusion of a meditation course within college curriculums for paramedic students is feasible and may benefit students in terms of stress, anxiety, and sleep quality.

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Hill, Robert, Michael Heller, Alexander Rosenau, Scott Melanson, David Pronchik, John Patterson, and H. Gulick. "Paramedic Interpretation of Prehospital Lead-II ST-Segments." Prehospital and Disaster Medicine 12, no. 2 (June 1997): 70–73. http://dx.doi.org/10.1017/s1049023x00037432.

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AbstractObjective:To determine the reliability of ST-segment interpretation by paramedics from lead-II rhythm strips obtained in the prehospital setting.Design:Prospective, blinded study of 127 patients transported by an urban/rural emergency medical services system with complaints consistent with ischemic heart disease.Methods:Emergency department physicians asked emergency medical technician-paramedics (EMT-P) via radio to evaluate ST-segments for elevation or depression and grade it as “mild,” “moderate,” or “severe.” Then, this rhythm strip was interpreted blindly by emergency physicians who also interpreted the lead-II obtained from a 12-lead electrocardiogram (ECG) obtained in the emergency department (ED). The field interpretation was compared with the subsequent readings and the final in-patient diagnosis using positive predictive value (PPV), negative predictive value (NPV), and the Kappa statistic. Markedly discrepant interpretations were analyzed separately.Results:Using physician interpretation as the reference standard, paramedic interpretation of the lead-II ST-segments obtained in the prehospital setting was correct (within ±1 gradation) in 113 out of 127 total cases (89%). Of 105 patients for whom final hospital diagnosis was available, the ST-segment on the rhythm strip obtained in the prehospital setting, had a positive predictive value of 74% and a negative predictive value of 85% for myocardial ischemia or myocardial infarction (MI) (p <0.001, Kappa = 0.59). Discordant interpretations between the paramedics and emergency physicians often were related to a basic misunderstanding of rhythm strip morphology.Conclusion:Field interpretation of ST-segments by paramedics is fairly accurate as judged both by emergency physicians and correlation with final patient outcome, but its clinical utility is unproved. A small but clinically significant number of outliers, consisting of markedly discrepant false positives, reflects paramedic uncertainty in identifying the deviations of the ST-segment.

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Thomas, Jade. "Mental health difficulties in paramedics: A review of the literature." Counselling Psychology Review 38, no. 2 (December 1, 2023): 18–29. http://dx.doi.org/10.53841/bpscpr.2023.38.2.18.

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BackgroundParamedics are frequently exposed to traumatic events as part of their role. The implications of this constant exposure have suggested that paramedics are at high risk of developing long-term mental health issues such as depression, anxiety, burnout, trauma, PTSD, and suicide.PurposeTo synthesise studies to examine factors that play a role in the development of mental health difficulties in ambulance personnel. As well as, establishing gaps within the literature for further research.Data SourcesFrom the first 77 published journals reviewed from Psycinfo, PsychArticles, CINAHL, Education Research Complete, ERIC and grey literature, 15 studies met the inclusion criteria for this review and were included in the present study.ResultsFindings of this review suggest that the mental health and wellbeing of paramedics are significant issues. In reviewing the research, it was found that several different factors may play a role in the development of mental health difficulties in ambulance personnel. Four main themes were determined, (1) occupational stressors, (2) negative attitude towards emotional expression, (3) peer and social support, and (4) preparing paramedics for mental health challenges.ConclusionsIt is paramount for further research to explore paramedic students’ mental health experiences, as well as a focus on research to investigate a UK paramedic population due to most of the literature focusing on an international population. Psychological support and early interventions should be made a priority for all ambulance workers, as a way of improving the quality of the working life of paramedics.

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Kammoun, I., O. Maatouk, R. Kammoun, M. Shiri, H. Nefzi, K. Ben Salah, M. Karoui, and F. Ellouz. "Coping strategies among medical and paramedic frontline healthcare workers during the coronavirus pandemic." European Psychiatry 65, S1 (June 2022): S511. http://dx.doi.org/10.1192/j.eurpsy.2022.1301.

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Introduction The epidemic of COVID-19 has affected the psychological health of people, especially frontline medical and paramedical staff. Several coping strategies have been used to combat the impact of this virus on their lives. Objectives Describe the impact of coronavirus on mental health and identify coping strategies Methods We carried out a cross-sectional, descriptive and analytical study, conducted over a period of two months ( september and october 2020), in 22 hospitals in Tunisia, including frontline medical and paramedical staff. To evaluate anxiety and depression, we used the Beck Inventory. To identify coping strategies, we used the Brief COPE. Results We collected 78 professionals. The mean age was 29.86+-5.4. The majority were medical residents (67.9%) working in covid units in 39.7% of cases. The rythm of work was daily in almost half of the cases, giving direct care to the patients tested positive in 76.9%. More than half had not received adequate training, and protective equipment was available in only 50% of cases. We found 35.9% of the staff who had to move for fear of infecting their families. More than half of the frontline staff were victims of stigma (57.7%). Depression and anxiety were tested minor in 40%. The most used coping strategy in the face of this distressing virus was social support (64.1%) followed by emotion-focused mechanisms (53,8%). Social support strategy was significantly correlated with prevention of anxiety (p=0.048) Conclusions Participants practiced and recommended various coping strategies to deal with stress, depression and anxiety emerging from COVID-19 pandemic. Disclosure No significant relationships.

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Smith, Erin C., and Frederick M. Burkle. "Paramedic and Emergency Medical Technician Reflections on the Ongoing Impact of the 9/11 Terrorist Attacks." Prehospital and Disaster Medicine 34, no. 1 (February 2019): 56–61. http://dx.doi.org/10.1017/s1049023x18001255.

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AbstractIntroductionIn the years following the September 11, 2001 terrorist attacks in New York City (New York USA), otherwise known as 9/11, first responders began experiencing a range of health and psychosocial impacts. Publications documenting these largely focus on firefighters. This research explores paramedic and emergency medical technician (EMT) reflections on the long-term impact of responding to the 9/11 terrorist attacks.MethodsQualitative methods were used to conduct interviews with 54 paramedics and EMTs on the 15-year anniversary of 9/11.ResultsResearch participants reported a range of long-term psychosocial issues including posttraumatic stress disorder (PTSD), anxiety, depression, insomnia, relationship breakdowns and impact on family support systems, and addictive and risk-taking behaviors. Ongoing physical health issues included respiratory disorders, eye problems, and cancers.DiscussionThese findings will go some way to filling the current gap in the 9/11 evidence-base regarding the understanding of the long-term impact on paramedics and EMTs. The testimony of this qualitative research is to ensure that an important voice is not lost, and that the deeply personal and richly descriptive experiences of the 9/11 paramedics and EMTs are not forgotten.SmithEC,BurkleFMJr.Paramedic and emergency medical technician reflections on the ongoing impact of the 9/11 terrorist attacks.Prehosp Disaster Med.2019;34(1):56–61.

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Gramlich, Michael A., and Sandra M. Neer. "Firefighter-Paramedic With Posttraumatic Stress Disorder, Horrific Images, and Depression: A Clinical Case Study." Clinical Case Studies 17, no. 3 (April 22, 2018): 150–65. http://dx.doi.org/10.1177/1534650118770792.

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Despite the existence of evidence-based treatments for posttraumatic stress disorder (PTSD), no identifiable study reported delivery of exposure therapy for a first responder with PTSD, as well as horrific images that generalized beyond the index trauma to loved ones. Horrific images have been defined as strongly aversive intrusive thoughts such as images of dismembered bodies or disgusting scenes. This clinical case describes the assessment and treatment of Ryan, a 41-year-old, firefighter-paramedic who completed a multifaceted intervention that included imaginal exposure therapy, behavioral activation, and cognitive therapy for depression. PTSD symptoms as measured by the PTSD Checklist for DSM-5 (PCL-5) displayed a clinically significant decrease from 25 at pretreatment to 3 at 2-month-follow-up, indicating Ryan no longer met diagnostic criteria for PTSD. In addition, Ryan endorsed a clinically significant reduction in horrific images from 21 per week at pretreatment to 0 at 2-month-follow-up. Depressive symptoms as measured by the Beck Depression Inventory–Second Edition (BDI-II) demonstrated a clinically significant decrease from 18 at pretreatment to 1 at 2-month-follow-up, indicating Ryan no longer met diagnostic criteria for depression. This clinical case study provides evidence for the feasibility and effectiveness of delivering a multifaceted intervention for a first responder with multiple psychiatric disorders.

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Zubair, U., S. Mansoor, and T. Mansoor. "Mental health impact of the COVID-19 pandemic on the front-line health care workers in a tertiary care hospital in rawalpindi, pakistan." European Psychiatry 64, S1 (April 2021): S260—S261. http://dx.doi.org/10.1192/j.eurpsy.2021.699.

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IntroductionIn these unprecedented times, the medical workers particularly at the frontlines of the pandemic are vulnerable to psychological trauma rooted in the new demands of their work, as well as the prevailing sense of insecurity and safety concerns for themselves and their loved ones.ObjectivesTo explore the mental health impact of the covid-19 pandemic on the front-line health care workers in a tertiary care hospital in Rawalpindi, PakistanMethodsFrontline healthcare workers will include all doctors, nurses and paramedical staff performing duties that involve dealing directly with known or suspected cases of COVID-19 at triage clinics, ICUs and isolation wards. Depression Anxiety and Stress Scale (DASS) and Impact of events scale-revised (IES-R) were administered to them to assess the mental health of these frontlines.ResultsA total of 94 frontlines were included in the study. 76(80.9%) had no significant depression while 18 (19.1%) had presence of significant depression. 62 (66%) had no significant anxiety while 32 (34%) had significant anxiety. Female gender and degree of contact with high clinical suspicion cases were significantly related with presence of anxiety and depression among the study participants. Being female, single, a nurse or a paramedic and degree of contact with high clinical suspicion cases was significantly related with presence of stress among the frontlines. People working in ICU or corona isolation unit had more chances of having trauma as compared to other frontlines.ConclusionsDepression, anxiety, stress and trauma were common among the front liners fighting in this pandemic

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Bonner, Mhairi, Matt Capsey, and Jo Batey. "A paramedic’s role in reducing number of falls and fall-related emergency service use by over 65s: a systematic review." British Paramedic Journal 6, no. 1 (May 1, 2021): 46–52. http://dx.doi.org/10.29045/14784726.2021.6.6.1.46.

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Background: Around 10‐25% of emergency calls for adults aged over 65 are attributed to falls. Regardless of whether injuries are caused, quality of life is often affected by fear of falling, leading to reduced confidence and activity, negatively impacting mobility and risking depression and isolation. Ambulance service staff are well placed to identify falls risk factors so patients can be directed to falls prevention services. This article aims to determine how the referral by paramedics of uninjured falls patients to community falls services may reduce future falls and emergency services use.Methods: The CINAHL, MEDLINE and AMED electronic databases, grey literature sources and reference lists of relevant papers were systematically searched to identify primary research of an experimental design. Studies were eligible if they included elderly patients, aged over 65, who had received a paramedic response following a fall, were found to be uninjured and who were referred to local falls services rather than being transported to hospital. The study outcomes were required to include the rate of subsequent falls and emergency service use.Results: Four papers from three studies were included in the review following quality assessment. Results were not always statistically significant but showed a reduction in subsequent falls, particularly in the high-risk population, and in emergency service call-outs. A consistent positive effect was seen on the patients’ well-being and independence related to activities of daily living across the studies.Conclusions: The relationship between paramedics and local falls services has changed the pre-hospital management of these patients. Generally, access to a falls-specific care package has proved beneficial in supporting independence and reducing unnecessary transport to hospital. Further research into the uptake of this care pathway by paramedics now it is more established may be useful, as would research into barriers to adherence of the elderly to such an intervention.

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Alzahrani, Adnan, Judith Johnson, and Chris Keyworth. "499 Prevalence of Anxiety, Depression, and Post-Traumatic Stress Disorder among Paramedic Students: A Systematic Review and Meta-Analysis." Resuscitation 203 (November 2024): S232. http://dx.doi.org/10.1016/s0300-9572(24)00778-0.

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Figueroa Cabello, Rodrigo Andrés, Tomás León, and Richard Sorensen. "Post-traumatic symptoms in the staff of a mental health inpatient unit after the suicide of a patient: a case report in Chile." Summa Psicológica 13, no. 2 (November 23, 2016): 13–22. http://dx.doi.org/10.18774/448x.2016.13.304.

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BACKGROUND: Multiple studies have shown that the suicide of a patient can produce posttraumatic and depressive symptoms among the mental health care providers, who typically have high levels of baseline burnout. OBJECTIVES: To measure posttraumatic, depressive and burnout symptoms in the staff of an inpatient psychiatric unit after the suicide of a patient. METHODS: Two months after the suicide all the employees were invited to answer, anonymously, the Posttraumatic Check-List (PCL), the Beck Depression Inventory (BDI), and the Maslach Burnout Inventory (MBI), for measuring posttraumatic, depressive, and burnout symptoms, respectively. RESULTS: Over 80% of the staff participated. A total of 17.1% had probable PTSD, 19.5% probable major depression, 24.4% and 14.6% high levels of emotional exhaustion and depersonalization, respectively, and 24.4% low levels of professional accomplishment. The group consisting of nurses, paramedic technicians, and nursing assistants ("nursing staff") had PTSD significantly greater than other workers (p < .001). CONCLUSIONS: Suicide in a psychiatric ward can produce posttraumatic and depressive symptoms among the staff, as high as another kind of traumas. The impact may be greater on the nursing staff. It is essential that organizations involved in the provision or teaching of mental health care incorporate this reality into their agenda, to prevent, mitigate and respond better to this phenomenon.

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Chaudhry, Fatima, Hassan Asghar, Chaudhry Umar Asghar, Amina Asghar, and Heba Imtiaz. "Risk Perception Mental Health Impact and Coping Strategies during Covid 19 Pandemic among Health Care Workers." Pakistan Journal of Medical and Health Sciences 16, no. 6 (June 29, 2022): 333–34. http://dx.doi.org/10.53350/pjmhs22166333.

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Objective: To assess the risk perception mental health impact and coping strategies during Covid-19 pandemic among health care workers. Study Design: Cross-sectional study. Place and Duration of Study: Department of Community Dentistry, Frontier Medical & Dental College, Abbottabad from 1st January 2021 to 31st December 2021. Methodology: Two hundred health care workers were given questionnaire for complete detailing their information regarding demographic, occupational, anxiety scoring and depression state. Results: The age of the health care workers was mostly within 26-40 years followed by greater than 18 years. It was observed that anxiety was presented at a mild score within doctors and other health care worker staff while it was seen to a moderate level within the nursing health care workers. Furthermore, the gender distribution of anxiety showed higher level of anxiety among females than males. Within genders a low risk perception was seen within males than females. Among the health care workers, the risk perception was highest in nurses followed by paramedic and other health care staff. Conclusion: Covid-19 has caused devastating effects on the psychological stability of the health care workers which needs to be properly assessed and addressed. Keywords: Covid-19, Health care workers, Anxiety, Risk perception

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Haywood, Kirstie L., Chen Ji, Tom Quinn, Jerry P. Nolan, Charles D. Deakin, Charlotte Scomparin, Ranjit Lall, et al. "OP6 Long term outcomes of participants in the paramedic-2 randomised trial of adrenaline in out of hospital cardiac arrest." Emergency Medicine Journal 37, no. 10 (September 25, 2020): e4.2-e4. http://dx.doi.org/10.1136/emermed-2020-999abs.6.

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BackgroundWe recently reported early outcomes in patients enrolled in a randomised trial of adrenaline in out-of-hospital cardiac arrest: the PARAMEDIC-2 (Prehospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug Administration in Cardiac Arrest) trial. The purpose of the present paper is to report long-term survival, quality of life, functional and cognitive outcomes in cardiac arrest patients who survived.MethodsPARAMEDIC-2 was a pragmatic, individually randomised, double blind, controlled trial and economic evaluation. Patients were randomised to either adrenaline or placebo. The 12-months survival post randomisation was checked. The 3- and 6-months outcomes included the modified Rankin Scale (0–3 defined as favourable neurological outcome), Two Simple Questions, the Mini Mental State Examination, the Informant Questionnaire on Cognitive Decline Evaluation for Cardiac Arrest, Hospital Anxiety and Depression Scale, the Post Traumatic Stress Disorder Checklist - Civilian Version and general health-related quality of life (HRQoL) assessed with both the Short-Form 12-item Health Survey and the EuroQoL EQ-5D-5L.Results8,014 patients were randomised with confirmed trial drug administration. Adrenaline survivors had marginally better 12-months survival (adjusted odds ratio: 1.385, 95% confidence interval: [1.000, 1.917], p=0.050). There was no significant treatment difference in favourable neurological outcome at both follow-ups. Similarly, no significant difference was found in other outcomes. Moderate to large effect sizes are reported in both arms when survivors were compared to the UK general population regarding general HRQoL and physical health.ConclusionsAdrenaline had a short to long-term effect on survival to 12-months post OHCA, compared to placebo, but more survivors in the adrenaline arm had poor functional, cognitive and HRQoL. A large proportion of the survivors experienced significant cognitive impairment and an important reduction in mental and physical wellbeing over the initial 6-months when compared to the general population.

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Roberts, B., N. Makhashvili, J. Javakhishvili, A. Karachevskyy, N. Kharchenko, M. Shpiker, and E. Richardson. "Mental health care utilisation among internally displaced persons in Ukraine: results from a nation-wide survey." Epidemiology and Psychiatric Sciences 28, no. 1 (July 27, 2017): 100–111. http://dx.doi.org/10.1017/s2045796017000385.

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AimsThere are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine.MethodsA cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used.ResultsPTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care.ConclusionsThe study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.

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Hamada, H., M. Soussi, R. Chrigui, S. Guellim, M. Kahloul, and W. Naija. "Psychological impact of the covid-19 pandemic on the operating room paramedical staff." European Psychiatry 65, S1 (June 2022): S134. http://dx.doi.org/10.1192/j.eurpsy.2022.366.

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Introduction the recent covid19 pandemic is not devoid of psychological risks on paramedical staff. Among them, those who work in the operating theaters are exposed to such risks. Objectives to determine the perceived stress level and the psychological impact of COVID-19 on paramedics in the operating room. Methods This is an observational, descriptive and analytical study carried out in the operating rooms of Sahloul University Hospital during a 3 month period. The data collection tool was a self-administered questionnaire composed of 5 main parts (socio-demographic characteristics, occupational characteristics, exposure to COVID-19, the Perceived Stress Scale (PSS) and the Hospital Anxiety and depression scale (HADS)). Results 96 paramedical staff participated in our study. The average perceived stress score was significantly higher among anesthetists. 48% of participants had anxiety. Anesthetists had significantly higher anxiety scores (p = 0.001). 26.1% of participants had definite depression. Of those with definite depression, 35.3% were anesthetists (p = 0.028). Factors significantly associated with the occurrence of anxiety were: psychiatric history, increased workload, contact with a positive coronavirus patient in the operating room, and severe perceived stress. However, the factors significantly associated with the occurrence of depression were: initial training in the management of covid-19 patients, personal infection with SARS-COV2 and severe perceived stress. Conclusions Covid-19 pandemic is causing significant symptoms of anxiety and depression among operation room staff. Primary and secondary prevention strategies must then be undertaken. Disclosure No significant relationships.

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Roza, Elvi, Cicilia Nopita, Wahyu Indah Dewi Aurora, Erny Kusdiyah, and Ima Maria. "SKRINNING PENYAKIT TIDAK MENULAR (PTM): PEMERIKSAAN EKG DAN GULA DARAH SEWAKTU DALAM RANGKA HUT IDI KE 72 KOTA JAMBI." Medical Dedication (medic) : Jurnal Pengabdian kepada Masyarakat FKIK UNJA 6, no. 1 (July 10, 2023): 1–4. http://dx.doi.org/10.22437/medicaldedication.v6i1.25101.

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ABSTRACT Non-communicable diseases (PTM) are diseases that are not transmitted from person to person or are known as chronic diseases. The development of PTM disease is generally slow and has a long duration. In Indonesia, the most NCDs aged 30-70 years are cerebrovascular disease (20.7%), ischemic heart disease (14.7%), diabetes (9.6%), tuberculosis (7%), hypertension (5.4%). %), chronic obstructive pulmonary disease (4.2%) and malignant tumors of the breast (1.7%). This activity was carried out on October 20, 2022 in Jambi City, which coincided with IDI's 72nd Anniversary in 2022. Where previously the participants would be recorded first as basic data before the examination. ECG examination and interpretation are carried out by a medical team who are experts in their field and blood sugar when carried out by a paramedic team and if there are abnormalities, consult a doctor who is competent in his field. On the EKG examination, 6 participants had abnormal ECG features, including: non-specific ST depression, Grade I Borderline AV Block, non-specific abnormal T waves, ectopic atrial rhythm, Left Ventricle Hypertrophy, and demand pacing e.c. ECG abnormalities. While checking blood sugar when 5 participants who had high blood sugar (> 140 mg/dl). From the screening conducted in the community, abnormal EKG images were found and people with high blood sugar were asymptomatic, which could be dangerous if not managed further. The need for monitoring of non-communicable diseases from the relevant health agencies. Keywords: Non-communicable Diseases, EKG, Temporary Blood Examination ABSTRAK Penyakit tidak menular (PTM) merupakan penyakit yang tidak ditularkan dari orang ke orang atau dikenal penyakit kronis. Perkembangan penyakit PTM pada umumnya lambat dan memiliki durasi yang panjang. Diindonesia PTM yang terbanyak diusia 30-70 tahun adalah penyakit pembukuh darah otak (20,7%), penyakit jantung iskemik (14,7%), diabetes (9,6%), tuberculosis (7%), hipertensi (5,4%), penyakit paru obstruksi kronis (4,2%) dan tumor ganas pada payudara (1,7%). Kegiatan ini dilaksanakan pada tanggal 20 Oktober 2022 di Kota Jambi yang bertepatan dengan HUT IDI ke-72 tahun 2022. Dimana sebelumnya peserta akan didata terlebih dahulu sebagai data dasar sebelum pemeriksaan. Pemeriksaan EKG serta intepretasi dilakukan oleh tim medis yang ahli dibidangnya dan Gula darah sewaktu dilakukan oleh tim paramedis dan apabila terdapat kelainan maka dikonsultasikan ke dokter yang berkompeten dibidangnya. Pada pemeriksaan EKG didapatkan 6 peserta memiliki gambaran EKG abnormal antara lain: ST depresi non spesifik, AV Block Grade I Borderline, T wave abnormal non specific, ectopic atrial rhythm, Left Ventricle Hypetrophy, dan demand pacing e.c. abnormal EKG. Sedangkan pemeriksaan gula darah sewaktu 5 peserta yang memiliki gula darah tinggi (>140mg/dl). Dari skrining yang dilakukan pada masyarakat, masih ditemukan gambaran EKG abnormal dan masyarakat dengan gula darah tinggi dengan kondisi tanpa gejala, yang bisa berbahaya jika tidak ditatalaksana lebih lanjut. Perlunya pemantauan penyakit tidak menular dari instansi kesehatan yang terkait. Kata Kunci: Penyakit Tidak Menular, EKG, Pemeriksaan Darah Sewaktu

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Khan, Wahaj Anwar A., Russell Conduit, Gerard A. Kennedy, Ahmed Abdullah Alslamah, Mohammad Ahmad Alsuwayeh, and Melinda L. Jackson. "Sleep and Mental Health among Paramedics from Australia and Saudi Arabia: A Comparison Study." Clocks & Sleep 2, no. 2 (June 8, 2020): 246–57. http://dx.doi.org/10.3390/clockssleep2020019.

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Paramedics face many challenges while on duty, one of which is working different types of shifts. Shift work has been linked to a number of health issues such as insomnia, depression, and anxiety. Besides shift work, Saudi paramedics, a group that has not been investigated for sleep or mental health issues previously, may be facing more demands than Australian paramedics due to lower numbers of paramedics in comparison to the general population. The aim of this study was to investigate the prevalence of sleep and mental health disorders among paramedics in Saudi Arabia and Australia. Paramedics were invited to complete a survey to assess stress, post-traumatic stress disorder (PTSD), depression, anxiety, daytime sleepiness, insomnia, sleep quality, shift work disorder, obstructive sleep apnoea, fatigue, and general health. A total of 104 males Saudi paramedics (M age = 32.5 ± 6.1 years) and 83 males paramedics from Australia (M age = 44.1 ± 12.1 years) responded to the survey. Significantly higher rates of depression, PTSD, insomnia, and fatigue, along with significantly poorer physical functioning were observed among Saudi paramedics in comparison with Australian paramedics. However, Australian paramedics reported significantly poorer sleep quality and general health in comparison to Saudi paramedics. After removing the effect of driving and working durations, outcomes were no longer significant. The higher burden of depression and PTSD among Saudi paramedics may be explained by longer hours spent driving and longer work durations reported by this group. Taking into consideration the outcomes reported in this study, more investigations are needed to study their possible effects on paramedics’ cognition, performance, and safety.

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George, Susan Annie, Ben Salu, and Bijo K. R. "A Survey Study on Stress and Depression among Paramedical Students in Virtual Classroom during COVID-19 Pandemic in Kerala." International Journal of Research and Review 9, no. 5 (May 18, 2022): 146–51. http://dx.doi.org/10.52403/ijrr.20220523.

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Background: The epidemic of Covid -19 caused paramedical students to become more stressed and depressed. Exacerbated study load, online classes, and lack of practical sessions, examination fear increased their stress level. So the aim of the study was to analyze the stress and depression among those paramedical students. Method: A cross sectional survey study in hand was done. A convenient sample method was used. It consists of 200 paramedical students between the age of 18 and 23 years from various paramedical colleges in Kerala especially from Ernakulum. The participants were selected according to inclusion, exclusion criteria. The survey was conducted during the first week of August 2021.The outcome measures were Beck’s depression inventory scale for assessing depression and perceived stress scale was used for assessing stress. Result: This study result shows that, there are 5% of highly stressed subjects and 85% are of medium stress, 10% of study sample has low stress. In case of depression, 1% have extreme depression, 11% subjects have severe depression, 33% of the samples have moderate depression, 15% have borderline depression, 17% have mild depression and 23% of subjects were normal. Conclusion: From the study we concluded that, there is a presence of stress and depression among paramedical students in virtual classroom during Covid- 19 outbreak period. The scoring helped us to find out who is prone to severe stress and depression. It also shows the importance of management of the issue of paramedical students. Keywords: Stress, depression, paramedical students, Beck's depression inventory, perceived stress scale.

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Suresh, Atul, Nandini G., Krishnaraj Rajeev, Ashid Salim, and Mohamed Jawad P. T. "A cross sectional study on depression among paramedical students in MES Institute of Paramedical Sciences." International Journal of Research in Medical Sciences 11, no. 7 (June 30, 2023): 2584–89. http://dx.doi.org/10.18203/2320-6012.ijrms20232104.

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Background: Depression is characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities. It is very important to identify the factors predisposing to depression among paramedical students. The main objective of this study was to assess the prevalence of depression and the factors associated with depression among the paramedical students. Methods: A cross-sectional study was done among all the 208 paramedical students studying in MES using a predesigned questionnaire along with Beck’s depression inventory tool to identify depression. Chi-square test and multivariate regression analysis were used to find the association between variables. Results: The prevalence of depression was found to be 24.5%. 11.54 % of the total study participants have borderline depression, while 10.58%, 1.92% and 0.48 % had moderate, severe and extreme form of depression respectively. Chi square test showed type of family, course of study, smoking habits, traumatic events in the past, bad interpersonal relationship, concern regarding the future were found to be statistically associated with depression. In multivariate analysis, bad interpersonal relationship between friends and family members (OR= 3.13), worrying about the future (OR=6.03) and those who never sought any form of help for mental stress (OR=1.5) were the risk factors identified. Conclusions: Course selection, type of family they came from, any traumatic events in the past, lack of interpersonal relationship between friends, worrying about the job opportunities after completing the course, not seeking help for mental stress were the factors contributing towards depression.

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Baumgartner, R. W., T. Landis, and M. Regard. "Relapsing Depression in Paramedian Thalamic Infarctions." Behavioural Neurology 5, no. 2 (1992): 129–32. http://dx.doi.org/10.1155/1992/967838.

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Depression has recently been associated with lesions in the CNS, particularly with large infarctions in the cerebral hemispheres. We report a patient in whom two episodes of acute depression were related to relapsing paramedian thalamic infarctions, which were accompanied by additional transient mild neuropsychological deficits, hypersomnia and a discrete sensory disturbance of the left face. Thalamic infarctions have been shown to mimic a variety of higher functional deficits, such as aphasias, apraxias and attentional disorders, traditionally associated with hemispheric strokes. We conjecture that the paramedian thalamic infarctions observed in our patient have in a similar manner been responsible for the transient depression.

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Halpern, Janice, Robert G. Maunder, Brian Schwartz, and Maria Gurevich. "Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics." BioMed Research International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/483140.

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Effective workplace-based interventions after critical incidents (CIs) are needed for emergency medical technicians (EMT)/paramedics. The evidence for a period out of service post-CI (downtime) is sparse; however it may prevent posttraumatic stress disorder (PTSD) and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores). Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between<30 minutes and end of shift, with>1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

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Kanwar, Neeraj, Roshan Lal, and Ramesh Kumar. "Burn out and depression in paramedical workers of tertiary care hospital during COVID-19 pandemic." International Journal of Research in Medical Sciences 10, no. 5 (April 26, 2022): 1122. http://dx.doi.org/10.18203/2320-6012.ijrms20221186.

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Background: Medical/paramedical professionals are prone to various behavioral disorders due to work pressure. The aim of the study was to evaluate burnout and depression in paramedical workers of a tertiary care hospital during COVID-19.Methods: Paramedical health care workers were assessed using online questionnaire containing self-administered questionnaire in this cross-sectional study between March 2021 and May 2021. Burnout self-test, depression, and anxiety were measured.Results: In this study, only 2.6% had at very severe risk of burnout and 7.8% were at severe risk of burnout while 3.9% had no signs of burnout. Approximately 80% of the patients had no depression. While there were 19.5% had mild to severe depression. Only eight out of 77 subjects had clinically significant symptoms of anxiety. Two subjects were having comorbid illness.Conclusions: A considerable percentage of HCWs experience burnout, depression, and anxiety.

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Kanwar, Neeraj, Roshan Lal, and Ramesh Kumar. "Burn out and depression in paramedical workers of tertiary care hospital during COVID-19 pandemic." International Journal of Research in Medical Sciences 10, no. 5 (April 26, 2022): 1122. http://dx.doi.org/10.18203/2320-6012.ijrms20221186.

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Background: Medical/paramedical professionals are prone to various behavioral disorders due to work pressure. The aim of the study was to evaluate burnout and depression in paramedical workers of a tertiary care hospital during COVID-19.Methods: Paramedical health care workers were assessed using online questionnaire containing self-administered questionnaire in this cross-sectional study between March 2021 and May 2021. Burnout self-test, depression, and anxiety were measured.Results: In this study, only 2.6% had at very severe risk of burnout and 7.8% were at severe risk of burnout while 3.9% had no signs of burnout. Approximately 80% of the patients had no depression. While there were 19.5% had mild to severe depression. Only eight out of 77 subjects had clinically significant symptoms of anxiety. Two subjects were having comorbid illness.Conclusions: A considerable percentage of HCWs experience burnout, depression, and anxiety.

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Ur Rahman, Dr Aitmad, Dr Usman Ejaz, Dr Ahtasm Dr.Ahtasm, Dr Amina Zartasha, Dr Saman Zafar, and Dr Namra Asif. "Frequency of Depression, Anxiety and Stress in Health Care Workers Serving in COVID-19 Wards." American Journal of Health, Medicine and Nursing Practice 8, no. 3 (May 11, 2023): 22–31. http://dx.doi.org/10.47672/ajhmn.1458.

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Purpose: The COVID-19 pandemic has affected the lifestyles of millions of individuals worldwide and is likely to cause psychological health issues in those who work in Covid-19 wards. To find out the Frequency of depression, anxiety and stress in health care workers serving in Covid-19 wards. Methodology: In this cross-sectional study, data were gathered from various hospitals in Lahore and 280 participants were recruited using a non-probability convenient sampling technique. The study included both male and female health care professionals, in particular doctors, nurses, and paramedics, working in Covid wards for at least one month in both the public and private sectors. Participants with experience of less than 1 month and lab workers were excluded from the study. Depression Anxiety and Stress scale was used to collect data. Data was collected by distributing questionnaires to the participants and analyzed their response by using SPSS version 21.0 statistical software. Findings: The results showed that mean ±S.D of participants were 26.55±3.367. Among all participants 148 participants were female and 132 were males. Among 89 doctors 10 felt severe stress, 2 found moderate and 65 doctors were normal.136 Nurses participated in study and 15 felt severe stress, 53 found moderate stress working in COVID-19 wards. Among 55 paramedics, 7 participants felt severe stress, 13 found moderate stress working in COVID-19 wards. Among 89 doctor participants 17 found moderate depression, 77 nurses and 50 paramedics found moderate depression working in COVID-19 wards. Recommendations: It was concluded from the study high levels of stress and burnout, and moderate depression were found in Nurses', then paramedics were affected and least stress, depression and anxiety were found in doctors.

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Brahim, D., N. Mechergui, I. Youssef, W. Ayed, M. Mersni, S. Ernez, and N. Ladhari. "Identification of anxiety-depressive disorders in paramedics working shift work." European Psychiatry 66, S1 (March 2023): S473. http://dx.doi.org/10.1192/j.eurpsy.2023.1013.

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IntroductionShift work can lead to mental health problems evolving into real anxiety disorders with significant socio-professional repercussions.ObjectivesThe purpose of our work was to screen paramedics with shift work for anxiety disorders.MethodsCross-sectional study carried out among the paramedical staff of a Tunisian university hospital. The data was collected from a pre-established record sheet. Screening for anxiety-depressive disorders was done using the HAD scaleResultsThe study included 158 paramedics. The average age was 36.48 years with female predominance at 70.9%. The average working time was 11.1 8.9 years and the average working time in shift work was 10.27 9.2 years. Of the 13 departments with non-standard hours of work, the main departments represented were resuscitation (n=24; 15.2%), emergencies (n=18; 11.4%) and radiology (n=17; 10.8%). Nurses accounted for 46.2%, manual workers for 23.4% and senior technicians for 19%.Certain anxiety symptomatology was found in 53.2% (n=84) and doubtful symptomatology in 29.1% (n=46) of the general population. Certain depressive symptomatology was noted in 17.1% (n=27) and doubtful symptomatology in 30.4% (n=48) of the general population. Occupational seniority and seniority in shift work were statistically significantly associated with both anxiety (p=0.04/p=0.05) and depression (p=0.05/p=0.006) symptomatology. ). Similarly, this anxiety-depressive symptomatology was associated with the position occupied (p=0.02 / p=0.04) and the assignment department (p=0.008 / p=0.01).ConclusionsAnxiety-depressive disorders are common among paramedics working shift work in hospitals. Screening consultations in occupational medicine are necessary to detect these disorders early.Disclosure of InterestNone Declared

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Sellami, I., A. Feki, N. Remadi, N. Kotti, M. L. Masmoudi, K. Jmal Hammami, and M. Hajjaji. "Chronic diseases among paramedics and their impact on mental health." European Psychiatry 66, S1 (March 2023): S433. http://dx.doi.org/10.1192/j.eurpsy.2023.931.

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IntroductionWorking in a care setting is characterised by an increased mental and physical load. During their professional life, personnel in this sector can develop essentially degenerative pathologies, which could influence their professional career as well as their psychological balance.ObjectivesWe aimed to evaluate the impact of chronic pathologies on the prevalence of anxiety and depression among this group.MethodsWe conducted a cross-sectional study in hospitals in Sfax using a self-administered questionnaire. This questionnaire evaluated socio-demographic, professional, and clinical characteristics as well as an evaluation of the degree of anxiety and depression by the HAD questionnaire.ResultsOur population consisted of 120 participants. The average age was 37 years, with a female predominance (a sex ratio of 0.69). The chronic pathologies found in the participants were mainly diabetes (18%), high blood pressure (4%), and rheumatic disease (6.7%). The average anxiety score was 8.18± 3.5 and that of depression was 9.02± 3.5. Certain depressive and anxious signs were found in 28.4% and 23.6% of participants, respectively. Although the average scores for anxiety and depression were higher in the subgroup of personnel with chronic pathologies (respectively, 9.8 versus 9.04 and 9.3 versus 8.46), these differences were not statistically significant (p > 0.05).ConclusionsPhysical and mental health are both important to ensure a balanced life. Having good control of somatic illness can improve mental health.Disclosure of InterestNone Declared

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Maatouk, O., R. Kammoun, I. Kammoun, K. Souabni, M. Karoui, H. Nefzi, and F. Ellouz. "Depression among frontline medical and paramedical staff during the coronavirus pandemic." European Psychiatry 65, S1 (June 2022): S525—S526. http://dx.doi.org/10.1192/j.eurpsy.2022.1341.

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Introduction The current coronavirus pandemic is a unique and unusual situation. It is putting the general population under severe strain. However, frontline medical and paramedical staff remain particularly vulnerable to depression because of its close contact with patients. Objectives The aim of this work was to screen and evaluate depression in the frontline professionals during the pandemic and to study their associated factors . Methods In this study , we conducted a national descriptive and analytical cross-sectional study over a 2-month period from September to October 2020. We used “Beck Depression Inventory” to assess depression and “Brief Cope Scale” to detect a possible correlation between depression and coping mechanisms. Results We collected 78 professionals. The mean age was 29.86 years. 2/3 of workers were women. 67.9% of the staff were residents. 39.7% worked in Covid units. 7.7% had personal psychiatric history. 56.4% of the staff worked daily and 76.9% of them provided direct care to patients with Coronavirus. 52.6% of workers did not receive adequate training of protection against Covid-19.The staff reported 66.7% of death among their patients. 42.3% suffered from minor depression and only 2.3% suffered from severe depression. During this period we objectified an increase of 14.1% in the psychoactive substances use. Stigma affected 57.7% of professionals. We didn’t objectify a significant correlation between Depression and coping mechanisms . Conclusions Screening depression among healthcare professionals should be considered in order to prevent it, ensure continuity of care and avoid sick leaves. Disclosure No significant relationships.

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Marczewski, Kamil Piotr, Magdalena Piegza, Alicja Zofia Gospodarczyk, Natalia Justyna Gospodarczyk, and Krystyn Sosada. "Impact of Selected Sociodemographic and Clinical Parameters on Anxiety and Depression Symptoms in Paramedics in the Era of the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 19, no. 8 (April 8, 2022): 4478. http://dx.doi.org/10.3390/ijerph19084478.

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Introduction: The emergence of the SARS-CoV-2 virus, which caused the outbreak of the pandemic declared by the World Health Organization (WHO, World Health Organization) on 11 March 2020, has resulted in the introduction of many restrictions worldwide to contain the rapidly spreading pathogen. A particularly vulnerable professional group are paramedics working in Emergency Medical Teams. Aim: The main aim of this study was to investigate the influence of selected sociodemographic and clinical parameters on anxiety and depression symptoms in paramedics during the COVID-19 pandemic. Materials and methods: The study involved 387 paramedics working in Medical Rescue Teams in Poland. The majority of respondents were male (72.35%). In order to achieve the aim of the study, an online diagnostic survey was conducted using a questionnaire of the author’s own design and standardized questionnaires: Hospital Anxiety and Depression Scale (HADS) and General Anxiety Disorders (GAD-7). Results: Significantly higher values were observed for all analysed scales in females compared to males. The main factors influencing the occurrence of anxiety and depression symptoms were gender, seniority at work, family relations, use of sleeping pills. Alcohol consumption increased in this professional group during the pandemic. Conclusions: Females and users of sleep medication who work in the emergency department during a pandemic are more likely to experience symptoms of depression and anxiety. A longer length of service and satisfying relationships with family are factors in reducing these symptoms. Paramedics who are in informal relationships and single manifest more emotional problems compared to those who are married. Increased alcohol consumption can be considered as a way of coping with stress. However, further studies in this professional group are needed to assess the further impact of the pandemic on psychiatric symptoms among emergency medical workers.

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Peppou, L. E., T. Giannouchos, M. Economou, and A. Paschali. "The impact of the COVID-19 pandemic on paramedics’ mental health in Greece." European Psychiatry 64, S1 (April 2021): S274. http://dx.doi.org/10.1192/j.eurpsy.2021.736.

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IntroductionConverging evidence substantiates a negative impact of the COVID-19 pandemic on the mental health of frontline workers. Nonetheless, there is paucity of research on paramedics.ObjectivesTo estimate the prevalence of stress, anxiety and depression in frontline paramedics in the Athens region, Greece, and to investigate the coping skills that are associated with less favourable mental health outcomesMethods A total of 100 ambulance paramedics participated in the study. The online questionnaire encompassed the DASS-21 for assessing mental health outcomes and the Brief-COPE for measuring coping skills. Information about socio-demographic characteristics and personal/relatives’ vulnerability to COVID-19 was also gleaned.Results The prevalence for moderate to severe cases was found to be 7.2% for stress, 9.4% for anxiety and 11.3% for depression. Multiple linear regression analysis indicated that men demonstrated significantly higher stress [B = -2.28, 95%CI = -3.88 - -0.68] and depression compared to women [B = -1.69, 95%CI = -3.19 - -0.19]. Similarly, the use of denial was found to be associated with higher stress [B = 0.69, 95%CI = 0.11 -1.37] and anxiety [B= 0.55, 95%CI = 0.13 – 0.98]. Moreover, emotional support was linked to heightened anxiety [B= 0.71, 95%CI = 0.36 – 1.06] and self-distraction to depression [B = 0.60, 95%CI = 0.16 – 1.04]. Personal or relatives’ vulnerability to COVID-19 did not impinge on mental health outcomes.ConclusionsHealthcare initiatives should be tailored at the mental health needs of frontline paramedics, especially men. Psychosocial interventions should target maladaptive coping, especially the use of denial.

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Papadopoulou, Athina, Nicole Müller-Lenke, Yvonne Naegelin, Gabriela Kalt, Kerstin Bendfeldt, Pascal Kuster, Markus Stoecklin, et al. "Contribution of cortical and white matter lesions to cognitive impairment in multiple sclerosis." Multiple Sclerosis Journal 19, no. 10 (March 4, 2013): 1290–96. http://dx.doi.org/10.1177/1352458513475490.

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Background: Cortical lesions (CLs) have been reported to be a better predictor for cognitive impairment than white matter (WM) lesions in relapsing–remitting multiple sclerosis (RRMS). Objectives: The objectives of this article are to investigate the contribution of CLs and WM lesions to cognitive impairment in 91 patients with MS and clinically isolated syndrome, and to test potential associations of CLs and WM lesions with fatigue and depression. Methods: Lesions were scored and segmented on 3D double inversion recovery sequences, according to their location (cortical, WM). Normalised grey matter volume was also determined. Cognitive performance was assessed with the SDMT and PASAT-3, fatigue with the FSMC and depression with the German version of the CES-D. Results: CL volume did not correlate with fatigue or depression, but correlated significantly with both neuropsychological outcome measures: PASAT-3 ( r = −0.275, p = 0.009) and SDMT ( r = −0.377, p < 0.001). Multiple regression analyses with age, WM lesions, CLs and GM volume as independent variables, however, did not reveal CL volume as a significant predictor of neuropsychological outcomes, whereas WM lesion volume significantly predicted SDMT and by trend PASAT performance. Conclusions: These findings suggest a role of WM lesions in the development of cognitive deficits, especially information-processing speed, which may be higher than previously assumed. Abbreviations: CES-D: Center for Epidemiologic Studies Depression scale (ADS-L: Allgemeine Depressions Skala-L, German version of CES-D), CIS: clinically isolated syndrome, CL: cortical lesion, DIR: double inversion recovery, EDSS: Expanded Disability Status Scale, FSMC: fatigue scale for motor and cognitive functions, GM: grey matter, MRI: magnetic resonance imaging, MS: multiple sclerosis, PASAT-3: paced auditory serial addition test 3s, PPMS: primary progressive multiple sclerosis, RRMS: relapsing–remitting multiple sclerosis, SDMT: symbol digit modalities test, SPM: statistical parametric mapping, SPMS: secondary progressive multiple sclerosis, WM: white matter

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Wolkow, Alexander, Rachael Harris, Elle Nguyen, Ben Meadley, Shantha M. W. Rajaratnam, Brett Williams, Karen Smith, Kelly-Ann Bowles, Megan L. Dobbie, and Sean P. A. Drummond. "0346 Insomnia in the Initial Months of Emergency Work Is Associated with Future PTSD Symptoms in New Recruit Paramedics." SLEEP 47, Supplement_1 (April 20, 2024): A148—A149. http://dx.doi.org/10.1093/sleep/zsae067.0346.

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Abstract Introduction New paramedics commencing emergency work and adjusting to shift work can experience an increase in sleep problems. Sleep disturbances have been closely associated with poor mental health in emergency personnel. It is unknown, however, whether poor sleep experienced in the initial months of emergency work represents an early risk factor for future mental health problems in paramedics. The present study examined whether sleep disturbances in paramedics after 6-months of shift and emergency work were associated with mental health symptoms later in their career. Methods Sleep disorder and mental health symptoms were examined in new recruit paramedics (n=105) after their first 6- and 12-months of shift and emergency work. At each timepoint, participants completed validated self-report measures of insomnia (Insomnia Severity Index), shift work disorder (SWD; SWD Screening Questionnaire), obstructive sleep apnoea (OSA; Berlin Questionnaire), depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), post-traumatic stress disorder (PTSD; PTSD Checklist-5) and trauma exposure (Life Events Checklist-5). Linear regressions examined whether sleep at 6-months (i.e., insomnia, SWD, and OSA) predicted mental health symptoms (i.e., depression, anxiety, and PTSD) at the 12-month follow-up, while controlling for demographics (i.e., age and sex) and mental health symptoms at the 6-month timepoint. Additionally, the regression models examining sleep and PTSD also controlled for trauma exposure at 6-months via the Life Events Checklist-5. Results Increased insomnia symptoms at 6-months of emergency work and shift work significantly predicted higher PTSD symptoms at the 12-month timepoint (b=0.09 [0.03,0.15], p=0.01) while controlling for trauma exposure, PTSD symptoms and demographics at 6-months. Insomnia at 6-months was not, however, related to depression (p=0.36) or anxiety (p=0.42) at follow-up, and OSA and SWD risk at 6-months were not related to any of the mental health outcomes at follow-up (all p>0.05). Conclusion Our findings highlight insomnia symptoms in the initial months of emergency work as an early risk factor for the development of PTSD later in new paramedics’ careers. Given sleep is a largely modifiable factor, this finding highlights the need to investigate interventions that target insomnia early in paramedics’ careers to reduce the risk of future mental health problems in this high-risk occupation. Support (if any)

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McCann, Terence V., Michael Savic, Nyssa Ferguson, Alison Cheetham, Katrina Witt, Kate Emond, Emma Bosley, Karen Smith, Louise Roberts, and Dan I. Lubman. "Recognition of, and attitudes towards, people with depression and psychosis with/without alcohol and other drug problems: results from a national survey of Australian paramedics." BMJ Open 8, no. 12 (December 2018): e023860. http://dx.doi.org/10.1136/bmjopen-2018-023860.

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ObjectiveContinuing stigma towards mental health problems means that many individuals—especially men—will first present in crisis, with emergency services often the first point of call. Given this situation, the aims of this paper were to assess paramedics’ ability to recognise, and their attitudes towards, males with clinically defined depression and psychosis with and without comorbid alcohol and other drug (AOD) problems.MethodsA cross-sectional national online survey of 1230 paramedics throughout Australia. The survey was based on four vignettes: depression with suicidal thoughts, depression with suicidal thoughts and comorbid alcohol problems, and psychosis with and without comorbid AOD problems.ResultsJust under half of respondents recognised depression, but this decreased markedly to one-fifth when comorbid AOD problems were added to the vignette. In contrast, almost 90% recognised psychosis, but this decreased to just under 60% when comorbid AOD problems were added. Respondents were more likely to hold stigmatising attitudes towards people in the vignettes with depression and psychosis when comorbid AOD problems were present. Respondents endorsed questionnaire items assessing perceived social stigma more strongly than personal stigma. Desire for social distance was greater in vignettes focusing on psychosis with and without comorbid AOD problems than depression with and without comorbid AOD problems.ConclusionsParamedics need a well-crafted multicomponent response which involves cultural change within their organisations and more education to improve their recognition of, and attitudes towards, clients with mental health and AOD problems. Education should focus on the recognition and care of people with specific mental disorders rather than on mental disorders in general. It is essential that education also focuses on understanding and caring for people with AOD problems. Educational interventions should focus on aligning beliefs about public perceptions with personal beliefs about people with mental disorders and AOD problems.

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Arnone, Danilo, Dominic Job, Sudhakar Selvaraj, Osamu Abe, Francesco Amico, Yuqi Cheng, Sean J. Colloby, et al. "Computational meta-analysis of statistical parametric maps in major depression." Human Brain Mapping 37, no. 4 (February 8, 2016): 1393–404. http://dx.doi.org/10.1002/hbm.23108.

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KARATAŞ, Yusuf, Faiz Ullah KHAN, and Zakir KHAN. "Antidepresan ilaçlarla advers ilaç reaksiyonları: Depresyon farmakoterapisinde farmakovijilansın önemi." Arşiv Kaynak Tarama Dergisi 31, no. 3 (September 30, 2022): 151–59. http://dx.doi.org/10.17827/aktd.1112770.

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Depression is a major public health psychiatric problem that affects people all over the world, with a high lifetime incidence and severe disability. Depending on the severity and pattern of depression episodes over time, antidepressant (ADs) medication may be advised as one of the therapeutic methods. On the other hand, ADs medication may have adverse drug reactions (ADRs). ADRs reduce people's quality of life, which leads to poor adherence to ADs, longer hospital stays, higher healthcare costs, poor therapeutic outcomes, physical morbidity, stigma and also death in the worst-case scenario. Psychiatrists must be familiar with the procedures for identifying and reporting ADRs, especially those that are new or unknown. Pharmacovigilance is a medical discipline based on these processes. Pharmacovigilance is not a "specialist" activity; it is a requirement for all those involved in the care of patients on medications, including doctors, nurses, and pharmacists and paramedical staff. This narrative review paper provides an overview of depression, ADs, Antidepressant-related ADRs, and the significance of pharmacovigilance. Articles were found using PubMed, Scopus, Google Scholar, MEDLINE and DergiPark databases. Firstly, we examined the title, then the abstract and finally the entire study. Depression appears to be associated with an increased risk of developing ADRs. Various ADRs are associated with ADs as per previously published literature. This review emphasizes the implementation of the pharmacovigilance system and the importance of monitoring ADRs in psychiatric depressive patients regularly by all healthcare professionals.

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Marik, Sharanya, Anshika Arora, and Sunil Saini. "Pattern of Psychological Distress in Cancer Patients Visiting Out-Patient Department- A Prospective Study in A Tertiary Cancer Care Hospital in Northern India." European Journal of Clinical Medicine 3, no. 6 (November 26, 2022): 8–13. http://dx.doi.org/10.24018/clinicmed.2022.3.6.145.

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Context: Psychological distress in cancer patients is a well recognized but under diagnosed problem. Aims: This study aimed to study the prevalence and pattern of distress among cancer patients visiting the out-patient department of oncology. Settings and Design: This was a prospective observational study, carried out at Cancer Research Institute, Swami Rama Himalayan University, Dehradun, India, between January 2018 and April 2018. Material and Methods: We enrolled 390 cancer patients prospectively after written informed consent. Their demographic, disease and treatment details were recorded. Self reporting Hospital Anxiety and Depression Scale was used for anxiety and depression. Statistical analysis used: After checking for normality of data, normal data was analyzed using Parametric, non-normal using Non-parametric methods. Association between baseline and outcome categorical variables was tested with Chi-square test. A p-value of <0.05 was considered significant. Spearman’s Rho was used for linear correlation. Results: The prevalence of anxiety was 34.6% and depression 40.3% Factors significantly associated with anxiety were female gender (p=0.051), advanced stage (p=0.036), primary site (p=0.006); with depression advanced stage (p=0.001) and number of metastatic sites (p=0.025). Linear correlation between anxiety and depression was strong (Spearman’s rho= 0.735). Conclusions: The prevalence of cancer related psychological distress is high in out-patients. Variables like female gender, primary tumor site, advanced stage and number of metastasis were significantly associated with distress.

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Belhadj Chabbah, N., S. Chatti, Z. Athimni, M. Bouhoula, A. Chouchane, A. Aloui, I. Kacem, et al. "Levels of anxiety, depression and stress among health care workers during the COVID19 pandemic: Study conducted at the University Hospital Farhat Hached of Sousse-Tunisia." European Psychiatry 66, S1 (March 2023): S815. http://dx.doi.org/10.1192/j.eurpsy.2023.1728.

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Introduction During the COVID-19 pandemic, health care workers found themselves threatened by developing psychological effects.ObjectivesThe objective of this study is to evaluate the impact of exposure to COVID-19 on the mental health of medical and paramedical staff at Farhat Hached Hospital in Sousse and to identify potential risk factors.MethodsThis is a descriptive cross-sectional study that included 166 health care workers of Farhat Hached Hospital of Sousse throughout 3 months. The patient health questionnaire (PHQ-9), the generalized anxiety disorder (GAD-7), and the revised event impact scale (IES- R) were used to assess depression, anxiety, and stress respectively.ResultsThe mean age of the participants was 37.06 ±11.07 years with a female predominance (80.1%). The median professional seniority was 7.5 years with extremes ranging from 1 to 39 years. Nurses were the most represented (34.3%) followed by medical residents (24.7%). PHQ-9, GAD-7, and IES- R scores revealed that 51.8%, 40.4%, and 28.3% of participants had moderate or severe levels of depression, anxiety, and stress, respectively. Personal history of psychiatric disorders was significantly associated with depression (p<10-3) and anxiety (p=0.004). On the other hand, paramedical staff had a significantly higher risk of experiencing symptoms of depression (OR = 2.40 ; 95% CI [1.28-4.48] ; p= 0.006) and stress (OR = 2.03 ; 95% CI [1.01-4.11] ; p= 0.04) than medical personnel.ConclusionsThis study reported a high prevalence of symptoms of anxiety, depression and stress among health care workers. Improving mental well-being and providing psychological support to health care workers is recommended.Disclosure of InterestNone Declared

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Harris, Rachael, Sean P. A. Drummond, Ben Meadley, Shantha M. W. Rajaratnam, Brett Williams, Karen Smith, Kelly-Ann Bowles, Elle Nguyen, Megan L. Dobbie, and Alexander P. Wolkow. "0347 Sleep Behaviour and Shift Work Tolerance in New Paramedics Beginning Shift Work." SLEEP 47, Supplement_1 (April 20, 2024): A149. http://dx.doi.org/10.1093/sleep/zsae067.0347.

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Abstract Introduction In experienced shift workers, researchers have evaluated levels of shift work tolerance (SWT) and sleep behaviours. SWT refers to not experiencing negative consequences associated with shift work, whereas sleep behaviours, describe strategies workers may use to cope with shift work. Neither sleep behaviours nor SWT have been longitudinally investigated in new emergency personnel. The current study aimed to track changes in sleep behaviour during the first 12-months of shift work, and secondly to explore whether changes in sleep behaviour were associated with SWT after 12-months of work. Methods One-hundred and five recruit paramedics were investigated at baseline (before shift work), and after 6- and 12-months of shift work. Paramedics’ sleep and mental health were evaluated at each timepoint via questionnaires. Participants also completed a 14-day shift work (via work diaries) and sleep (via sleep diaries and actigraphy) monitoring period at each timepoint. Sleep opportunity (SO), regularity, and behaviours in relation to nightshift were investigated. SWT at 12-months was categorised based on symptoms of depression, anxiety, insomnia, and sleep quality and efficiency on rest days. Results Linear mixed models found SO increased on day shifts and rest days, and sleep regularity declined from baseline to 6- and 12-months of shift work. There were no changes in SO on rest days, day shifts, or nightshifts between 6- and 12-months of shift work. Latent profile analyses identified levels of SWT as high (n=52), medium (n=27), and low (n=9) after 12-months of shift work. These profiles were primarily distinguished by levels of insomnia, depression, and anxiety. Increasingly irregular sleep between 6- and 12-months of shift work, and prioritising major sleep episodes (i.e., ≥3hrs) rather than naps at 6-months predicted classification as high SWT. Conclusion Our findings suggest after 12-months of shift work, different levels of SWT exist in paramedics, distinguished by their severity of insomnia, depression, and anxiety symptoms. Though sleep behaviours across the whole cohort did not change between 6- and 12-months, those whose sleep became less regular were more likely to have high SWT. Likewise, prioritising major sleep episodes at 6-months was associated with better SWT after 12-months of shift work. Support (if any)

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Ofili, Perpetua Chinyere, Moses Onyemaechi Ede, Ngozi Joannes Anyaegbunam, Kingsley Okechukwu Oforka, Innocent Ebere Okereke, Joshua Emeka Umeifekwem, Chukwuebuka Nnagozie Bosa, et al. "Physical activity and depressive symptoms during the fifth wave of COVID-19 pandemic: Implication for public policy and administrators." Medicine 103, no. 7 (February 16, 2024): e37155. http://dx.doi.org/10.1097/md.0000000000037155.

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Depression is a public mental health problem that can progress to suicidal ideation, literature suggests regular physical activity may ameliorate it. The study assessed the link between physical activity and depression symptoms during the fifth wave of the COVID-19 pandemic and the Academic Staff Union (ASU) strike among undergraduates. Four hundred and eighteen undergraduates were recruited and participated in the study. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Patient Health Questionnaire-9 (PHQ-9) to measure depression severity. The result on PA showed that about one-third of the participants were inactive, above half were moderately active, while a few achieved high PA levels. Above one-fifth of the participants experienced minimal or no depression while a good percent had mild, moderate, moderately severe, and severe depression. Non-parametric tests between PA total score and depression total score with demographic variables were not significant. Spearman’s correlation showed a strong negative relationship between PHQ-9 scores and IPAQ-SF scores. This suggests that a high PA level is associated with lower depression symptoms. The COVID-19 pandemic and the ASU strike experiences resulted in increased depression among undergraduates. The university administration needs to formulate an urgent policy to promote PA among undergraduates and provide treatment for the affected students.

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Sovianti, Vivi, Gianinda Wening Saraswanty, Emilia Puspitasari, Maya Cobalt Angio S, Siti Juwariyah, and Siti Nafisah. "Pengaruh Terapi Musik Klasik Terhadap Penurunan Tingkat Gejala Depresi pada Pasien Gagal Ginjal Kronis yang Menjalani Hemodialisa." NURSING UPDATE : Jurnal Ilmiah Ilmu Keperawatan P-ISSN : 2085-5931 e-ISSN : 2623-2871 14, no. 4 (December 30, 2023): 556–63. http://dx.doi.org/10.36089/nu.v14i4.1838.

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Background: Chronic Kidney Failure problems during hemodialysis may include depression. Depression refers to the mental, thought, feeling, and behavioral problems of patients. The causes of depression include genetics, physical disease, lifestyle, and drugs. One of the therapies to relieve depression is music therapy. This research determines the influence of music therapy to relieve the depression levels of chronic kidney failure patients with hemodialysis. The applied method was quantitative with a quasi-experimental design and one group pretest-posttest. The samples consisted of 45 respondents taken by accidental sampling. The applied instruments were BDI and the music therapy SOP. All instruments were examined in terms of validity, reliability, and expert judgment. The statistic test applied a non-parametric Wilcoxon test. The results showed the influence of classical music therapy and the relieved depression levels of chronic kidney failure patients with hemodialysis. The obtained p-value is 0.000, lower than 0.05. The researcher concluded the implementation of classical music was effective to relieve the depression symptoms of chronic kidney failure patients with hemodialysis. The researcher suggests developing a combined classical music therapy to relieve depression in chronic kidney failure patients. The researcher suggests the implementation of intervention and control groups to compare the significance of the results.

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Vivi Sovianti, Gianinda Wening Saraswanty, Emilia Puspitasari, Maya Cobalt Angio S, Siti Juwariyah, and Miss Nafisah. "Reducing Depression with Classical Music Therapy in Chronic Kidney Failure Patients Undergoing Hemodialysis." JOURNAL of HEALTH SCIENCE REVIEW 1, no. 2 (September 30, 2024): 51–59. http://dx.doi.org/10.70519/jhsr.v1i2.71.

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Background: Chronic Kidney Failure problems during hemodialysis may include depression. Depression refers to the mental, thought, feeling, and behavioral problems of patients. The causes of depression include genetics, physical disease, lifestyle, and drugs. One of the therapies to relieve depression is music therapy. This research determines the influence of music therapy to relieve the depression levels of chronic kidney failure patients with hemodialysis. The applied method was quantitative with a quasi-experimental design and one group pretest-posttest. The samples consisted of 45 respondents taken by accidental sampling. The applied instruments were BDI and the music therapy SOP. All instruments were examined in terms of validity, reliability, and expert judgment. The statistic test applied a non-parametric Wilcoxon test. The results showed the influence of classical music therapy and the relieved depression levels of chronic kidney failure patients with hemodialysis. The obtained p-value is 0.000, lower than 0.05. The researcher concluded the implementation of classical music was effective to relieve the depression symptoms of chronic kidney failure patients with hemodialysis. The researcher suggests developing a combined classical music therapy to relieve depression in chronic kidney failure patients. The researcher suggests the implementation of intervention and control groups to compare the significance of the results

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