BACKGROUND: Healthcare providers (HCP) continue to provide patient care during the COVID-19 pandemic despite the known risks for transmission. Studies conducted early in the pandemic showed that factors associated with higher levels of distress among HCP included being of younger age, female, in close contact with people with COVID-19, and lower levels of education. The goal of this study was to determine if level of patient contact was associated with concern for post-traumatic stress disorder (PTSD) as measured by the Impact of Event Scale-Revised (IES-R).
METHODS: This cross-sectional study, embedded within a prospective cohort study, recruited HCP working in hospitals in four Canadian provinces from June 2020 to June 2023. Data were collected at enrolment and annually from baseline surveys with the IES-R scale completed at withdrawal/study completion. Modified Poisson regression was used to determine the association between level of patient contact and concern for PTSD (i.e., IES-R scores ≥24).
RESULTS: The adjusted rate ratio (RR) associated with concern for PTSD among HCP with physical contact/direct patient care was 1.19 (95% confidence interval (CI) 1.03, 1.38) times higher than for HCP with no direct contact. In fully adjusted linear regression models, physical care/contact was associated with higher avoidance and hyperarousal scores, but not intrusion scores.
CONCLUSIONS: Administrators and planners need to consider the impact of heightened and ongoing stress among HCP by providing early screening for adverse emotional outcomes and delivery of tailored preventive strategies to ensure immediate and long-term HCP health.

Background: Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.Objective: This study investigated the longitudinal impact of trauma incidents during duty on firefighters using latent transition analysis.Method: Data from 346 firefighters in South Korea who had experienced trauma events while on duty were utilized. Initially, latent groups were identified based on the relationship between post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). Groups were labelled based on the analysis of differences in PTSD, mental health, and growth-related factors among classified groups. Subsequently, transition probabilities and patterns from Time 1 to Time 2 were examined, followed by an investigation into variances based on demographic factors (gender, age) and occupational factors (work experience, shift pattern) using variance analysis and multinomial logistic regression analysis.Results: First, at Time 2, a five-group model was classified into \'Growth,\' \'Resilience or Numbness,\' \'Struggle,\' \'Partial Struggle,\' and \'PTSD\' groups. Second, upon examining the transition patterns between latent groups, four patterns emerged: \'continued distress,\' \'growth,\' \'adaptation,\' and \'escalated distress.\' Third, the \'Struggle\' group showed a 0% probability of transitioning to the \'Growth\' group, whereas it displayed the highest probability among the groups transitioning to the \'PTSD\' group. Fourth, latent transition analysis results showed a strong tendency for the \'Growth\' group and \'Resilience or Numbness\' group to remain in the same category. Fifth, age was found to be a significant factor affecting the transition of latent groups.Conclusion: This research represents the inaugural attempt to longitudinally investigate the interplay between PTSD and PTG among firefighters.
Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.The transition patterns of firefighters between latent groups revealed at Time 1 and Time 2 were examined, revealing four transition patterns: ‘continued distress,’ ‘growth,’ ‘adaptation,’ and ‘escalated distress.’This research represents the inaugural attempt to longitudinally investigate the interplay between post-traumatic stress disorder and post-traumatic growth among firefighters.

BACKGROUND: Autolοgous Hematopoietic Stem Cell Transplantation (AHSCT) is a treatment οption fοr patients with hematological malignancies that improves prοgnοsis and survival. Thus, it is necessary tο deal with its long-term cοmplications, such as sexual dysfunction and trauma that significantly affect survivors\' quality οf life.
OBJECTIVE: The aim οf this study was to evaluate the Sexual Function (SF) and the Pοst-traumatic Stress Disorder (PTSD) οf survivοrs οf hematolοgical malignancy and AHSCT.
METHODS: A multicenter, quantitative, crοss-sectional, descriptive, and cοrrelational study was cοnducted from December 2019 to March 2022. Thrοugh cοnvenience sampling, 127 adults and sexually active survivors οf hematolοgic malignancy whο underwent AHSCT frοm 6 mοnths tο 5 years were recruited frοm 5 hοspitals in Athens. The survivοrs cοmpleted questionnaires on demοgraphic and clinical data, a male or female SF assessment tοοl [Internatiοnal Index Erectile Functiοn (IIEF) and Female Sexual Functiοn Index (FSFI), respectively], and the Impact of Event Scale-Revised (IES-R).
RESULTS: Patients\' mean age was 45.6 (±12.8) years. The median time frοm transplant was 3 years and the majοrity οf the survivοrs had Hodgkin\'s lymphοma. Accοrding tο the FSFI, wοmen had a mοderate level of SF, with a better functional area the \"pain\" and wοrse the \"οrgasm\". Accοrding tο the IIEF, men had a high level of SF, with a better functional area the \"erection\" and wοrse the \"οverall satisfaction\". Survivοrs had lοw levels οf PTSD based οn the IES-R, with nο differences between men and women. The subscale οf \"hyperarοusal\" had the lοwest values and the subscale οf \"avοidance\" had the highest values fοr bοth men and wοmen survivοrs. There was a lοw tο mοderate negative statistically significant cοrrelation between the IES-R and bοth FSFI and IIEF, suggesting a high level οf PTSD to be correlated with wοrse sexual function.
CONCLUSIONS: Survivοrs οf AHSCT had impaired SF tο varying degrees and areas of functionality depending οn their gender, but lοw levels of PTSD and lοw correlations between these twο variables. This matter is impοrtant in survivοrship care and needs further investigatiοn.

BACKGROUND: Paediatric Multisystem Inflammatory Syndrome (PIMS-TS) is a novel condition that was identified for the first time during the COVID-19 pandemic. Limited research exists that describes the psychological needs of children and young people (CYP) following an acute hospital admission for PIMS-TS.
METHODS: A retrospective cohort study was conducted to explore both psychological need and access to psychology services for CYP and their families who were admitted to a paediatric tertiary hospital in London, UK, for PIMS-TS between April 2020 and May 2021.
RESULTS: We included 121 CYP and a parent/caregiver for each. In total, 23.3% of the CYP were at risk of developing a traumatic stress response and 11.6% were at risk of experiencing emotional disturbance. Of the parents screened, 40.5% also scored above clinical cut-off for a trauma response. There was a significant relationship observed between CYP and parents identified as having a trauma risk.
CONCLUSIONS: The importance of proactive screening for both trauma and emotional distress in CYP and their parents/caregivers following acute hospital admission is highlighted. In addition, there is a need to think about a CYP as part of a system of care and to ensure that clinicians pay attention to parental wellbeing and mental health when understanding the psychological impact on a child.

The COVID-19 pandemic has led to long-lasting consequences for workers leading to what has been termed a \"psychological pandemic\". Some categories, such as healthcare workers (HCWs), are considered high risk due to factors such as increased exposure and stressful working conditions. In this study, we investigate whether levels of posttraumatic stress symptoms and COVID-19-related fear (IES-6 and PSI-4) are associated with illness severity in a sample of 318 infected HCWs in Italy. To investigate the presence of different profiles of COVID-19 severity, Latent Class Analysis (LCA) was performed based on 11 symptoms. Differences in the IES-6 and PSI-4 scores across the latent classes were compared using the non-parametric Kruskal-Wallis (KW) test with Dunn\'s multiple comparison post hoc testing. Our analyses show that the LCA identified three classes of symptoms, reflecting no/low, mild and severe symptoms. The classes include vomiting, confusion, conjunctivitis, diarrhea, dyspnea, headache, ageusia, fever, anosmia, osteo muscle articular pain and asthenia. We found that HCWs who experienced more intense symptoms reported significantly higher IES-6 and PSI-4 scores. Moreover, we found gender-related differences in IES-6 and PSI-4 scores as females exhibited higher levels than males. Indeed, these findings are useful for developing health prevention and emergency management programs.

Recent evidence suggests that indirect verbal exposure to traumatic events can be sufficient to cause intrusions and other posttraumatic stress symptoms. In this study, we used a verbal trauma report to experimentally induce intrusions and a tactile task to manipulate the putative processes underlying intrusion development. Our findings indicate that the verbal report indeed induced intrusive recall. Moreover, the verbal report induced negative mood, state anxiety, and state dissociation, with mood and state dissociation predicting intrusion development. Additionally, the tactile task interfered with intrusion formation as indicated by the primary diary measure, but not the retrospective self-report. However, these results await further replication as this and previous trials suffered from limited statistical power. The findings support the reports by trauma therapists who experience secondary traumatization. They also challenge the assumption that all intrusions develop bottom-up from low-level sensory input via sensory representations. Future studies should explore differential processes for intrusion development based on their modality.

The present study aimed to investigate the interplay between adult attachment style, perceived social support, and post-traumatic stress (PTS) symptoms among adult female victims of sexual assault)SA(. While prior research has established the link between insecure attachment style and PTS, the underlying mechanisms are not well understood. The potential role of perceived social support as a mediator in this relationship has been largely neglected and there is a dearth of studies investigating this mediation among victims of SA. The present study sought to address this gap in literature. Two hundred twenty-six women who have endured SA completed self-report measures of attachment style, perceived social support, and PTS, using an online survey. The results confirmed the anticipated pattern, showing a positive correlation between insecure attachment styles and PTS, as well as a negative correlation with perceived social support. A mediation analysis indicated that perceived social support may be a mechanism linking attachment styles to PTS. Following SA, insecurely attached women, especially those with avoidant attachment, have difficulties relying on and utilizing support from their environment, which may render them more susceptible to PTS. Nevertheless, the mediation was partial, indicating that attachment anxiety and attachment avoidance independently contribute to the development and maintenance of PTS.

BACKGROUND: Maternity support workers (MSWs) are now a key part of the maternity workforce. They work in environments with potential exposure to traumatic events, but little is known about their rates of exposure or psychological responses.
OBJECTIVE: We aimed to identify the proportion of MSWs reporting exposure to a traumatic work event and consequential rates of post-traumatic stress disorder (PTSD). We also aimed to identify factors associated with PTSD and to describe levels of burnout, empathy, and functional impairment, and to explore their potential associations with PTSD symptoms.
METHODS: MSWs were recruited via the Royal College of Midwives newsletter, which is sent to all MSW members, and via social media on the College MSW Facebook page. Participants completed an online survey. They provided information on demographic details, job role, and exposure to traumatic events, and completed questionnaires covering PTSD symptoms related to work events, related functional impairment, burnout, and empathy. Data were analysed via correlations and multiple regression.
RESULTS: Of 98 respondents, 88 had been exposed to a traumatic work event; 79 of these through being present and nine through hearing about traumatic events. Of those exposed, 14.8% (n = 13) participants had probable PTSD, while a further 5.7 % (n = 5) met the subclinical threshold. Over a third (35.2 %) of the sample showed high levels of emotional exhaustion, a key feature of burnout, and 27.3 % reported functional work impairment. PTSD symptoms were associated with younger age, higher empathic concern, and direct exposure to traumatic perinatal events.
CONCLUSIONS: MSWs are routinely exposed to traumatic events at work and are at risk of work-related PTSD. Younger and more empathic staff appear more at risk, although our methods could not distinguish cause and effect. It must also be noted that the survey took place during the COVID-19 pandemic, and findings could be influenced by this context. MSWs need to be routinely included in programmes to support staff in relation to trauma exposure at work.

OBJECTIVE: Women who experience obstetric interventions and complications during childbirth have an increased risk of developing postnatal post-traumatic stress and mental illness. This study aimed to test the effect of a trauma-informed support programme based on psychological first aid (PFA) to reduce the mothers\' symptoms of stress, fear of childbirth (FOC), anxiety and depression after a complicated childbirth.
METHODS: The study population consisted of women ≥ 18 years old who had undergone a complicated childbirth (i.e. acute or emergency caesarean section, vacuum extraction, child in need of neonatal care, manual placenta removal, obstetric anal sphincter injury, shoulder dystocia or major haemorrhage (>1000 ml)). A total of 101 women participated in the study, of whom 43 received the intervention. Demographic questions and three self-assessment instruments measuring stress symptoms, FOC, anxiety and depression were answered one to three months after birth.
RESULTS: The women in the intervention group scored significantly lower on the stress symptom scale, with a halved median score compared to the control group. There was no significant difference between the groups regarding FOC, depression and anxiety.
CONCLUSIONS: Our results indicate that this PFA-based support programme might reduce post-traumatic stress symptoms in women who have gone through a complicated childbirth. With further studies in a larger population, this support programme has the potential to contribute to improved maternal care optimizing postnatal mental health.

OBJECTIVE: To analyse the levels of anxiety, depression, post-traumatic stress, and burnout among nursing professionals working in the Imbabura region of Ecuador during the COVID-19 pandemic and identify the contributing socio-occupational factors.
BACKGROUND: The high demand for care of COVID-19 patients led to increased work pressure on nurses, owing to increased demands for care and shortages of medical supplies and protective equipment.
METHODS: A cross-sectional study was conducted from September to December 2022 using a self-administered questionnaire addressed to nursing professionals who cared for COVID-19 patients.
METHODS: The questionnaire included socio-demographic characteristics, the Spanish adaptation of Hospital Anxiety and Depression Scale (HADS-Spanish), Impact of Event Scale-Revised (IES-R) for the evaluation of post-traumatic stress disorder (PTSD), and the Spanish adaptation of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS-Spanish) for burnout assessment. Univariate and multivariate analyses were performed.
RESULTS: Of the 782 participants, 88.6% had a high level of burnout (MBI-HSS-Spanish scale score > 27). Female nurses, nurses with eight-hour work shifts, and older professionals exhibited high levels of anxiety and depression. Prolonged working hours in COVID-19 patient care services were found to be a risk factor for burnout and post-traumatic stress.
CONCLUSIONS: Participating nurses presented with a high level of chronic work stress and exhibited signs of anxiety and depression during the period under consideration. Providing nurses with psychological support measures and performing liaison consultations will alleviate the psychological burden on nurses.
CONCLUSIONS: The study has shown that accounting for the environments where the emotional impact is greatest and how to reduce it would not only reduce anxiety, depression, and burnout in nurses but also improve the quality of care, not only in pandemic.
UNASSIGNED: Nurses contributed to the conduct of the study by participating in the data collection via questionaries.