Two McMaster University researchers working on projects targeting pandemic-related post-traumatic stress disorder (PTSD) among health care workers have received more than $4.5 million in federal funding from Canada.
Projects include a website with evidence-based resources and a smartphone app that promotes early intervention and peer support. Together, the projects are expected to reach more than 100,000 health workers across Canada.
Moral distress
“We began studying the mental health and well-being of Canadian health care workers during the Delta wave and found that 1 in 4 endorsed symptoms consistent with PTSD,” said Margaret McKinnon, PhD, professor of psychiatry and behavioral neuroscience at McMaster . Medscape Medical News. “With the advent of Omicron, we see 1 in 2 considering leaving their positions due to moral distress.”
A recent team review of health care workers and public safety officials showed that moral distress was caused by factors such as feelings of helplessness when caring for critically ill patients with COVID, having to perform care that was perceived as futile, and finding to dying COVID patients instead of their family members who were barred from entering the hospital due to the COVID restrictions. Additional stressors include a lack of time to process events, a rush to change personal protective equipment, and a large number of patients.
The findings prompted the team to create a website called “A Cheers to Healthcare. Thank you for your service.” This project received $2.96 million. “Through this platform, we want to thank healthcare workers for their sacrifices during the pandemic and also provide tools to help them recognize the symptoms of PTSD, depression and anxiety and validate their experiences,” MacKinnon explained.
The website, which is scheduled to launch in the fall, will feature personal stories; psychoeducational modules addressing trauma, post-traumatic stress disorder and moral distress or injury; coping resources; and treatment options.
Beyond Silence App.
Federal funding also supported the development of the McMaster Beyond Silence smartphone app, a project led by Dr. Sandra Moll, an occupational therapist and associate professor in the McMaster School of Rehabilitation. Moll and her team, which includes McKinnon, developed and tested version 1.0 of the app “and then the pandemic hit,” Moll told Medscape. “At this point, we’ve made the app available for free to organizations that don’t have another form of support for healthcare workers.”
With an additional $1.56 million, the team is developing version 2.0, which includes insights from clinicians who used the earlier version. The new version will include links to resources on the Healthcare Salute website. “We’re charged with building a trauma-informed app, and we’re looking at improvements through that lens,” Moll explained. “That means things like making everything easy to access, providing choice and privacy, and building trust and empowerment. If people are struggling, they need to get information quickly, they need to know what to do, and they need validation of their They need a button that says, “Click here for help.” Those are some of the types of features we’re starting to build in.”
Partner support is a priority
A key component is the app’s peer support feature. “We don’t have an established peer support culture for health workers or an established training program, even though the evidence shows it’s beneficial,” said Moll, who will work with Homewood Health to build a peer support capacity curriculum. “Organizations using the app will receive this training for their partner support providers.”
To help validate users’ feelings, the app includes a chatbot that asks at the start of the interaction, “How are you today? What do you need? How can I help you?” When the user is feeling stressed, anxious, scared or insecure, the bot conveys the message, ‘You’re not alone,’ Moll said. “I was shocked that being asked about the feelings of something on your phone turned out to be super helpful.”
The team will study workplace implementation of the app in a variety of settings, including small practices, large hospitals, long-term care communities and rural sites, Mol noted. “We’ll be working with organizational champions to answer questions like, ‘Who’s taking it?’ ‘How are they downloading it?’ ‘Are people using it just once or every day?’ , because we don’t really know.”
A 3-month implementation trial period is scheduled to begin on November 1st. In the meantime, a brief overview of the application and some of the findings so far are available online.
System in danger
“All in all, an app is just one piece of the puzzle,” Mol said. “There needs to be systemic change. There needs to be a massive rethink and support for our health workers.”
MacKinnon added: “We are now in a dangerous situation with our health system. Many hospitals are understaffed, healthcare workers are leaving the profession, and the result can be suboptimal care. If we lose any more of these workers, we will be in deep trouble.”
Follow Marilyn Larkin on Twitter: @MarilynnL.
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