Total Impact Of Event Scale-Revised Score Research Articles

North-African doctors as second victims of medical errors: a cross sectional survey

IntroductionPhysicians involved in medical errors (MEs) can experience loss of self-esteem and negative psychological experiences. They are called “second victims” of the ME.AimsTo i) describe the profile, the types and the severity of MEs, and ii) explore the psychological impact on “second victims” to better understand how they cope.MethodsIt was a cross sectional retrospective study conducted from March to August 2018. All physicians working at Farhat Hached and Sahloul University hospitals were asked to complete a questionnaire about their possible MEs. The impact of MEs was evaluated using the Impact of Event Scale-Revised (IES-R) (scoring, 0–88) (subscales ranges; intrusion, (0–32); avoidance, (0–32); hyperarousal, (0–24)). The diagnosis of post-traumatic stress disorder (PTSD) was made when the total IES-R score exceeded 33. The coping strategies were evaluated using Ways of Coping Checklist Revised (WCC-R) scale (scoring, problem-focused, (10–40); emotion focused, (9–36); seeking social support, (8–32)).ResultsAmong 393 responders, 268(68.2%) reported MEs. Wrong diagnosis (40.5%), faulty treatment (34.6%), preventive errors (13.5%) and faulty communication (6.4%) were the main frequent types of MEs. The most common related causes of MEs were inexperience (47.3%) and job overload (40.2%). The physicians’ median (range) score of the IES-R was 19(0–69). According to the IES-R score, the most frequent psychological impacts were median (range): intrusion, 7(0–28) and avoidance symptoms, 7(0–24). PTSD symptoms affected 23.5% of physicians. Female sex and serious MEs were identified as predictors of PTSD. On the WCC-R check list, coping was balanced between the three coping strategies median (range), problem focused, 28.5(10–40); emotion-focused, 24(9–36) and seeking social support 21(8–32).ConclusionThere is a relatively high impact of ME within these North-African university hospital physicians. Coping was balanced within different three strategies as reported worldwide. Physicians adopted more likely constructive changes than defensive ones.

Self-reported measure of subjective distress in response to COVID-19 pandemic in patients referred to our skin cancer unit during the first wave

During the Italian first wave of the COVID-19 pandemic, social restrictions and bad news spread daily by mass media inevitably had a huge influence on the mental state of the population. To assess how much the COVID-19 outbreak impacted the psychologic state of patients referring to our Skin Cancer Unit from March 9 to May 31, 2020, we administered to them a self-report questionnaire, the Impact of Event Scale-Revised (IES-R). To evaluate the trend of the IES-R score over time, we set a temporal cutoff of March 27 (the day with the highest number of deaths for COVID-19 in Italy during the first wave). Three hundred fifty-five patients completed the questionnaire, reporting an average IES-R score of 25.5 (±16.4); 32.4% of participants reached a total IES-R score >32. Patients who visited after March 27, 2020 reported a higher psychologic impact, since the IES-R score significantly increased from 23.6 (±15.6) to 28.3 (±17.2). A group reported higher scores (of participants reaching an IES-R score >32, 57.4% were women and 33.9% were men). We gathered that, at an early stage of events of this magnitude, it could be useful to submit the IES-R questionnaire in high-risk and oncologic patients: we could potentially identify individuals at risk of developing post-traumatic stress disorders, who might be tempted to postpone necessary medical consultations. This could be also the basis for increasing targeted psychologic support in selected patients.

Psychosocial impact of COVID-19 pandemic on Malaysian families: a cross-sectional study

ObjectiveTo investigate the psychosocial impact of COVID-19 on Malaysian families.DesignA cross-sectional study performed using an anonymous online questionnaire distributed through social media, email and the Department of Social Welfare.SettingMalaysian families...

Living with type 2 diabetes in COVID-19: Exploring the challenges faced

Background: The COVID-19 pandemic seems to have influenced lifestyle behaviors and diabetes self-management practices. The aim of the present study is to determine the impact of psychological stress on various lifestyle behaviors, diabetes self-management practices, and glycemic control among Indian adults with type 2 diabetes (T2D), amidst the COVID-19 pandemic. Materials and Methods: This was a cross-sectional observational study. The data pertaining to psychological stress, lifestyle behaviors, diabetes self-management practices, and glycemic control were collected at two time-points (before and after lockdown). Results: A total of 252 T2D patients (145 males, 57.5%) with mean age 51.2 ± 9.8 years and mean diabetes duration of 8.5 ± 6.3 years participated in the study. A statistically significant decrease in body mass index (27.68 vs. 27.22 kg/m2; P < 0.0001) and an increase in HbA1c was noted in the post-lockdown period (8.31% vs. 8.70%; P < 0.0001). The mean Impact of Event Scale-Revised (IES-R) score was 19.3 ± 11.6. No significant correlation of mean IES-R score was observed with the age of the participants (r =−0.077, P = 0.224) and diabetes duration (r = 0.002, P = 0.970). Female gender (mean rank 140.4; P = 0.007) and co-existing hypertension (mean rank 132.18; P = 0.016) were associated with significantly higher IES-R score. No impact of total IES-R score was seen on the various lifestyle behaviors, diabetes self-management practices, and glycemic control. Conclusion: Psychological stress was higher among female gender and those with co-existing hypertension. Further, glycemic control worsened despite preserved diabetes self-management practices.

Impact of cancer related stress on illness beliefs and glycemic control in breast cancer survivors with comorbid diabetes.

e24053 Background: Cancer and diabetes mellitus (DM) are leading causes of death in the US and survivors with comorbid DM have a significantly higher mortality. Furthermore, posttraumatic stress disorder (PTSD) can be triggered by life-threatening illnesses such as cancer; however, little is known about the impact of cancer-related PTSD (Ca-PTSD) on illness beliefs and glycemic control. We undertook this study to assess factors associated with DM management in breast cancer survivors with DM. Methods: We recruited women with Stage 0-IIIA breast cancer diagnosed in the past 10 years, who had completed chemotherapy and/or hormonal therapy and had pre-existing DM on ≥1 oral DM medication. The Impact of Event Scale-Revised (IES-R) was used to assess distress caused by cancer. A total IES-R score of ≥33 identified those with probable Ca-PTSD. Cancer and DM related beliefs were assessed using the Illness Perception Questionnaire. Objective adherence to DM medication was assessed using electronic caps that record bottle openings. Wilcoxon rank-sum tests were used to examine the relationship between Ca-PTSD and illness beliefs. Pearson correlation tests were used to assess the relationship between cancer related stress, DM medication adherence, and glycemic control. Results: Of 111 women recruited to date, mean age was 65.4 years and 37% were black, 31% white, 14% Hispanic, 6% Asian, and 8% other. Of these, 15% had probable Ca-PTSD. Survivors with Ca-PTSD were more likely to believe the consequences of cancer and DM were more severe (median score 23.5 vs. 19.0 [p &lt; 0.001] and 24.0 vs. 16.0 [p &lt; 0.001], respectively), that cancer and DM were more cyclical or recurrent (15.0 vs. 9.0 [p = 0.002] and 13.0 vs. 8.5 [p = 0.002], respectively), and there was greater emotional impact due to cancer and DM (24.0 vs. 16.5 [p &lt; 0.001] and 23.0 vs. 14.0 [p &lt; 0.001], respectively). Additionally, those with Ca-PTSD were less likely to understand their cancer (14.0 vs. 20.0, p = 0.004). Furthermore, as cancer-related stress scores increased, glycemic control worsened (r = 0.23, p = 0.03) and DM medication adherence decreased (r = -0.23, p = 0.04). Conclusions: Breast cancer survivors with comorbid DM who have Ca-PTSD are more likely to have negative beliefs about both cancer and DM. Cancer-related stress is also associated with poorer glycemic control and DM medication adherence. Providers should be aware of the impact of cancer related stress on beliefs about comorbid illnesses and increase interventions that support cancer survivors to better manage their comorbidities.

Posttraumatic stress symptom in women with termination of pregnancy for fetal anomalies and its correlation with big five personality traits

Objective To know about the post-traumatic stress disorders (PTSD) of women with termination of pregnancy for fetal anomalies (TOPFA) , and investigate the relationship of PTSD and the big five personality traits. Methods The general questionnaire, the Impact of Event Scale-Revised (IES-R) and the Big Five Questionnaire were administered to the women with TOPFA in hospital from February 2014 to February 2015. Results The total score of IES-R of 84 cases was 26.20 ± 16.38. The scores of 49 cases (58.3%) were more than 19 and that of 20 cases (23.8%) more than 35. Women who had the first pregnancy had higher level of arousal symptoms,12.84±7.41 vs. 9.65±5.53 (t = 2.25,P < 0.05) . Women whose scores were above 19 had lower adaptation, sociality, altruism and conscience compared with those scored ≤19, 14.96±3.29, 16.84±3.00, 18.55±3.49, 17.57±2.99 vs. 13.57±2.82, 18.31±2.65, 20.03±2.32, 18.86±2.21,t= 2.02-2.33,P < 0.05. The IES-R score had no linear correlation with that of the big five personalities, and intrusion subscale had linear correlation with the adaptation. Avoidance symptoms had low positive relationship with sociality in women whose IES-R were above 19,r = 0.23,P < 0.05. In populations whose IES-R scored above 19, avoidance subscale had positive weak correlation with sociality,r=0.31,P < 0.05. Conclusions The women with TOPFA had high level of PTSD before termination. Women with sever posttraumatic stress symptoms had lower sociality and altruism. Moreover, of the women who had sever posttraumatic stress symptoms, one with higher sociality always had higher avoidance symptoms. Key words: Pregnant women; Fetal anomaly; Post-traumatic stress; Big five personality traits

Acute Stress Symptoms in Families of Patients Admitted to the Intensive Care Unit during the First 24 Hours Following Admission in Japan

Families of patients in the intensive care unit often experience sever stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of patients admitted to the intensive care unit (ICU). To evaluate the prevalence and factors associated with acute stress symptoms among families of patients admitted to the ICU, we carried out a cross-sectional study at a teaching and advanced treatment hospital. The mean total Impact of Event Scale-Revised (IES-R) score differed significantly between planned and unplanned ICU admissions (t = 4.03, p < 0.05), indicating a main effect of admission type (F = 18.5, p < 0.05). There was no significant main effect of relationship (F = 0.05, p = 0.82) or interaction effect of admission type and relationship (F = 0.54, p = 0.47). Multiple regression analysis indicated that admission type was significantly associated with acute stress symptoms (B = 18.09, β = 0.47, p < 0.01), and explained 22% of the variance in total IES-R score. Whether a patient had a planned or unplanned admission to the ICU influenced symptoms associated with acute stress symptoms of family members more than did getting support from nurses, being the patient’s spouse, or the severity of illness of the patient.

Application of the triage assessment system for psychological assessment for pregnant women with a deadly fetal abnormality.

To explore suitable scales to assess psychological status of pregnant women whose fetuses have grave deformities, a face-to-face interview guided by the Triage Assessment System (TAS) was conducted. Also, a questionnaire of the Impact of Event Scale-Revised (IES-R) was obtained in 44 pregnant women diagnosed with a fetal deformity. Percentages and non-parametric Spearman correlations were used to analyse the scores of the two scales. The total score of TAS ranged from 3 to 26, with a mean of 9.93; and the total score of IES-R ranged from 5 to 63, with a mean of 40.36. The total score and the two subscales of each scale were significantly correlated (P < 0.05). The TAS subscale of emotion and IES-R subscale of intrusion were not significantly correlated, with r = 0.24 (P = 0.11). Combined use of TAS and IES-R can make up for each other's deficiencies and guide the clinician to make individual interventions during screening and treatment.

Impact of 2013 south Asian haze crisis: study of physical and psychological symptoms and perceived dangerousness of pollution level

BackgroundThe widespread forest fires in Indonesia in June 2013 led to widespread haze to neighbouring countries. This is the first study in the medical literature reporting the acute physical and psychological symptoms of the general population during a haze crisis. We evaluated the factors that are associated with psychological stress of haze exposure.MethodsThis study was conducted between June 21 to June 26, 2013. Participants were recruited by an online recruitment post and snowball sampling techniques. Participants were required to complete an online survey which was composed of demographics questionnaire, physical symptom checklist, perceived dangerous Pollutant Standard Index (PSI) value and views on the N-95 mask and the Impact of Event Scale-Revised (IES-R).ResultsA total of 298 participants returned the completed study questionnaire. The respondents reported a mean number of 4.03 physical symptoms (S.D. = 2.6). The five most common physical symptoms include mouth or throat discomfort (68.8%), nose discomfort (64.1%), eye discomfort (60.7%), headache (50.3%) and breathing difficulty (40.3%). The total IES-R score was 18.47 (S.D. = 11.69) which indicated that the study population experienced mild psychological stress but not to the extent of acute stress reaction syndrome. The perceived dangerous PSI level and number of physical symptoms were significantly associated with the mean intrusion score, mean hyper-arousal score, total mean IES-R score and total IES-R score (p < 0.05).ConclusionsOur findings suggest that a haze crisis is associated with acute physical symptoms and mild psychological stress. The number of physical symptoms and the perceived dangerous PSI values are important factors associated with psychological stress.

Treatment of posttraumatic stress disorder using the traditional Japanese herbal medicine saikokeishikankyoto: a randomized, observer-blinded, controlled trial in survivors of the great East Japan earthquake and tsunami.

The Great East Japan earthquake and tsunami caused immense damage over a wide area of eastern Japan. Hence, many survivors are at high risk for posttraumatic stress disorder (PTSD). This randomized, observer-blinded, controlled trial examined the efficacy and safety of the traditional Japanese herbal formula saikokeishikankyoto (SKK) in the treatment of PTSD among survivors of this disaster. Forty-three participants with an Impact of Event Scale-Revised (IES-R) score ≥ 25 were randomized into SKK (n = 21) and control (n = 22) groups. The primary endpoint was the change in IES-R scores from baseline till after 2 weeks of treatment. Intergroup statistical comparisons were performed. The magnitude of changes in total IES-R scores differed significantly between the two groups (P < 0.001). Post hoc analysis showed that the total IES-R score improved significantly in the SKK group from 49.6 ± 11.9 to 25.5 ± 17.0 (P < 0.001). Subscale scores improved significantly in the SKK group (avoidance, P = 0.003; hyperarousal, P < 0.001; intrusion, P < 0.001). Two-week treatment with SKK significantly improved IES-R scores among PTSD patients. This traditional medicine may be a valid choice for the treatment of psychological and physical symptoms in PTSD patients.

Cognitive Behavioral Therapy for Young People after L’Aquila Earthquake

Objective: Cognitive behavior therapy (CBT) emerges as the best validated therapeutic approach for children and adolescents who experienced trauma-related symptoms, particularly associated with anxiety or mood disorders. The aim of this study was to evaluate the CBT efficacy among young people exposed to L’Aquila earthquake, in 2009. Methods: one year after the disaster, 39 young subjects as a case group (CBT treated) and 24 as a comparison group (no CBT treated) were evaluated with the Impact of Event Scale Revised (IES-R), the General Health Questionnaire-12 items (GHQ-12) and the Brief Cope. CBT was conducted in 12 sessions (once per week for 3 months). After CBT intervention, both groups were evaluated again with the same psychometric instruments.Results: our results show a significantly decrease in post traumatic symptoms and psychological distress severity in CBT group. It was attributable to an improvement in each of three PTSD dimensions (intrusion, avoidance, and arousal) and in the total score of IES-R (p< 0.04). Among CBT treated group, subjects that adopted “planning/problem solving” coping strategies (p < .02) and “religiosity” (p < .045) show higher improvement in psychological distress. Conclusions: our findings show the efficacy of CBT and the influence of individual coping strategies in the improvement of posttraumatic stress symptoms and psychological distress among young people seeking help from an outpatients service for young people with psychiatric problems (the SMILE) after the catastrophic disaster in L’Aquila.

Characteristics of traumas and PTSD symptom among perpetrators of domestic violence

Objective To explore characteristics of traumatic events and posttraumatic stress disorder (PTSO)symptom among perpetrators of domestic violence(DV).Methods A structured psychiatric interview,self-report Traumatic Life Events Questionnaire(TLEQ)and Impact of Event Scale-revised(IES-R)were administered to 50 male perpetrators of DV and 80 controls matched by age,education and family structure,who were selected from certain community in Mianyang city,Sichuan province,China.Results (1)80%of perpetrators of DV(n=40)had experienced more than three traumatic events,significantly higher than that in the controls (46.2%)(x2=21.70,P=0.000),and the mean number of traumatic events in perpetrators of DV was significantly higher than that in the controls(5.5:3;Z=3.94,P=0.000).(2)The perpetrators of DV had experienced more types oftraumatic events than the controls,such as sudden death of a close friend or aloved one(x2=3.74),witness to domestic violence(x2=6.24),intimate partner abuse(x2=10.06)and childhood sexual abuse(x2=4.53～8.45),with all significant differences(P＜0.05).(3)The total score of IES-R and its'three subscale sores among perpetrators of DV were all significantly higher than those among the controls(P＜0.05).Conclusion In the perpetrators of DV,exposure to traumatic events were very conunon.The importance of screening and early intervention and prevention programmes for psychological traumas among perpetrators of DV was highly emphasized. Key words: Domestic violence; Cross-section survey; Psychological trauma; Childhood abuse