Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease

In the paper

“Our finding of an association of psychiatric morbidity with younger age is consistent with the results of our study on health care workers [31] as well as the study by Leung et al. [41] who found that greater anxiety was associated with younger age within the community.”

What the sources say

• Not checked yetcites [31] Sim, 2004, Severe acute respiratory syndrome-related psychiatric and posttraumatic morbidities and coping responses in medical staff within a primary health care setting in Singapore, J Clin Psychiatry source
• Partly supported

  The ‘Anxiety levels (STAI scores)’ section reports greater anxiety among community respondents aged 30–49. That supports an age-related association, but not the broader implication that anxiety increased with younger age generally; Table 2 does not show the youngest group consistently having the highest scores. Page numbers are unavailable in our copy. (LLM, conf=0.85)

  cites [41] Leung, 2005, Longitudinal assessment of community psychobehavioral responses during and after the 2003 outbreak of severe acute respiratory syndrome in Hong Kong, Clin Infec Dis sourceExperimental — accuracy not yet measured

In the paper

“The total GHQ scores were also correlated with the IES-R total (r s=0.34, P<.001) and mean intrusion (r s=0.35, P<.001), avoidance (r s= 0.28, P<.001), and hyperarousal (r s=0.37, P<.001) subscale scores.”

In the paper

“Of the 415 community health care setting respondents, we found significant rates of SARS-related psychiatric (22.9%) and posttraumatic morbidities (25.8%).”

• Also stated in: § Psychiatric morbidity and coping · plain

  “Psychiatric morbidity was reported in 95 (22.9%) participants.”

In the paper

“other factors that could potentially contribute to the complex psychosocial responses of an individual such as personality variables, cognitive appraisal mechanisms, and past trauma were not examined in this study.”

In the paper

“better safeguarding of the psychological wellbeing of the community with practical mental health programs is crucial as it would help to prevent or ameliorate any disruption of health care delivery in the community during such outbreaks [12].”

What the sources say

• Not checked yetcites [12] Low, 2005, Infectious respiratory illnesses and their impact on healthcare workers: a review, Ann Acad Med Singapore source

In the paper

“traumatic morbidity was determined by using the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder (>1 re-experiencing symptoms, >3 avoidance symptoms, and >2 arousal symptoms) [27].”

What the sources say

• Not checked yetcites [27] American Psychiatric Association, 1994

In the paper

“indicating the extent of psychological impact involving all areas ascertained using the scales and not limited to certain domains.”

In the paper

“it is possible that some of the participants who visited primary heath care centers may be self selected or worried well and who were more predisposed to the development of psychiatric morbidity.”

In the paper

“All the three outcome measures were chosen as they were self-reported scales, easy to administer, and widely used in studies to evaluate psychiatric morbidity and posttraumatic stress [25], [29].”

What the sources say

• Not checked yetcites [25] Silver, 2002, Nationwide longitudinal study of psychological responses to September 11, JAMA source
• Not checked yetcites [29] Tjemsland, 1998, Posttraumatic distress symptoms in operable breast cancer III: status one year after surgery, Breast Cancer Res Treat source

In the paper

“such psychological morbidities occurring in a substantial proportion of the community can impact on the daily functioning of these affected individuals with immediate social and economic consequences such as lost job productivity and financial hardship [1].”

What the sources say

• Not checked yetcites [1] Allenby, 2005, Toward inherently secure and resilient societies, Science source

In the paper

“There were no significant differences in the age and gender between participants versus nonparticipants.”

In the paper

“The participants had all been instructed to rate their symptoms and coping measures based on their experiences specifically with respect to SARS akin to similar methods used in other studies [16], [32].”

What the sources say

• Not checked yetcites [16] Lee, 2007, Stress and psychological distress among Severe Acute Respiratory Syndrome (SARS) survivors 1 year after the outbreak, Can J Psychiatry source
• Not checked yetcites [32] Phua, 2005, Coping responses of emergency physicians and nurses to the 2003 severe acute respiratory syndrome outbreak, Acad Emerg Med source

In the paper

“recall bias can still be a potential confounder although measures had been taken during the recruitment process to minimize this as much as possible.”

In the paper

“Using the conventional GHQ binary scoring method (range 0–28), a total GHQ score of 5 and above is indicative of a case of “psychiatric morbidity” [23].”

What the sources say

• Not checked yetcites [23] Goldberg, 1988

In the paper

“This is in agreement with previous reports which have also documented high levels of anxiety, depression amongst survivors of SARS (35%) [35], quarantined individuals (31%) [36], and nurses (38.5%) [34].”

What the sources say

• Not checked yetcites [35] Cheng, 2004, Psychological distress and negative appraisals in survivors of severe acute respiratory syndrome (SARS), Psychol Med source
• Not checked yetcites [36] Hawryluck, 2004, SARS control and psychological effects of quarantine, Toronto, Canada, Emerg Infect Dis source
• Not checked yetcites [34] Su, 2007, Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak, J Psychiatr Res source

In the paper

“most of the research on the psychological responses to infectious disease outbreaks were conducted on either affected individuals such as in the case of HIV/AIDS [13], health care workers working to combat the illness such as in the case of SARS [14], [15], and survivors of SARS [16].”

What the sources say

• Not checked yetcites [13] Ruiz, 2000, Psychiatric considerations in the diagnosis, treatment, and prevention of HIV/AIDS, J Psychiatr Pract source
• Not checked yetcites [14] Maunder, 2003, The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital, Can Med Assoc J
• Not checked yetcites [16] Lee, 2007, Stress and psychological distress among Severe Acute Respiratory Syndrome (SARS) survivors 1 year after the outbreak, Can J Psychiatry source

In the paper

“Alternatively, it is also possible that those with posttraumatic symptoms may be inherently more predisposed to using denial as a coping measure in the first place.”

In the paper

“Covariates entered in the multivariate logistic regression models included age, marital status, psychiatric, or posttraumatic “caseness,” consultation at fever stations, and the 14 coping strategies).”

In the paper

“The association with younger age and being seen at fever stations may allow better identification of individuals at risk of developing psychological morbidities.”

In the paper

“Participation in the survey was voluntary and the study was approved by the institutional research and ethics committee.”

In the paper

“These findings could potentially inform the development of practical community mental health programs for future infectious disease outbreaks.”

• Also stated in: § Discussion · hedged

  “These findings could potentially inform the formulation of much needed mental health awareness programs for the community who may face similar disease outbreaks in the future.”

In the paper

“The relationship of different coping styles in those with psychological morbidity allows a better understanding of their use in these individuals.”

In the paper

“Of the 532 eligible individuals approached, 415 agreed to participate giving a response rate of 78.0%.”

• Also stated in: § Results · plain

  “The overall response rate was 78.0%.”

In the paper

“infection control measures that were rapidly implemented included the use of the personal protective equipment amongst the health care workers attending to patients including those presenting with a febrile illness, regular temperature monitoring, filling of health declaration forms, regular audit of infection control measures, and the setting up of fever stations to isolate and manage individuals”

What the sources say

• Not checked yetcites [21]

In the paper

“Psychosocial responses towards such infectious disease outbreaks are variable and can range from feelings of anxiety, a sense of shame, failure or weakness of the individual and society [3], and an underestimation of likelihood of survival, an overestimation of likelihood of infection [4] to a sudden flight from the outbreak [5], an excessive and inappropriate adoption of precautionary measures,”

What the sources say

• Not checked yetcites [3] Verghese, 2004, What is in a word?, Clin Infect Dis source
• Not checked yetcites [4] Koh, 2005, Risk perception and impact of Severe Acute Respiratory Syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn?, Med Care source
• Not checked yetcites [5] Cherian, 1995, Plague in India, The Lancet source

In the paper

“psychiatric morbidity was associated with being seen at fever stations which may reinforce the sense of vulnerability and threat of infection, and this can interact with the younger age to produce more severe stress symptoms [40].”

What the sources say

• Not checked yetcites [40] Epstein, 1998, Posttraumatic stress disorder following an air disaster: a prospective study, Am J Psychiatry source

In the paper

“The use of self blame may reflect an underlying sense of frustration and guilt related to responsibility attribution and interpersonal reactions which can, in turn, contribute to psychiatric morbidity [42], [43].”

What the sources say

• Not checked yetcites [42] Shaver, 1986, On causality, responsibility, and self-blame: a theoretical note, J Pers Soc Psychol source
• Not checked yetcites [43] Karasawa, 2001, Anger vs guilt: inference of responsibility attribution and interpersonal reactions, Psychol Rep source

In the paper

“The less use of substance in our study is in line with a previous local study of coping responses of staff within an emergency room setting [32] but is contrary to the findings of some previous studies [44], [45], which had noted increased substance use in individuals facing stress.”

What the sources say

• Not checked yetcites [32] Phua, 2005, Coping responses of emergency physicians and nurses to the 2003 severe acute respiratory syndrome outbreak, Acad Emerg Med source
• Not checked yetcites [44] Miller, 2006, PTSD and substance-related problems: the mediating roles of disconstraint and negative emotionality, J Abnorm Psychol source
• Not checked yetcites [45] Waldrop AE, Back SE, Verduin ML, Brady KT. Triggers for cocaine and alcohol use in the presence and absence of posttraumatic stress disorder. Addict Behav, Published online: 24 July 2006. doi:10.1016/j.addbeh.2006.06.001. source

In the paper

“This data, together with that of other studies, can hopefully inform the development of practical and responsive mental health programs for the community”

In the paper

“This has negative impact on the social functioning of the individuals as evidenced by the lower scores on the same affected domain in GHQ, thus underlining the need to address the community psychosocial responses in any situation-specific mental health program related to an infectious disease outbreak.”