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      Long-term Psychological and Occupational Effects of Providing Hospital Healthcare during SARS Outbreak

      , * , , * , , * , , * , * , , § , , # , , ** , , †† , * , , , , * , , ‡‡ , §§ , , , , * , , * , , †† , ¶¶ , ,

      Emerging Infectious Diseases

      Centers for Disease Control and Prevention

      Severe Acute Respiratory Syndrome, Stress, Psychological, Health Personnel, Stress, Traumatic, Burnout, Professional, research

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          TOC Summary Line: Healthcare workers in hospitals affected by SARS experience increased psychological stress 1–2 years after the outbreak.

          Abstract

          Healthcare workers (HCWs) found the 2003 outbreak of severe acute respiratory syndrome (SARS) to be stressful, but the long-term impact is not known. From 13 to 26 months after the SARS outbreak, 769 HCWs at 9 Toronto hospitals that treated SARS patients and 4 Hamilton hospitals that did not treat SARS patients completed a survey of several adverse outcomes. Toronto HCWs reported significantly higher levels of burnout (p = 0.019), psychological distress (p<0.001), and posttraumatic stress (p<0.001). Toronto workers were more likely to have reduced patient contact and work hours and to report behavioral consequences of stress. Variance in adverse outcomes was explained by a protective effect of the perceived adequacy of training and support and by a provocative effect of maladaptive coping style and other individual factors. The results reinforce the value of effective staff support and training in preparation for future outbreaks.

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          Most cited references 16

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          Coronavirus as a possible cause of severe acute respiratory syndrome.

          An outbreak of severe acute respiratory syndrome (SARS) has been reported in Hong Kong. We investigated the viral cause and clinical presentation among 50 patients. We analysed case notes and microbiological findings for 50 patients with SARS, representing more than five separate epidemiologically linked transmission clusters. We defined the clinical presentation and risk factors associated with severe disease and investigated the causal agents by chest radiography and laboratory testing of nasopharyngeal aspirates and sera samples. We compared the laboratory findings with those submitted for microbiological investigation of other diseases from patients whose identity was masked. Patients' age ranged from 23 to 74 years. Fever, chills, myalgia, and cough were the most frequent complaints. When compared with chest radiographic changes, respiratory symptoms and auscultatory findings were disproportionally mild. Patients who were household contacts of other infected people and had older age, lymphopenia, and liver dysfunction were associated with severe disease. A virus belonging to the family Coronaviridae was isolated from two patients. By use of serological and reverse-transcriptase PCR specific for this virus, 45 of 50 patients with SARS, but no controls, had evidence of infection with this virus. A coronavirus was isolated from patients with SARS that might be the primary agent associated with this disease. Serological and molecular tests specific for the virus permitted a definitive laboratory diagnosis to be made and allowed further investigation to define whether other cofactors play a part in disease progression.
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            Risk perception and impact of Severe Acute Respiratory Syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn?

            Healthcare workers (HCWs) were at the frontline during the battle against Severe Acute Respiratory Syndrome (SARS). Understanding their fears and anxieties may hold lessons for handling future outbreaks, including acts of bioterrorism. We measured risk perception and impact on personal and work life of 15,025 HCWs from 9 major healthcare institutions during the SARS epidemic in Singapore using a self-administered questionnaire and Impact of Events Scale and analyzed the results with bivariate and multivariate statistics. From 10,511 valid questionnaires (70% response), we found that although the majority (76%) perceived a great personal risk of falling ill with SARS, they (69.5%) also accepted the risk as part of their job. Clinical staff (doctors and nurses), staff in daily contact with SARS patients, and staff from SARS-affected institutions expressed significantly higher levels of anxiety. More than half reported increased work stress (56%) and work load (53%). Many experienced social stigmatization (49%) and ostracism by family members (31%), but most (77%) felt appreciated by society. Most felt that the personal protective measures implemented were effective (96%) and that the institutional policies and protocols were clear (93%) and timely (90%). During epidemics, healthcare institutions have a duty to protect HCWs and help them cope with their personal fears and the very stressful work situation. Singapore's experience shows that simple protective measures based on sound epidemiological principles, when implemented in a timely manner, go a long way to reassure HCWs.
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              Hospital staffing, organization, and quality of care: cross-national findings.

               L. H. Aiken (2002)
              To examine the effects of nurse staffing and organizational support for nursing care on nurses' dissatisfaction with their jobs, nurse burnout, and nurse reports of quality of patient care in an international sample of hospitals. Multisite cross-sectional survey. Adult acute-care hospitals in the United States (Pennsylvania), Canada (Ontario and British Columbia), England, and Scotland. 10 319 nurses working on medical and surgical units in 303 hospitals across the five jurisdictions. None. Nurse job dissatisfaction, burnout, and nurse-rated quality of care. Dissatisfaction, burnout, and concerns about quality of care were common among hospital nurses in all five sites. Organizational/managerial support for nursing had a pronounced effect on nurse dissatisfaction and burnout, and both organizational support for nursing and nurse staffing were directly, and independently, related to nurse-assessed quality of care. Multivariate results imply that nurse reports of low quality care were three times as likely in hospitals with low staffing and support for nurses as in hospitals with high staffing and support. Adequate nurse staffing and organizational/managerial support for nursing are key to improving the quality of patient care, to diminishing nurse job dissatisfaction and burnout and, ultimately, to improving the nurse retention problem in hospital settings.
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                Author and article information

                Journal
                Emerg Infect Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                December 2006
                : 12
                : 12
                : 1924-1932
                Affiliations
                [* ]Mount Sinai Hospital, Toronto, Ontario, Canada;
                []University of Toronto, Toronto, Ontario, Canada;
                []Saint Michael's Hospital, Toronto, Ontario, Canada;
                [§ ]The Scarborough Hospital, Toronto, Ontario, Canada;
                []Hamilton Health Sciences Centre, Hamilton, Ontario, Canada;
                [# ]McMaster University, Hamilton, Ontario, Canada;
                [** ]Centre for Addiction and Mental Health, Toronto, Ontario, Canada;
                [†† ]Sunnybrook and Women's Health Sciences Centre, Toronto, Ontario, Canada;
                [‡‡ ]Rouge Valley Health System, Toronto, Ontario, Canada;
                [§§ ]Whitby Mental Health Centre, Whitby, Canada;
                [¶¶ ]North York General Hospital, Toronto, Ontario, Canada
                Author notes
                Address for correspondence: Robert Maunder, Department of Psychiatry, Mount Sinai Hospital, 600 University Ave, Toronto, Ontario M5G 1X5; email: rmaunder@ 123456mtsinai.on.ca
                Article
                06-0584
                10.3201/eid1212.060584
                3291360
                17326946
                Categories
                Research

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