Total Impact Of Event Scale-Revised Research Articles

Medical malpractice in hospitals-how healthcare staff feel.

Literature is limited on quantified acute stress reaction, the impact of event scale on medical staff when facing medical malpractice (MMP), and how to individually care for staff. We analyzed data in the Taichung Veterans General Hospital from October 2015 to December 2017, using the Stanford Acute Stress Reaction Questionnaire (SASRQ), the Impact of Event Scale-Revised (IES-R), and the medical malpractice stress syndrome (MMSS). Of all 98 participants, most (78.8%) were women. Most MMPs (74.5%) did not involve injury to patients, and most staff (85.7%) indicated receiving help from the hospital. The internal-consistency evaluations of the three questionnaires showed good validity and reliability. The highest score of IES-R was the construct of intrusion (30.1); the most severe construct of SASRQ was "Marked symptoms of anxiety or increased arousal," and the most were having mental and mild physical symptoms for MMES. A higher total IES-R was associated with younger age (<40 y/o), and more severe injury on patients (mortality). Those who indicated receiving very much help from the hospital were those having significantly lower SASRQ sores. Our study highlighted that hospital authorities should regularly follow up on staff's response to MMP. With timely interventions, vicious cycles of bad feelings can be avoided, especially in young, non-doctor, and non-administrative staff.

TRAUMATIC STRESS AND HEALTH ANXIETY IN INTENSIVECARE WORKERS DURING THE COVID-19 PANDEMIC

Aims: Intensive care professionals are the individuals who are most exposed to the psychological effects of the COVID-19 pandemic&#x0D; The aim of the present study was to evaluate and compare the, traumatic stress symptoms and health anxiety in intensive care unit (ICU) workers and non-ICU workers who have been playing an active role in caring for COVID-19 patients.&#x0D; Method: The sociodemographic characteristics of all the healthcare professionals working in the ICU and other units, were recorded. In addition, their history of COVID-19 infection, living with an elderly person, intensive care hospitalization history of relatives, and death status of relatives due to COVID-19 were recorded. The participants were divided into two groups, namely ICU workers and non-ICU workers. The Health Anxiety Inventory (HAI)and the Impact of Event Scale-Revised (IES-R) scales were applied to all the participants.&#x0D; Results: Of the 150 healthcare workers initially identified, 116 agreed to participate in this study. Sixty-nine (59.5%) of them were working in the ICU, while 47 (40.5%) were in non-ICU. &#x0D; The mean IES-R score of all participants was 40.19 ± 15.73. When the IES-R scores and ICU results with non-ICUs were compared, the healthcare workers who work in ICU had significantly higher total IES-R scores (42.83 ± 14.65, p

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

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 &lt; 0.0001) and an increase in HbA1c was noted in the post-lockdown period (8.31% vs. 8.70%; P &lt; 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.

Post-traumatic stress symptoms among an Egyptian sample of post-remission COVID-19 survivors: prevalence and sociodemographic and clinical correlates

BackgroundGiven its global spread, the COVID-19 virus infection itself may be experienced as a traumatic and stressful event among survivors. The post-traumatic stress symptoms (PTSS) among those surviving the disease were under evaluated. This study aimed to identify and compare PTSS and associated correlates among COVID-19 survivors and control subjects. A cross-sectional design with a convenience sampling included a total of 85 adults who survived COVID-19 virus infection and 85 control subjects (matched for age, sex, education, and socioeconomic level) who were recruited from Zagazig University Hospitals, Sharkia Province, Egypt. The participants were interviewed using a semistructured demographic and clinical checklist, Structured Clinical Interview for DSM-5 Axis I Disorders (SCID-5), the Impact of Event Scale-Revised (IES-R), and the Hospital Anxiety Depression Scale (HADS).ResultsApproximately, 72% of COVID-19 survivors experienced moderate-to-severe PTSS (compared to 53% of control subjects). Individuals who survived the COVID-19 virus infection were more likely to have intensified hyperarousal symptoms (OR: 2.7, 95% CI: 1.7–4.4), with higher total IES-R scoring (OR: 1.03, 95% CI: 1.01–1.05). Among COVID-19 survivors, those who reported moderate-to-severe PTSS were likely to experience severe COVID-19 symptoms during their illness (OR: 4.1, 95% CI: 1.4–11.9).ConclusionsPTSS was prevalent among COVID-19 survivors in Egypt. The hyperarousal symptoms were the most experienced ones. The symptom severity of COVID-19 virus infection predicted PTSS in COVID-19 survivors.

The psychological impact of the coronavirus disease pandemic on hospital workers in Daegu, South Korea

ObjectiveThis study aimed to assess the immediate stress and psychological impact experienced by healthcare workers and other personnel during the Coronavirus disease (COVID-19) pandemic. MethodThe sample consisted of 2554 hospital workers (i.e., physicians, nurses, allied health professionals, and auxiliary staff members) who were working in Yeungnam University Hospital in Daegu, South Korea. The Impact of Event Scale-Revised (IES-R) was administered to the hospital workers twice over a 2 week interval. A high-risk group, identified on the basic of first total IES-R, was assessed further with the Mini International Neuropsychiatric Interview (MINI) and the Clinical Global Impressions-Severity (CGIS) scale and was offered periodic psychiatric consultations on a telephone. ResultsThe participating nurses and auxiliary staff members had significantly higher IES-R scores (p < 0.01) than the physicians. During the second evaluation, the IES-R scores of the high-risk participants had decreased by 13.67 ± 16.15 points (p < 0.01), and their CGI-S scores had decreased by 1.00 ± 0.74 points (p < 0.01). The psychological symptoms of the high-risk group who received telephone-based psychiatric consultation showed improvement after 2 weeks. ConclusionsThe present findings suggest that hospital workers experience high levels of emotional stress during a pandemic. In particular, the present findings underscore the need to provide more information and support to nurses and other administrative workers. There is a need for greater awareness about the importance of mental health care among hospital workers, and rapid and ongoing psychiatric interventions should be provided to workers during the pandemic period.

Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients.

IntroductionFamily presence during emergency resuscitations is increasingly common, but the question remains whether the practice results in psychological harm to the witness. We examine whether family members who witness resuscitations have increased post-traumatic stress disorder (PTSD) symptoms at one month following the event.MethodsWe identified family members of critically ill patients via our emergency department (ED) electronic health record. Patients were selected based on their geographic triage to an ED critical care room. Family members were called a median of one month post-event and administered the Impact of Event Scale-Revised (IES-R), a 22-item validated scale that measures post-traumatic distress symptoms and correlates closely with Diagnostic and Statistical Manual of Mental Disorders-IV criteria for post-traumatic stress disorder (PTSD). Family members were placed into two groups based on whether they stated they had witnessed the resuscitation (FWR group) or not witnessed the resuscitation (FNWR group). Data analyses included chi-square test, independent sample t-test, and linear regression controlling for gender and age.ResultsA convenience sample of 423 family members responded to the phone interview: 250 FWR and 173 FNWR. The FWR group had significantly higher mean total IES-R scores: 30.4 vs 25.6 (95% confidence interval [CI], −8.73 to −0.75; P<.05). Additionally, the FWR group had significantly higher mean score for the subscales of avoidance (10.6 vs 8.1; 95% CI, −4.25 to −0.94; P<.005) and a trend toward higher score for the subscale of intrusion (13.0 vs 11.4; 95% CI, −3.38 to .028; P = .054). No statistical significant difference was noted between the groups in the subscale of hyperarousal (6.95 vs 6.02; 95% CI, −2.08 to 0.22; P=.121). All findings were consistent after controlling for age, gender, and immediate family member (spouse, parent, children, and grandchildren).ConclusionOur results suggest that family members who witness ED resuscitations may be at increased risk of PTSD symptoms at one month. This is the first study that examines the effects of family visitation for an unsorted population of very sick patients who would typically be seen in the critical care section of a busy ED.

Post-traumatic stress disorder in critical illness survivors and its relation to memories of ICU.

Stressors in intensive care units (ICUs) are sometimes so severe that they result in Post-traumatic Stress Disorder (PTSD) in ICU survivors. The memories that survivors have from the ICU may play a role in developing PTSD. This study aimed to determine the prevalence of PTSD-related symptoms in ICU survivors in Southeast Iran and its relationship with their memories of the ICU. In this descriptive correlational study, 100 people discharged from ICUs in southeastern Iran completed the Impact of Event Scale-Revised (IES-R) and ICU memory tool (ICU-MT). Findings indicated that, from 100 participants who, on average, were assessed 3.19 ± 5.37 months after discharge, 13% were suffering from PTSD. The total mean IES-R score and the scores of "Intrusion," "Avoidance," and "Hyperarousal" subscales in patients with delusional memories were higher compared with the patients who did not have such memories. In the patients who were mechanically ventilated at the time of their stay in the ICU, the total mean IES-R score was 6.86 times higher (P = .03). This research provided further evidence of the relationship between delusional memories and PTSD in patients who had been discharged from the ICU. In the care of patients admitted to the ICU, preventive strategies should be used to minimize delusional memories and PTSD. It is necessary to detect post-ICU psychiatric morbidities and provide early psychological intervention in post-discharge follow-up programmes to improve psychological outcomes after critical illness.

The Impact of Health Consciousness on the Association Between Walking Durations and Mental Health Conditions After a Disaster: a Cross-Sectional Study

BackgroundIn communities affected by a disaster, walking can be a feasible form of physical exercise to improve physical and mental health conditions. However, there is limited evidence to support relationships between walking habits and mental health conditions in post-disaster settings. Cross-sectional epidemiological data obtained from a questionnaire survey (conducted in October 2017) of a community affected by the 2011 Great East Japan Earthquake (GEJE) was analyzed to evaluate the relationships.MethodsParticipants included individuals over 20 years of age (N = 718) from Shichigahama town in Miyagi prefecture, whose houses were significantly damaged by the GEJE. Their mental health conditions were assessed by the Kessler Psychological Distress Scale (K6), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Impact of Event Scale-Revised (IES-R). Additionally, the questionnaire asked the participants spent duration walking on average and their walking purpose by the following items: (1) longer than 60 min per day, (2) between 30 and 60 min per day, or (3) less than 30 min per day, and whether they walked to maintain healthy living habits (health-conscious walkers) or merely for transportation without considering health consequences (non-health-conscious walkers). These information and mental health indicators were analyzed using analysis of covariance (ANCOVA).ResultsAmong the three walking duration groups of health-conscious walkers, there were significant differences in CES-D and K6 scores (p = 0.01 and p = 0.04), but not in IES-R scores, considering age, gender, and alcohol drinking habits as covariates. CES-D score was significantly higher among short walkers (p = 0.004). Among the three walking duration groups of non-health-conscious walkers, there were significant differences in avoidance symptoms, the subdomain of IES-R (p = 0.01), but not in CES-D, K6, and total IES-R scores, considering the variants.ConclusionOur study suggests that walking durations may positively affect mood, but not PTSR, only when walking is performed with the purpose of maintaining healthy living habits. Walking durations were negatively associated with avoidance symptoms among non-health-conscious walkers in the community affected by the GEJE, indicating that the disaster may have had a long-lasting impact on walking habits.

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.

Masters Athlete Screening Study (MASS): Insights Into the Psychological Impact of Cardiovascular Preparticipation Screening.

To determine the psychological impact of a cardiovascular disease (CVD) diagnosis identified during preparticipation screening (PPS) of masters athletes. Cross-sectional study. Masters athletes diagnosed with CVD through the Masters Athletes Screening Study. Sixty-seven athletes (89.6% male, mean age at diagnosis 60.1 ± 7.1 years, range 40-76) with diagnoses of coronary artery disease (CAD) (73.1%), high premature ventricular contraction burden (9.0%), mitral valve prolapse (7.5%), atrial fibrillation (AF) (3.0%), bicuspid aortic valve (3.0%), aortic dilatation (1.5%), coronary anomaly (1.5%), and rheumatic heart disease (1.5%). Three participants had multiple diagnoses. Online survey distributed to masters athletes identified with CVD. Assessment of psychological distress [Impact of Event Scale-Revised (IES-R)], perceptions of screening, and preferred support by CVD type. The median total IES-R and subscale scores were within the normal range {median [interquartile range (IQR)] total 2.0 [0-6.0]; intrusion 1.0 [0-3.0]; avoidance 0 [0-3.0]; hyperarousal 0 [0-1.0]}. Athletes with bicuspid aortic valve [20.5 (IQR, 4.0-37.0)], AF [7.0 (IQR, 0-14.0)], and severe CAD [5.5 (IQR, 1.0-12.0)] had the highest total IES-R scores. One individual with bicuspid aortic valve reported a significant stress reaction. Ten athletes (14.9%) had scores >12. Ninety-three percent of athletes were satisfied having undergone PPS. Preferred type of support varied by cardiovascular diagnosis. The majority of masters athletes diagnosed with CVD through PPS do not experience significant levels of psychological distress. Athletes diagnosed with more severe types of CVD should be monitored for psychological distress. Support should be provided through a multidisciplinary and individualized approach.

Earthquake Exposure and Post-traumatic Stress Among Nepalese Mothers After the 2015 Earthquakes.

Introduction: Nepal suffered from major earthquakes in April 2015 resulting in great damage to the society. The objective of the current study is to describe the earthquake exposure, the impact on family’s daily life and the symptoms of post-traumatic stress disorder (PTSD) and their association in Nepalese mothers 20 months following the earthquakes.Methods: In a clinical trial in Bhaktapur, Nepal, 558 mothers responded to an inventory on earthquake exposure and the Impact of Event Scale – Revised (IES-R) 20 months after the earthquakes. In multiple linear regression models, we estimated the associations between the earthquake exposure and the impact on the families’ life and the IES-R score.Results: Over 60% reported that the earthquakes had a great deal of negative impact on their family’s life. In 4.7%, close family members died, and in 10.5%, family members were injured. 24% had IES-R scores indicating PTSD symptoms within clinical concern or a possible diagnosis. Lower levels of education were associated with higher scores on the total IES-R. Mothers who report that the earthquakes had a great deal of negative impact had higher total IES-R scores [9.8, 95% CI (5.9, 13.6)] compared to mothers that reported no such negative impact. Mothers with family members who were killed had higher IES-R scores [3.6, 95% CI (1.6, 5.5)] than those with no family members who died. Mothers assisting in rescue efforts had lower IES-R scores [2.8, 95% CI (0.8, 4.8)] than those not assisting.Conclusion: Our study demonstrates high levels of exposure to traumatic events, large negative impact on the everyday life of the families, and a high level of PTSD symptoms. There was a consistent and graded association between the exposure variables and PTSD symptoms. The large impact of the earthquakes on these Nepalese mothers underscore the importance of awareness of mental disorders following major natural catastrophes for marginalized families.

Posttraumatic stress symptoms in families of cancer patients admitted to the intensive care unit: a longitudinal study.

BackgroundFamilies of cancer patients in the ICU often experience severe stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of cancer patients admitted to the ICU. This study evaluated the prevalence of posttraumatic stress symptoms (PTSS) among families of cancer patients admitted to the ICU.MethodsWe carried out a longitudinal study at a teaching and advanced treatment hospital. Participants were 23 family members of 23 ICU patients. Family members provided demographic data, electronic medical records of patients, and completed the Impact of Event Scale-Revised (IES-R), the Center for Epidemiologic Studies Depression Scale (CES-D), and the State-Trait Anxiety Inventory Form X (STAI-state, trait).ResultsMean total IES-R total score, IES-R re-experience score, IES-R avoidance score, and STAI-state score within 24 h of ICU admission and 3 months later differed significantly. The IES-R score of families of patients with recurrent cancer was significantly higher than the score of families of patients with an original cancer diagnosis (t = 2.63, p = 0.029). For two-way analysis of variance, time point was significantly associated with IES-R score (F = 1.751, p = 0.011, df = [1]).ConclusionsFamilies of recurrent cancer patients admitted to the ICU experience serious PTSS within 24 h of admission. It is important that appropriate psychiatric support be provided to family members of these patients.

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.

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.

Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns

The Impact of Event Scale (IES) and the Impact of Event Scale-Revised (IES-R) are often used as self-report instruments for symptoms of post-traumatic stress disorder (PTSD). However, there are few validations of the IES and the IES-R against structured clinical interviews. In this study the two scales, together with the three subscales of the IES-R, were assessed for their agreement with a diagnosis of PTSD in patients with burns 1 year after injury. Sixty patients with burns were evaluated 1 year after injury using the Structured Clinical Interview for the DSM-IV Axis I (SCID-I) psychiatric disorders and a Swedish version of the IES-R. The total score of the IES-R had the best discriminant ability (0.89) with a sensitivity of 1.0 and a specificity of 0.78. In conclusion, the total IES-R had good properties as a screening tool for PTSD and subsyndromal PTSD 1 year after burn injury.