{"id":375539,"date":"2021-01-26T15:34:44","date_gmt":"2021-01-26T18:34:44","guid":{"rendered":"https:\/\/revistapesquisa.fapesp.br\/?p=375539"},"modified":"2021-01-26T18:11:16","modified_gmt":"2021-01-26T21:11:16","slug":"health-professionals-under-emotional-stress","status":"publish","type":"post","link":"https:\/\/revistapesquisa.fapesp.br\/en\/health-professionals-under-emotional-stress\/","title":{"rendered":"Health professionals under emotional stress"},"content":{"rendered":"

Because they are in contact with COVID-19 patients, doctors, nurses, first responders, and community health workers are under intense emotional stress, which can translate into insomnia, anxiety, depression, irritability, and fear of becoming infected or spreading the novel coronavirus to their family members. Teams of mental health experts from several universities who observed these changes have identified measures to mitigate the effects of the pandemic. By late July, according to the Federal Nursing Council and the Ministry of Health, about 310 nurses and 113 doctors had died due to COVID-19 in Brazil.<\/p>\n

\u201cTeam supervisors and colleagues should be attentive to signs of emotional exhaustion,\u201d suggests psychiatrist Ana Bresser Tokeshi, a psychiatry resident at the Integrated Mental Health Care Center (CAISM) of the Federal University of S\u00e3o Paulo (UNIFESP). She and Amanda Steil, an emergency medicine resident at Hospital S\u00e3o Paulo (HSP), linked to UNIFESP, coordinated an online survey of resident doctors from all over the country. The study gathered 3,067 responses, or 8% of doctors in training in Brazil. Preliminary analyses indicated a depression rate of 67% and an anxiety rate of 52% during the pandemic, compared to the rates of 20% and 40%, respectively, recorded in previous surveys in Brazil. “The lower the support from their supervisors, the greater the risk of anxiety and depression,” concluded Tokeshi.<\/p>\n

In May, the only national service for health professionals who had questions about COVID-19\u2014which is in the state of Matos Grosso and can be reached through phone number 0800-644-6543\u2014incorporated a program called TELEPSICOVID-19, a psychological and psychiatric service provided by the Hospital de Cl\u00ednicas of Porto Alegre. After a screening, those with mild symptoms of anxiety, depression, or irritability get an email evaluation and are referred to a psychologist. Anyone with more significant symptoms gets four one-hour online psychotherapy sessions. The psychological services have one of three distinct approaches to problem-solving: cognitive-behavioral, interpersonal, and tele-psychoeducation. “The strategies should work, but we want to scientifically assess which is the most effective for these situations,\u201d explains psychiatrist and program coordinator Giovanni Salum, from the Federal University of Rio Grande do Sul (UFRGS).<\/p>\n

Read:<\/strong>
\n– Times of uncertainty<\/a>
\n– The puzzle of immunity<\/a>
\n– The risk of traveling by plane<\/a>
\n– Varying investment in science<\/a>
\n– Sharing and expanding knowledge<\/a>
\n– Pandemics as allegory<\/a>
\n<\/div>\n

Of the 300 people evaluated by mid-July, 30 had more serious symptoms. Of these, psychiatrists found that three had suicidal thoughts; they were referred to health services in the cities where they lived for urgent care. The TELEPSICOVID-19 team of 34 is prepared to help at least 10,000 SUS (Servi\u00e7o \u00danico de Sa\u00fade, Brazil\u2019s public healthcare system) employees\u2014out of a total of 3.5 million, about 1 million work directly with COVID-19.<\/p>\n

\u201cMost health professionals do not spontaneously seek help, especially doctors,\u201d points out psychiatrist Eur\u00edpedes Constantino Miguel, from the University of S\u00e3o Paulo (USP). Miguel coordinates COMVC-19, a psychological and psychiatric care program aimed at the approximately 20,000 employees of the Hospital das Cl\u00ednicas of the USP School of Medicine. By July 5, 345 people were referred to psychotherapy sessions after the initial screening. Of these, 142 reported feeling \u201cnervous, anxious, or very tense\u201d and 98 felt like they were \u201cunable to prevent or control concerns,\u201d according to the initial evaluation survey; 108 were nurses and technicians, 82 were administrative officials, 76 were doctors, and 79 were from other categories. Introduced in June in the medical journal Clinics<\/em>, the program offers theory and methodology videos for mental health professionals and motivational videos for those who care for COVID-19 patients.<\/p>\n

At the USP Ribeir\u00e3o Preto School of Medicine, psychologists Flavia de Lima Os\u00f3rio and Sonia Regina Loureiro coordinated an online survey that collected 1,000 responses by early July. More than half (56%) of the respondents reported feeling that people in general avoided contact with them because they work with COVID-19 patients and 16% regularly thought about quitting their jobs.<\/p>\n

\"\"Aline Van Langendonck<\/span><\/a><\/p>\n

Frightened yet fearless<\/strong>
\n\u201cI see everyone stressed out, running around all day to save the lives of patients,\u201d observes psychiatrist Vanessa de Albuquerque C\u00edtero, coordinator of the mental health service at HSP. Along with her team, she has increased her vigilance when it comes to medical teams in ICUs and outpatient clinics serving COVID-19 patients. C\u00edtero concluded that depression and fear, especially among resident physicians, can manifest as pessimism or, conversely, as recklessness regarding security measures against the virus, as if to just get infected and get it over with. “They are exacerbated forms of emotional self-defense against distress,” she explains. When she deems it necessary, she recommends psychotherapy.<\/p>\n

\u201cOne month after the start of the pandemic, I began seeing residents who had COVID-19 and talked about the fear of death and being isolated from family members,\u201d reports psychologist Daniela Betinassi Parro-Pires, coordinator of the Center for Assistance and Research for Medical Residents (NAPREME) at UNIFESP.<\/p>\n

In May, psychiatrist Marcelo Feij\u00f3 de Mello, along with his team, distributed e-mails and posters in an effort to motivate the HSP staff to seek online psychological and psychiatric services through the program he coordinates at CAIM, at UNIFESP. By mid-July, 96 people had asked for help. “In most cases, we saw acute stress, anxiety, and insomnia, which improve after three sessions, but they were all scared of watching people die without being able to help,” he shares.<\/p>\n

The pandemic exacerbated the physical, emotional, and professional stress faced by nurses and nursing assistants and technicians. Maria do Perp\u00e9tuo N\u00f3brega, from the USP School of Nursing, reached this conclusion in July, after analyzing the responses of 719 nursing professionals who participated in a national online survey. Among them, 78.6% had not had any psychological support from the institution where they worked, 74.9% make 1 to 3 times the minimum wage, 70.9% knew someone with COVID-19, and 29.6% had a family member or friend die of the disease. Among those who answered the questionnaire, 38.2% reported symptoms of depression, 32.2% of anxiety, and 7.7% of panic; after the start of the pandemic, 7.8% started psychological treatment and 5.4% sought psychiatric help. Professionals in this field who became ill due to COVID-19 expressed guilt for being unable to help colleagues who were still working in hospitals.<\/p>\n

Scientific paper<\/strong>
\nFUKUTI, P. et al<\/em>. How institutions can protect the mental health and psychosocial well-being of their healthcare workers in the current Covid-19 pandemic<\/a>. Clinics<\/strong>. Vol.\u200975, e1963. June 3, 2020.<\/p>\n","protected":false},"excerpt":{"rendered":"Depression rates for health professionals who care for COVID-19 patients have tripled ","protected":false},"author":17,"featured_media":375666,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[156,3674],"tags":[247,258,257,260],"coauthors":[5968],"class_list":["post-375539","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cover","category-covid-19-en","tag-medicine","tag-psychiatry","tag-psychology","tag-public-health","position_at_home-chamada_secundaria","keywords-coronavirus-en","keywords-covid-19-en","keywords-sars-cov-2-en"],"acf":[],"_links":{"self":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/375539","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/comments?post=375539"}],"version-history":[{"count":5,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/375539\/revisions"}],"predecessor-version":[{"id":378952,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/375539\/revisions\/378952"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/media\/375666"}],"wp:attachment":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/media?parent=375539"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/categories?post=375539"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/tags?post=375539"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/coauthors?post=375539"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}